Hospital-Acquired Respiratory Viral Infections (HA-RVIs) Over 10 Years Disproportionally Affect the Immunocompromised

Area of Science:

• Infectious Diseases
• Hospital Epidemiology
• Immunocompromised Patient Care

Background:

• Respiratory viral infections (RVIs) pose significant risks to immunocompromised individuals, increasing morbidity and mortality.
• Influenza (Flu), respiratory syncytial virus (RSV), and parainfluenza (PIV) are common RVIs.
• Understanding the origins of these infections (community-acquired vs. hospital-acquired) is vital for patient outcomes.

Purpose of the Study:

• To investigate the characteristics and outcomes of hospital-acquired (HA) versus community-acquired (CA) Flu, RSV, and PIV infections.
• To identify patient populations at higher risk for HA-RVIs.
• To inform infection prevention strategies for vulnerable patients.

Main Methods:

• Defined CA-RVI as positive lab results within 72 hours of admission.
• Defined HA-RVI as positive lab results ≥72 hours after admission.
• Compared patient demographics, underlying conditions, and clinical outcomes between CA and HA RVI cases.

Main Results:

• 12.2% of RSV, 10.9% of PIV, and 6.6% of Flu cases were hospital-acquired.
• Patients with cancer, recent chemotherapy, or recent stem cell transplant (SCT) were more prevalent in HA-RVI groups.
• HA-Flu, HA-RSV, and HA-PIV were linked to increased ICU admission; HA-Flu also increased risks for mechanical ventilation, renal replacement therapy, and death.

Conclusions:

• Immunocompromised patients are disproportionately represented among hospital-acquired RVI cases.
• There is a critical need for targeted infection prevention and control interventions for vulnerable populations.
• These interventions are especially important during periods of high community RVI transmission.