PEDIATRICS Vol. 100 No. 6 December 1997, pp. 943-946
Nosocomial Respiratory Syncytial Virus Infection in Canadian Pediatric Hospitals: A Pediatric Investigators Collaborative Network on Infections in Canada Study
Received Oct 3, 1996; accepted May 14, 1997.
,
,,
From the * Department of Pediatrics, Izaak Walton Killam Grace
Health Centre and Dalhousie University, Halifax, Nova Scotia;
Clinical Epidemiology Unit, The Hospital for Sick Children and
University of Toronto, Toronto, Ontario; § Department of Pediatrics,
Winnipeg Children's Hospital and University of Manitoba, Winnipeg,
Manitoba; Department of Pediatrics, Children's Hospital of Eastern
Ontario and University of Ottawa, Ottawa, Ontario; ¶ Department of
Pediatrics, Alberta Children's Hospital and University of Calgary,
Calgary, Alberta; # Department of Microbiology, Montreal Children's
Hospital and McGill University, Montreal, Quebec; ** Department of
Pediatrics, Centre Hôpitalier de l'Université Laval and
l'Université Laval, Laval, Quebec; and Department of
Pediatrics, British Columbia Children's Hospital and University of
British Columbia, Vancouver, British Columbia.
Objective. To determine nosocomial transmission of respiratory syncytial virus (RSV) in Canadian pediatric hospitals, outcomes associated with nosocomial disease, and infection control practices.
Design. A prospective cohort study in the 1992 to 1994 winter respiratory seasons.
Setting. Nine Canadian pediatric university-affiliated hospitals.
Participants. Hospitalized children with symptoms of lower respiratory tract infection (at least one of cough, wheezing, dyspnea, tachypnea, and apnea) and RSV antigen identified in a nasopharyngeal aspirate.
Results. Of 1516 children, 91 (6%) had nosocomial RSV (NRSV), defined as symptoms of lower respiratory tract infection and RSV antigen beginning >72 hours after admission. The nosocomial ratio (NRSV/[com-munity-acquired RSV {CARSV})] + NRSV) varied by site from 2.8% to 13%. The median length of stay attributable to RSV for community-acquired illness was 5 days, but 10 days for nosocomial illness. Four children with NRSV (4.4%) died within 2 weeks of infection, compared with 6 (0.42%) with CARSV (relative risk = 10.4, 95% confidence interval: 3.0, 36.4). All sites isolated RSV-positive patients in single rooms or cohorted them. In a multivariate model, no particular isolation policy was associated with decreased nosocomial ratio, but gowning to enter the room was associated with increased risk of RSV transmission (incidence rate ratio 2.81; confidence interval: 1.65, 4.77).
Conclusions. RSV transmission risk in Canadian pediatric hospitals is generally low. Although use of barrier methods varies, all sites cohort or isolate RSV-positive patients in single rooms. Children with risk factors for severe disease who acquire infection nosocomially have prolonged stays and excess mortality.
Key words: respiratory syncytial virus, nosocomial infections.
CiteULike 
Connotea 
Del.icio.us 
Digg 
Facebook 
Reddit 
Technorati 
Twitter What's this?
This article has been cited by other articles:
|
|
 |
|
  K Thorburn Pre-existing disease is associated with a significantly higher risk of death in severe respiratory syncytial virus infection Arch. Dis. Child., February 1, 2009; 94(2): 99 - 103. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J.-A. S. Harris, W. C. Huskins, J. M. Langley, J. D. Siegel, and for the Pediatric Special Interest Group of the So Health Care Epidemiology Perspective on the October 2006 Recommendations of the Subcommittee on Diagnosis and Management of Bronchiolitis Pediatrics, October 1, 2007; 120(4): 890 - 892. [Full Text] [PDF]
|
|
|
|
 |
|
 K Thorburn, S Harigopal, V Reddy, N Taylor, and H K F van Saene High incidence of pulmonary bacterial co-infection in children with severe respiratory syncytial virus (RSV) bronchiolitis Thorax, July 1, 2006; 61(7): 611 - 615. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M J Parker and R D Goldman Paediatric emergency department staff perceptions of infection control measures against severe acute respiratory syndrome Emerg. Med. J., May 1, 2006; 23(5): 349 - 353. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. A. Poehling, M. R. Griffin, R. S. Dittus, Y.-W. Tang, K. Holland, H. Li, and K. M. Edwards Bedside Diagnosis of Influenzavirus Infections in Hospitalized Children Pediatrics, July 1, 2002; 110(1): 83 - 88. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. C. Meissner Uncertainty in the Management of Viral Lower Respiratory Tract Disease Pediatrics, October 1, 2001; 108(4): 1000 - 1003. [Full Text] [PDF]
|
|
|
|
 |
|
 K. D. Dominguez Treatment and Prevention of RSV Bronchiolitis Journal of Pharmacy Practice, June 1, 2001; 14(3): 166 - 180. [Abstract] [PDF]
|
|
|
|
|
|
K. K. Macartney, M. H. Gorelick, M. L. Manning, R. L. Hodinka, and L. M. Bell Nosocomial Respiratory Syncytial Virus Infections: The Cost-Effectiveness and Cost-Benefit of Infection Control Pediatrics, September 1, 2000; 106(3): 520 - 526. [Abstract] [Full Text]
|
|
|
|
 |
|
 A. Mackenzie, N. Hallam, E. Mitchell, and T. Beattie Near patient testing for respiratory syncytial virus in paediatric accident and emergency: prospective pilot study BMJ, July 31, 1999; 319(7205): 289 - 290. [Full Text]
|
|
