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Published on: December 10, 2013
Epidemiology and Risk Factors for Healthcare-Associated Viral Infections in Children
Samantha Hanley1, Folasade Odeniyi1, Kristen Feemster1,2,3
1Pediatric Infectious Diseases Epidemiology and Antimicrobial Stewardship (IDEAS) Research Program, Division of Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Insights
Exposure to sick visitors is a key risk factor for healthcare-associated viral infections (HA-VIs) in hospitalized children. Implementing visitor screening and family partnerships can help reduce pediatric HA-VIs.
Area of Science:
- Pediatric Infectious Diseases
- Hospital Epidemiology
- Patient Safety
Background:
- Healthcare-associated viral infections (HA-VIs) are a significant concern in pediatric hospital settings.
- The epidemiology and modifiable risk factors for pediatric HA-VIs remain poorly understood, limiting prevention strategies.
Purpose of the Study:
- To identify risk factors and outcomes associated with pediatric HA-VIs.
- To investigate potential modifiable exposures contributing to HA-VIs in hospitalized children.
Main Methods:
- Retrospective case-control study at a quaternary care children's hospital.
- Utilized Centers for Disease Control and Prevention (CDC) definitions for HA-VI surveillance.
- Collected data from electronic medical records and conducted caregiver interviews for exposure assessment.
Main Results:
- Identified 143 eligible patients with HA-VIs during a 20-month period, with 64 matched case-control pairs enrolled.
- Case patients were significantly more likely to have been exposed to a sick visitor compared to control patients (OR = 5.19, P = .05).
- Patients with HA-VIs experienced longer durations of antibacterial therapy post-onset compared to controls.
Conclusions:
- Exposure to sick visitors is a significant, potentially modifiable risk factor for pediatric HA-VIs.
- Hospitalized children with HA-VIs show increased exposure to antibacterial agents.
- Revising hospital policies, including visitor screening and family engagement, is recommended to decrease pediatric HA-VIs.
Background:
Healthcare-associated viral infections (HA-VIs) are common in hospitalized children and are increasingly recognized as a cause of preventable harm; however, the epidemiology and modifiable risk factors for pediatric HA-VIs are poorly understood.
Methods:
We performed a retrospective case-control study to identify risk factors and outcomes associated with pediatric HA-VIs at a quaternary care children's hospital. HA-VI surveillance was performed hospital-wide using Centers for Disease Control and Prevention (CDC) definitions. We abstracted data from the electronic medical record and conducted semi-structured interviews with patient caregivers to identify potential exposures 4 days before the HA-VI onset.
Results:
During the 20-month study period, we identified 143 eligible patients with HA-VIs and enrolled 64 matched case-control pairs. In total, 79 viruses were identified among 64 case patients. During the exposure period, case, as compared with control, patients were more frequently exposed to a sick visitor (odds ratio = 5.19; P = .05). During the 7 days after the HA-VI onset, case, as compared with control, patients had a greater length of antibacterial therapy per patient-days (mean 411 vs 159) as well as greater days of antibacterial therapy per patient-days (mean 665 vs 247).
Conclusions:
The results of this study show that exposure to a sick visitor is a potentially modifiable risk factor for pediatric HA-VIs. Hospitalized children with HA-VIs also have increased exposure to antibacterial agents when compared with matched controls. Our findings suggest that hospital policies may need to be revised, with emphasis on visitor screening and partnership with families, to reduce the incidence of pediatric HA-VIs during hospitalization.
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