Variation in Visiting and Isolation Policies in Neonatal Units: A U.K. Nationwide Survey

Tan, Seng Sing; Clarkson, Mandy; Sharkey, Don

doi:10.1097/inf.0000000000001820

Cited by 6 publications

(7 citation statements)

References 9 publications

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“…Our data suggest that a combination of IP&C strategies including excluding family members with illnesses, excluding visitors less than 12 years of age year-round, and screening asymptomatic infants in close proximity to an infant with a respiratory virus decreases the transmission event rates, although our sample may have been too small to assess the sustained effect of the interventions over time. Excluding sibling visitors and screeningexposed infants are practices that have been implemented in some NICUs in the U.K [25] and others have shown that restricting sibling visitors reduced RSV [26]. While these interventions were associated with reducing transmission events in our NICU, they did not eliminate respiratory viruses.…”

Section: Discussionmentioning

confidence: 78%

“…As support for the importance of this priority, during this same time period, 46 central line-associated bloodstream infections occurred in our NICU compared with the 86 episodes of respiratory viral detection described in this study. However, optimal IP&C strategies for respiratory viruses in the NICU population are unknown and highly variable as demonstrated in a nationwide study conducted in the United Kingdom [25]. Our data suggest that a combination of IP&C strategies including excluding family members with illnesses, excluding visitors less than 12 years of age year-round, and screening asymptomatic infants in close proximity to an infant with a respiratory virus decreases the transmission event rates, although our sample may have been too small to assess the sustained effect of the interventions over time.…”

Section: Discussionmentioning

confidence: 99%

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Impact of respiratory viruses in the neonatal intensive care unit

et al. 2018

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Impact of respiratory viruses in the neonatal intensive care unit

et al. 2018

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“…There is a lack of good quality evidence to inform NICU policies regarding viral transmission prevention measures, screening protocols, and infection control as well as isolation procedures following identification of cases [7]. This has been observed with wide variations in the UK NICU policies [4]. During the pandemic influenza seasons, our hospitals trust like others implemented a policy of restricting visiting to parents only, reducing the incidence of VRTI by 39% [6].…”

Section: Discussionmentioning

confidence: 99%

“…On the NICU, VRTIs are hospital-acquired and so are most likely to originate from staff or visitors. In the UK, infection control and visiting policies relating to VRTIs vary widely [4]. The inpatient burden of hospital-acquired VRTIs in the NICU, compared with that of the local population in hospital with a VRTI, has not previously been established.…”

Section: Introductionmentioning

confidence: 99%

Hospital-Acquired Viral Respiratory Tract Infections in the Neonatal Unit: A Comparison with Other Inpatient Groups

et al. 2020

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Background: Hospital-acquired viral respiratory tract infections (VRTIs) cause significant morbidity and mortality in neonatal patients. This includes escalation of respiratory support, increased length of hospital stay, and need for home oxygen, as well as higher healthcare costs. To date, no studies have compared population rates of VRTIs across age groups. Aim: Quantify the rates of hospital-acquired VRTIs in our neonatal population compared with other inpatient age groups in Nottinghamshire, UK. Methods: We compared all hospital inpatient PCR-positive viral respiratory samples between 2007 and 2013 and calculated age-stratified rates based on population estimates. Results: From a population of 4,707,217, we identified a previously unrecognised burden of VRTI in neonatal patients, only second to the 0–1-year-old group. Although only accounting for 1.3% of the population, half of the infections were in infants <1 year old and neonatal intensive care unit (NICU) patients. Human rhinovirus was the most dominant virus across the inpatient group, particularly in neonatal patients. Despite a two- to three-fold increase in the rate of positive samples in all groups during the colder months (1.1/1,000 October–March vs. 0.4/1,000 April–September), rates in the NICU did not change throughout the year at 4.3/1,000. Pandemic H1N1 influenza rates were 20 times higher in neonatal patients and infants <1 year old. Conclusion: Good epidemiological and interventional data are needed to help inform visiting and infection control policies to reduce transmission of hospital-acquired viral infections to this vulnerable population, particularly during pandemic seasons.

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“…In particular, the significance of clinically asymptomatic VRTI remains unclear. Overall, evidence appears insufficient to inform clinicians and policy makers concerning indications for virus testing and visiting policies (6,8). Aim of this study was to evaluate the frequency of symptomatic and asymptomatic VRTI in our family-centered NICU.…”

Section: Introductionmentioning

confidence: 99%

Low Frequency of Viral Respiratory Tract Infections During Family-Centered Neonatal Intensive Care: Results of a Prospective Surveillance Study

et al. 2020

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Background: Viral respiratory tract infections (VRTI) may cause severe respiratory and sepsis-like symptoms in infants hospitalized in the neonatal intensive care unit (NICU). Little is known about the frequencies of VRTI in relation to visiting policies in the NICU. Objective: Aim of this study was to evaluate the frequency of symptomatic and asymptomatic VRTI in our family-centered NICU. Methods: This was a 12-month, prospective, observational study from February 2018 to January 2019. Infants hospitalized ≥72 h were eligible for the study. To determine the frequency of VRTI, multiplexed point-of-care testing (mPOCT) of symptomatic infants was combined with a weekly screening of all infants. Our 10-bed NICU is 24/7 open to families and visitors. The number of simultaneous visitors is restricted to two per patient. Parents and visitors are instructed in hand hygiene and advised to avoid visits in cases of respiratory illness. Siblings irrespective of age may visit the NICU following a physical check-up. Results Multiplexed point-of-care testing (71 symptomatic episodes) combined with the weekly screening (272 episodes) yielded in 21 positive samples from 2 of the 67 infants enrolled in the study. Both infants were first detected during symptomatic episodes. Rhino-/enterovirus were detected in all cases. Conclusion: Respiratory viruses were detected during symptomatic and asymptomatic episodes but affected <3% of infants enrolled in the study. In our unit, a low frequency of VRTI was attained despite adherence to family integrated care including liberal visiting policies for younger siblings.

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Variation in Visiting and Isolation Policies in Neonatal Units: A U.K. Nationwide Survey

Cited by 6 publications

References 9 publications

Impact of respiratory viruses in the neonatal intensive care unit

Impact of respiratory viruses in the neonatal intensive care unit

Hospital-Acquired Viral Respiratory Tract Infections in the Neonatal Unit: A Comparison with Other Inpatient Groups

Low Frequency of Viral Respiratory Tract Infections During Family-Centered Neonatal Intensive Care: Results of a Prospective Surveillance Study

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