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Hospital-acquired viral respiratory illness on a pediatric ward
Insights
Hospital-acquired respiratory infections are common in children, with viruses like rhinovirus being frequent culprits. However, transmission between roommates poses a low risk, suggesting current isolation protocols may not be necessary.
Area of Science:
- Pediatric infectious diseases
- Hospital epidemiology
- Virology
Background:
- Nosocomial respiratory infections pose a significant risk to hospitalized children.
- Understanding transmission routes is crucial for effective infection control.
Purpose of the Study:
- To investigate the incidence and sources of nosocomial respiratory infections in pediatric patients.
- To assess the risk of viral transmission between roommates in a hospital setting.
Main Methods:
- Surveillance of 171 pediatric patients in four study rooms over winter and spring.
- Serial viral cultures to identify pathogens and track transmission.
- Risk assessment for infection acquired from roommates.
Main Results:
- One-sixth of 90 at-risk children developed respiratory illness.
- Rhinovirus, RSV, parainfluenza, and influenza A/B were commonly isolated.
- Nine of 11 virus-positive infections were not acquired from roommates.
- The risk of roommate transmission was only 3%.
Conclusions:
- While nosocomial respiratory infections are prevalent, roommate transmission is infrequent.
- Data do not support the need for single-room isolation for all children with respiratory illness.
- Targeted infection control strategies may be more effective than universal isolation.
Abstract:
All 171 patients admitted to four study rooms containing cribs were under surveillance during the winter and spring for development of nosocomial respiratory and infection. One sixth of the 90 children at risk acquired respiratory illness while in the hospital. Viruses were isolated from two thirds of the patients with nosocomial infections: rhinovirus, respiratory syncytial virus, parainfluenza, and influenza A and B. Serial viral cultures of the children under surveillance suggested that nine of 11 virus-positive nosocomial infections were not acquired from a roommate. Furthermore, the risk to a patient of becoming infected with a virus being shed by a roommate was only 3%. The need for isolation of all children with respiratory illness in a single room with a separate air exhaust system is not suggested by these data.