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Human Bocavirus respiratory infections in a paediatric intensive care unit - A potential healthcare - associated
Srestha Mitra1, Vikas Manchanda1, Anju Sharma2
1Department of Microbiology, Maulana Azad Medical College, Delhi, India.
Insights
Human Bocavirus (HBoV) can cause severe acute respiratory illness (SARI) in children. This study identified a potential HBoV outbreak in a pediatric intensive care unit (PICU), highlighting the need for strict infection control.
Area of Science:
- Pediatric Intensive Care
- Infectious Diseases
- Respiratory Illnesses
Background:
- Human Bocavirus (HBoV) detection is increasing, prompting research into its role in severe acute respiratory illness (SARI).
- This study investigates HBoV as a potential healthcare-associated infection.
Purpose of the Study:
- To describe Human Bocavirus (HBoV) as a potential healthcare-associated infection.
- To investigate a potential outbreak of HBoV in a pediatric intensive care unit (PICU).
Main Methods:
- A prospective observational study of pediatric patients (0-12 years) with SARI was conducted over 21 months.
- Nasopharyngeal swabs were analyzed using real-time PCR to detect viral pathogens.
- Patient records were reviewed to identify transmission chains during a cluster of HBoV infections.
Main Results:
- Human Bocavirus (HBoV) was detected in 3.8% of 758 pediatric SARI patients, with a notable surge in May 2022 suggesting a healthcare-associated outbreak.
- HBoV mono-infections resulted in longer hospital stays (40.6 days) compared to co-infections (23.3 days).
- All HBoV patients required supplemental oxygen, and 52% needed mechanical ventilation, more frequently in co-infections.
Conclusions:
- A potential Human Bocavirus (HBoV) outbreak occurred in the PICU, with likely hospital acquisition.
- HBoV infections increase patient morbidity, necessitating intensive care and stringent infection control measures to prevent hospital-acquired spread.
Introduction:
Recent advancements in detection methods have increased the observed prevalence of Human Bocavirus (HBoV), leading to further investigation of its role in severe acute respiratory illness (SARI). This study describes HBoV as a potential healthcare-associated infection.
Methods:
A prospective observational study was performed on paediatric patients (0-12 years) hospitalized with SARI in the paediatric intensive care unit (PICU) between April-2022 to December-2023 (21 months) at a tertiary care hospital. Nasopharyngeal swabs were collected and analysed using real-time PCR. A cluster of patients infected with HBoV were identified and their records were reviewed to identify chain of transmission among them.
Result:
Among the 758 children tested, 441 were admitted to the PICU, with viral pathogens detected in 305 (69.1 %), including HBoV in 17 (3.8 %) children. HBoV was detected most commonly as mono-infection in 57.9 %. An unusual surge in HBoV infections (five cases in 23 days) was observed in the PICU during May 2022, suggesting a potential healthcare-associated outbreak; which declined that year after implementing strict infection control measures. The HBoV infection patterns in subsequent year confirmed the seasonality, with peak from May to September in two seasons. While the average length of stay for patients with HBoV infection was 31.4 days; mono-infected patients had a longer mean duration of stay as compared to those with coinfection (40.6 vs 23.3 days). All patients required supplemental oxygen, with 52 % needing mechanical ventilation, more commonly in coinfections (66.7 %) than in mono-infections (35.8 %).
Conclusion:
The current study documents a potential outbreak in the PICU, with several cases likely acquired within the hospital. The study highlights the increased morbidity of HBoV infections, thus, emphasizing the need for intensive care support and stringent infection control measures to prevent their spread within the hospital environment.
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