Reduction in Rate of Nosocomial Respiratory Virus Infections in a Children's Hospital Associated With Enhanced Isolation Precautions. (14th January 2018) - Rubin, Lorry G.
Abstract : OBJECTIVE: To determine whether the use of enhanced isolation precautions (droplet and contact precautions) for inpatients with respiratory tract viral infections is associated with a reduction in rate of nosocomial viral respiratory infections. DESIGN: Quasi-experimental study with the rate of nosocomial respiratory virus infection as the primary dependent variable and rate of nosocomial Clostridium difficile infection as a nonequivalent dependent variable comparator. SETTING: Cohen Children's Medical Center of NY, a tertiary-care children's hospital attached to a large general hospital. INTERVENTION: During years 1 and 2 (July 2012 through June 2014), the Centers for Disease Control and Prevention/Healthcare Infection Control Practices Advisory Committee's recommended isolation precautions for inpatients with selected respiratory virus infections were in effect. Enhanced isolation precautions were in effect during years 3 and 4 (July, 2014 through June, 2016), except for influenza, for which enhanced precautions were in effect during year 4 only. RESULTS: During the period of enhanced isolation precautions, the rate of nosocomial respiratory virus infections with any of 4 virus categories decreased 39% from 0.827 per 1, 000 hospital days prior to enhanced precautions to 0.508 per 1, 000 hospital days ( P <.0013). Excluding rhinovirus/enterovirus infections, the rates decreased 58% from 0.317 per 1, 000 hospital days to 0.134 per 1, 000 hospital days during enhanced precautions ( P <.0014). During these periods, no significant change was detected in the rate of nosocomial C. difficile infection. CONCLUSIONS: Enhanced isolation precautions for inpatients with respiratory virus infections were associated with a reduction in the rate of nosocomial respiratory virus infections. Infect Control Hosp Epidemiol 2018;39:152–156