Hostname: page-component-8448b6f56d-c4f8m Total loading time: 0 Render date: 2024-04-18T20:13:31.577Z Has data issue: false hasContentIssue false
  • English
  • Français

A Survey of Nosocomial Respiratory Viral Infections in a Children's Hospital: Occult Respiratory Infection in Patients Admitted During an Epidemic Season

Published online by Cambridge University Press:  21 June 2016

Paul N. Goldwater ,
A. James Martin ,
Brownwyn Ryan ,
Sylvia Morris ,
Jill Thompson ,
T.W. Kok  and
Christopher J. Burrell
Paul N. Goldwater*
Affiliation:
Adelaide Children's Hospital, a Division of the Adelaide Medical Centre for Women and Children, Adelaide, South Australia
A. James Martin
Affiliation:
Adelaide Children's Hospital, a Division of the Adelaide Medical Centre for Women and Children, Adelaide, South Australia
Brownwyn Ryan
Affiliation:
Adelaide Children's Hospital, a Division of the Adelaide Medical Centre for Women and Children, Adelaide, South Australia
Sylvia Morris
Affiliation:
Adelaide Children's Hospital, a Division of the Adelaide Medical Centre for Women and Children, Adelaide, South Australia
Jill Thompson
Affiliation:
Institute for Medical and Veterinary Science, Adelaide, South Australia
T.W. Kok
Affiliation:
Institute for Medical and Veterinary Science, Adelaide, South Australia
Christopher J. Burrell
Affiliation:
Institute for Medical and Veterinary Science, Adelaide, South Australia
*
Department of Microbiology, The Adelaide Children's Hospital, North Adelaide, South Australia, 5006
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To define the extent of shedding of respiratory viruses and Mycoplasma pneumoniae among a population of pediatric patients admitted to the hospital during a winter epidemic period and to identify nosocomial infections within this population.

Design:

An open, prospective survey of patients admitted to three wards (General Medical, Respiratory Infectious, and Infectious Diseases) of a pediatric hospital during a defined three-month period.

Patients:

All patients with medical, respiratory, and infectious conditions admitted to three wards of the Adelaide Children's Hospital had nasopharyngeal aspirations performed at the time of admission with the purpose of documenting viral and M pneumoniae shedding. Patients were monitored daily for the development of symptoms of respiratory infection or new symptoms of respiratory disease. Such patients underwent a further nasopharyngeal aspiration for the purpose of diagnosing hospital-acquired infection.

Results:

Nasopharyngeal aspirations were obtained from 601 patients. Forty-seven percent of asymptomatic patients were positive for a respiratory virus or M pneumoniae, and 61% of patients with respiratory symptoms were also positive. Gastroenteritis patients shed viruses in 66% of cases. Respiratory symptoms were initially overlooked by admitting physicians but subsequently identified in 110 cases, and 46% of these were found to be positive for a respiratory virus or M pneumoniae. There were 18 possible hospital acquired infections among the 293 initially virus-negative patients. Multiple isolates were obtained from a substantial number of patients, especially those with respiratory symptoms.

Conclusions:

A substantial proportion of all patients admitted to a pediatric hospital during winter represent a potential source of infection, and strict infection control measures should be enacted to limit the spread of these infections.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 12 , Issue 4 , April 1991 , pp. 231 - 238
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1991

