356. Reduction in Rate of Nosocomial Respiratory Virus Infections Associated with Enhanced Isolation Precautions in a Children's Hospital
Session: Poster Abstract Session: HAI: Respiratory Infections
Thursday, October 8, 2015
Room: Poster Hall
Posters
  • IDWeek_Oct_2015_Noso_viral_rates-poster FINAL.pdf (852.3 kB)
  • Background: Nosocomial respiratory viral infections (NRVIs) cause morbidity in pediatric patients.  Optimal measures for prevention have not been established.  In this study we evaluated the impact of enhanced isolation precautions (contact & droplet) on the incidence of NRVIs.

    Methods: NRVIs caused by adenovirus, human metapneumovirus (hMPV), influenza, parainfluenza  (PIV), respiratory syncytial virus (RSV), and rhinovirus/enterovirus (R/E) were prospectively monitored using laboratory-based surveillance with viral detection by nucleic acid amplification-based assay and standardized clinical definitions. The study period was 3 consecutive 10 month periods (Jul-Apr) 2012-2015. During years 1 & 2 special isolation precautions were as follow: hMPV, PIV, RSV, contact precautions; influenza, droplet precautions; adenovirus, contact & droplet precautions; R/E, droplet precautions during Nov through Mar, standard precautions Apr through Oct. During year 3 droplet precautions were in place for influenza and contact & droplet precautions were used for all other virus categories. The percentage of single bedded rooms increased from 22% during year 1 to 39% during years 2 and 3, with the opening of a new pavilion with all single bedded rooms. A severe restriction on visitation by young children was in place Nov through Mar in years 2 and 3, but not during year 1. Comparisons of nosocomial infection rates were made using the incidence density ratio method. 

    Results: The rate of NRVI with any of the 6 virus categories infection was 0.92, 0.91, and 0.43/1,000 patient days for years 1, 2, and 3, respectively, a 53% decrease during year 3 (P<0.002).  For each virus category the rate of nosocomial infection was lower during year 3 than years 1 and 2 except for influenza, which was higher during year 3 than in years 1 and 2. The number of hospitalized children with community-acquired infection with each of the 6 virus categories was higher during year 3 compared to years 1 and 2 except for influenza that was lower and hMPV that was unchanged.

    Conclusion: The use of both contact and droplet precautions for inpatients with viral respiratory tract infections was associated with a reduction in the incidence of NRVIs.

    Lorry Rubin, MD, FIDSA1,2, Susan Nullet, R.N.3, Margaret Hill, R.N.3 and Nina Kohn, MBA, MA4, (1)Pediatrics, Hofstra North Shore-LIJ School of Medicine, New Hyde Park, NY, (2)Pediatrics, Steven and Alexandra Cohen Children's Medical Center of New York of the North Shore-LIJ Health System, New Hyde Park, NY, (3)Infection Control, Steven and Alexandra Cohen Children's Medical Center of New York of the North Shore-Long Island Jewish Health System, New Hyde Park, NY, (4)Feinstein Institute for Medical Research, North Shore - LIJ Health System, Manhasset, NY

    Disclosures:

    L. Rubin, None

    S. Nullet, None

    M. Hill, None

    N. Kohn, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.