Screening for respiratory syncytial virus and assignment to a cohort at admission to reduce nosocomial transmission

Krasinski, Keith; LaCouture, Rita; Holzman, Robert S.; Waithe, Evans; Bonk, Stanley; Hanna, Bruce A.

doi:10.1016/s0022-3476(05)80646-8

Cited by 78 publications

(49 citation statements)

References 15 publications

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“…Four were from Europe, 15 from the United States and two from Canada. There were 13 experimental or prospective cohort studies15, 16, 18, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53 and seven retrospective cohorts54, 55, 56, 57, 58, 59, 60 (one was an abstract only and there was not enough information to identify the study type) 61. Most ( n = 18) were conducted in neonatal/paediatric settings,15, 16, 18, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 55, 56, 57, 60, 61 with three in units housing immunocompromised adults 54, 58, 59.…”

Section: Resultsmentioning

confidence: 99%

“…An additional potential bias is the ascertainment of community‐acquired rather than nosocomial RSV cases. Eleven of the 12 studies investigating the risk of RSV transmission to patients provided a clear definition of a nosocomial case, with most ( n = 8) defining this as a case occurring at least 5 days after hospital admission (some used a higher cut‐off) 15, 18, 45, 46, 47, 48, 49, 51. In studies assessing the risk of transmission to hospital staff, no such case definition would be possible.…”

Section: Resultsmentioning

confidence: 99%

“…Nine of the 13 studies presented evidence that nosocomial infections were significantly lower when a multicomponent intervention was implemented and provided supporting statistical data (e.g. P ‐value or risk ratio with confidence intervals) 16, 18, 46, 48, 49, 51, 54, 56, 60. Three studies reported data that were suggestive of a beneficial effect but did not present any supporting statistics (such as a P ‐value) 53, 59, 61.…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Risk of nosocomial respiratory syncytial virus infection and effectiveness of control measures to prevent transmission events: a systematic review

French¹,

McKenzie

Coope³

et al. 2016

Influenza Resp Viruses

105

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Respiratory syncytial virus (RSV) causes a significant public health burden, and outbreaks among vulnerable patients in hospital settings are of particular concern. We reviewed published and unpublished literature from hospital settings to assess: (i) nosocomial RSV transmission risk (attack rate) during outbreaks, (ii) effectiveness of infection control measures. We searched the following databases: MEDLINE, EMBASE, CINAHL, Cochrane Library, together with key websites, journals and grey literature, to end of 2012. Risk of bias was assessed using the Cochrane risk of bias tool or Newcastle–Ottawa scale. A narrative synthesis was conducted. Forty studies were included (19 addressing research question one, 21 addressing question two). RSV transmission risk varied by hospital setting; 6–56% (median: 28·5%) in neonatal/paediatric settings (n = 14), 6–12% (median: 7%) in adult haematology and transplant units (n = 3), and 30–32% in other adult settings (n = 2). For question two, most studies (n = 13) employed multi‐component interventions (e.g. cohort nursing, personal protective equipment (PPE), isolation), and these were largely reported to be effective in reducing nosocomial transmission. Four studies examined staff PPE; eye protection appeared more effective than gowns and masks. One study reported on RSV prophylaxis for patients (RSV‐Ig/palivizumab); there was no statistical evidence of effectiveness although the sample size was small. Overall, risk of bias for included studies tended to be high. We conclude that RSV transmission risk varies widely during hospital outbreaks. Although multi‐component control strategies appear broadly successful, further research is required to disaggregate the effectiveness of individual components including the potential role of palivizumab prophylaxis.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Risk of nosocomial respiratory syncytial virus infection and effectiveness of control measures to prevent transmission events: a systematic review

French¹,

McKenzie

Coope³

et al. 2016

Influenza Resp Viruses

105

View full text Add to dashboard Cite

show abstract

“…24 Several infectious control strategies have been studied to reduce nosocomial RSV transmission, mostly in pediatric populations. Nosocomial RSV incidence rate was reduced by 4.9-12.9 fold with strict handwashing and patient cohorting, 25 by 2-7.2 fold with rapid screening and cohorting of patients on admission, 26,27 and by a 2.1 fold with gloves and gowns alone. 27,28 A multifaceted infection control program including rapid diagnosis, adequate handwashing and patient cohorting is considered to be the minimally acceptable strategy to prevent nosocomial RSV transmission.…”

Section: Discussionmentioning

confidence: 97%

“…Nosocomial RSV incidence rate was reduced by 4.9-12.9 fold with strict handwashing and patient cohorting, 25 by 2-7.2 fold with rapid screening and cohorting of patients on admission, 26,27 and by a 2.1 fold with gloves and gowns alone. 27,28 A multifaceted infection control program including rapid diagnosis, adequate handwashing and patient cohorting is considered to be the minimally acceptable strategy to prevent nosocomial RSV transmission. 29 Other less studied measures are often added, such as use of masks, goggles and visit restriction for family members with URTI.…”

Section: Discussionmentioning

confidence: 97%

Successful prevention of respiratory syncytial virus nosocomial transmission following an enhanced seasonal infection control program

Lavergne

Ghannoum²,

Weiss

et al. 2010

Bone Marrow Transplant

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Respiratory syncytial virus (RSV) infections can be serious in severely immunocompromised patients. Use of a targeted infection control program (TICP) has been shown to reduce RSV nosocomial transmission. We evaluated the impact of an enhanced seasonal infection control program (ESICP) vs standard TICP in a hematology-oncology ward. TICP was applied from 1999 to 2001 and ESICP applied from 2001 to 2003. ESICP consisted of strict isolation for all patients admitted on the ward during the RSV season. We prospectively evaluated the incidence, related morbidity and mortality of nosocomial RSV in both field interventions. A total of 40 hospitalized RSV infections were documented. The cumulative incidence of nosocomial RSV during TICP and ESICP was respectively of 42.8 and 3.9 cases/1000 admissions (relative risk ¼ 0.09). ESICP needed to be implemented on 26 admitted patients on our ward to prevent one RSV nosocomial case. Furthermore, implementation of ESICP prevented four pneumonias and two deaths per RSV season. We conclude that ESICP is significantly more efficient than TICP to reduce the occurrence of nosocomial RSV infections and its related morbidity and mortality in patients with hematological malignancy and recipients of hematopoietic SCT.

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Use of a Large National Database for Comparative Evaluation of the Effect of a Bronchiolitis/Viral Pneumonia Clinical Care Guideline on Patient Outcome and Resource Utilization

Todd

Bertoch²,

Dolan³

2002

Arch Pediatr Adolesc Med

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Screening for respiratory syncytial virus and assignment to a cohort at admission to reduce nosocomial transmission

Cited by 78 publications

References 15 publications

Risk of nosocomial respiratory syncytial virus infection and effectiveness of control measures to prevent transmission events: a systematic review

Risk of nosocomial respiratory syncytial virus infection and effectiveness of control measures to prevent transmission events: a systematic review

Successful prevention of respiratory syncytial virus nosocomial transmission following an enhanced seasonal infection control program

Use of a Large National Database for Comparative Evaluation of the Effect of a Bronchiolitis/Viral Pneumonia Clinical Care Guideline on Patient Outcome and Resource Utilization

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