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.
M. Hill, None
N. Kohn, None