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Ditchburn, RK, McQuillan, J, Gardner, PS, et al. Respiratory syncytial virus in the hospital cross-infection. Br Med J. 1971;3:671–673.CrossRefGoogle ScholarPubMed
2. Gardner, PS, Court, SD, Brocklebank, JT, et al. Virus cross-infection in paediatric wards. Br Med J. 1973;2:571–575.CrossRefGoogle ScholarPubMed
3. Hall, CB, Douglas, RG Jr., Geiman, JM, et al. Nosocomial respiratory virus infections. N Engl J Med. 1975;293:1343–1346.CrossRefGoogle Scholar
4. Hall, CB, Douglas, RG. Nosocomial respiratory syncytial virus infections. Am J Dis Child. 1981;135:512–515.CrossRefGoogle Scholar
5. Schmitz, H, Wigand, R, Heinrich, W. Worldwide epidemiology of human adenovirus infections. Am J Epidemiol. 1983;117:455–466.CrossRefGoogle ScholarPubMed
6. Jackson, GG, Muldoon, RL. Viruses causing common respiratory infections in man. II. Enteroviruses and paramyxoviruses. III. respiratory syncytial viruses and coronaviruses. J Infect Dis. 1973;28:674–702.CrossRefGoogle Scholar
7. Holmes, IH. Viral gastroenteritis. Prog Med Virol. 1979;25:1–36.Google ScholarPubMed
8. Douglas, RG Jr. Pathogenesis of rhinovirus common colds in human volunteers. Ann Otol Rhinol Laryngol. 1970;79:563–571.CrossRefGoogle Scholar
9. Douglas, RG Jr. Influenza in man. In: Influenza Viruses and Influenza. Kilbourne, ED. ed. New York. NY: Academic Press: 1975:395.Google Scholar
10. Downham, MAPS, McQuillan, J, Gardner, PS. Diagnosis and clinical significance of parainfluenza virus infections in children. Arch Dis Child. 1974;49:8–15.CrossRefGoogle ScholarPubMed
11. Kapikian, AZ, Bell, JA, Mastrota, FM, et al. An outbreak of febrile illness and pneumonia associated with respiratory syncytial virus infection. Am J Hyg. 1961;74:234–248.Google ScholarPubMed
12. Baum, SG. Adenovirus. In: Principles and Practice of Infectious Diseases. 2nd ed. Mandell, GL, Douglas, RG, Bennett, JE, eds. New York. NY: John Wilev & Sons: 1985:991.Google Scholar
13. Foy, HM, Grayston, JT, Kenny, GE, et al. Epidemiology of Mycoplasma pneumoniae infection in families. JAMA. 1966;197:859–866.CrossRefGoogle ScholarPubMed
14. Hall, CB, Douglas, RG Jr. Clinically useful method for the isolation of respiratory syncytial virus infection. J Infect Dis. 1975;131:1–5.CrossRefGoogle Scholar
15. Gardner, PS, McQuillan, J. Application of immunofluorescent antibody technique in rapid diagnosis of respiratory syncytial virus infection. Br Med J. 1968;3:340–343.CrossRefGoogle ScholarPubMed
16. Hendry, RM, Mcintosh, K. Enzyme-linked immunosorbent assay for detection of respiratory syncytial virus infection: development and description. J Clin Microbiol. 1982;16:324–328.CrossRefGoogle ScholarPubMed
17. Kok, TW, Varkanis, G, Marmion, BP, Martin, J, Esterman, A. Laboratory diagnosis of Mycoplasma pneumoniae infection. Direct detection of antigen in respiratory exudates by enzyme immunoassay. Epidemiol Infect. 1988;101:669–684.CrossRefGoogle ScholarPubMed
18. Moffet, HL, Cramblett, HG. Viral isolations and illnesses in young infants attending a well baby clinic. N Engl J Med. 1962;267:1213–1218.CrossRefGoogle Scholar
19. Wenzel, RP, Deal, EC, Hendley, JO. Hospital-acquired viral respiratory illness in a pediatric ward. Pediatrics. 1977;60:367–371.CrossRefGoogle Scholar
20. McIntosh, K. Interferon in nasal secretions from infants with viral respiratory tract infections. J Pediatr. 1978;93:33–36.CrossRefGoogle ScholarPubMed
21. Roy, TE, McDonald, S, Patrick, ML, et al. A survey of hospital infection in a pediatric hospital. J Can Med Assoc. 1962;87:531–538.Google Scholar
22. Cooper, RG, Sumner, C. Hospital infection data from a children's hospital. Med J Aust. 1970;2:1110–1113.CrossRefGoogle ScholarPubMed
23. Gardner, P, Carles, DG. Infection acquired in a pediatric hospital. J Pediatr. 1972;81:1205–1210.CrossRefGoogle Scholar
24. Wenzel, RP, Osterman, CA, Hunting, KJ. Hospital-acquired infections. Am J Epidemiol. 1976;104:645–651.CrossRefGoogle ScholarPubMed
25. Exon, WJ, Hinz, W, Riley, HD. Nosocomial infections at a children's hospital. J Okla State Med Assoc. 1976;69:403–407.Google ScholarPubMed
26. Welliver, RC, McLauglin, S. Unique epidemiology of nosocomial infection in a children's hospital. Am J Dis Child. 1984;138:131–135.Google ScholarPubMed
27. Jarvis, WR. Epidemiology of nosocomial infections in pediatric patients. Pediatr Infect Dis J. 1987:6:344–351.CrossRefGoogle ScholarPubMed
28. Clyde, WA Jr. Mycoplasma pneumoniae in the pediatric population. In: Mycoplasmas as Agents of Human Disease. Chicago, II: Windermere Communications Inc; 1985;51–64.Google Scholar
29. Freeman, J, McGowan, JE. Methodologic issues in hospital epidemiology. I. rates, case-finding, and interpretation. Rev Infect Dis. 1981;3:658–667.CrossRefGoogle ScholarPubMed
30. Hall, CB, Geiman, JM, Douglas, RG Jr., Meagher, MI? M pneumoniae. Control of nosocomial respiratory syncytial viral infections. Pediatrics. 1978;62:728–732.CrossRefGoogle ScholarPubMed
31. Sims, DG, Downham, MAPS, Webb, JKG, Gardner, PS, Weightman, D. Hospital cross-infection on children's wards with respiratory syncytial virus and the role of adult carriage. Acta Pediatr Scand. 1965:64:541–545.CrossRefGoogle Scholar
32. Hall, CB. The nosocomial spread of respiratory syncytial viral infection. Ann Rev Med. 1983;34:311–319.CrossRefGoogle Scholar
33. Glezen, Wl? Viral pneumonia as a cause and result of hospitalization. J Infect Dis. 1983;147:765–770.CrossRefGoogle ScholarPubMed