386. Reduction in Rate of Nosocomial Respiratory Virus Infections with Enhanced Isolation Precautions in a Children’s Hospital.
Session: Poster Abstract Session: HAI: Pediatrics
Thursday, October 27, 2016
Room: Poster Hall
Posters
  • IDWeek_Oct_2016_Noso_viral_rates-poster.pdf (812.1 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 rate 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. The study period was 4 consecutive 10 month periods (Jul-Apr) from 2012 through 2016. 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 March, standard precautions Apr through Oct. During year 3 droplet precautions were in place for influenza; contact & droplet were used for all other virus categories. During year 4 contact & droplet were used for all virus categories including influenza. The % of single bedded rooms increased from 22% during year 1 to 39% during years 2-4 with the opening of a new pavilion. A restriction on visitation by young children was in place Nov through March in years 2, 3, and 4 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 was 0.95 and 0.56/1,000 patient days for years 1-2 and years 3-4, respectively, a 41% decrease during years 3-4 (P=0.0007). For adenovirus, PIV, and RSV, the rate of nosocomial infection was significantly lower (P=0.010, 0.023, and 0.014, respectively) during years 3&4 than years 1&2 and for R/E there was a 31% decrease that was not significant (P=0.07). There was no significant change in the rate of nosocomial influenza or hMPV infection between the 2 time periods. The number of children hospitalized with community-acquired infection with any of the 6 virus categories was 34% higher during year 3-4 compared to years 1-2. Conclusion: The use of contact and droplet precautions for inpatients with viral respiratory tract infections was associated with a reduction in the rate of NRVIs.
    Lorry Rubin, MD, FIDSA, Pediatrics, Cohen Children's Medical Center of New York of Northwell Health; Hofstra Northwell School of Medicine, New Hyde Park, NY, Margaret Hill, R.N., Infection Control, Steven and Alexandra Cohen Children's Medical Center of Northwell Health, New Hyde Park, NY, Nina Kohn, MBA, MA, Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY and Susan Nullet, R.N., Infection Control, Steven and Alexandra Cohen Children's Medical Center of New York of Northwell Health, New Hyde Park, NY

    Disclosures:

    L. Rubin, None

    M. Hill, None

    N. Kohn, None

    S. Nullet, None

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