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Reduction in Rate of Nosocomial Respiratory Virus Infections in a Children’s Hospital Associated With Enhanced Isolation Precautions

Published online by Cambridge University Press:  14 January 2018

Lorry G. Rubin*
Affiliation:
Division of Infectious Diseases, Cohen Children’s Medical Center of New York of Northwell Health, New Hyde Park, New York Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York Division of Infection Control and Prevention, Cohen Children’s Medical Center of New York of Northwell Health, New Hyde Park, New York
Nina Kohn
Affiliation:
Biostatistics Unit, Feinstein Institute for Medical Research of Northwell Health, Manhasset, New York
Susan Nullet
Affiliation:
Division of Infection Control and Prevention, Cohen Children’s Medical Center of New York of Northwell Health, New Hyde Park, New York
Margaret Hill
Affiliation:
Division of Infection Control and Prevention, Cohen Children’s Medical Center of New York of Northwell Health, New Hyde Park, New York
*
Address correspondence to Lorry G Rubin, MD, Cohen Children’s Medical Center of New York, 269-01 76th Avenue, New Hyde Park, NY 11040 ([email protected]).

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

Type
Original Articles
Copyright
© 2018 by The Society for Healthcare Epidemiology of America. All rights reserved 

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Footnotes

PREVIOUS PRESENTATION. Some of these results were presented as “Reduction in rate of nosocomial respiratory virus infections associated with enhanced isolation precautions in a children’s hospital” at ID Week 2016 in San Diego, California, on October 8, 2015; in abstract form (poster presentation) as “Reduction in rate of nosocomial respiratory virus infections with enhanced isolation precautions in a children’s hospital” at the Solutions for Patient Safety (SPS) meeting in Orlando, Florida, on September 13-15, 2016; and as “Reduction in rate of nosocomial respiratory virus infections associated with enhanced isolation precautions in a children’s hospital” at ID Week 2016 in New Orleans, Louisiana, on October 27, 2016.

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