Abstract
Viral testing is not always recommended in children with bronchiolitis due to doubts concerning its prognostic use. In this retrospective study, we investigated how the RSV testing would influence the frequency of nosocomial infections (NI). The files of 305 children, hospitalized due to the respiratory syncytial virus (RSV) infection in the period 2010–2014, were reviewed in the study. We found ten cases of NI. The RSV preventive measures did not vary in the consecutive years investigated, but the number of viral tests substantially varied. In 2010, 2012, and 2014, when ca. 2 tests per RSV(+) patient were performed, the risk of NI per patient was 1.3%, while in 2011 and 2013, when the RSV testing was less frequent, the accumulated risk per patient was 5.2%. There was a strong adverse relationship between the number of tests performed and the number of NI (rho = −0.975). The children with NI, when compared to those without NI, required a longer hospital stay, generating higher hospital costs regarding treatment, productivity loss, and indirect costs. The expenditure for RSV testing in the years of a low NI risk was higher than that in the high-risk years. Conversely, the expenditure related to NI management was lower in the years of a low NI risk. Each euro spent on RSV testing saved over 26 € from the NI management expenditure. We conclude that RSV testing is needed in the hospital setting to isolate the infected children and to prevent nosocomial RSV spread. This strategy is health advantageous and requires less resources than NI treatment.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
AAP, American Academy of Pediatrics Subcommittee on Diagnosis and Management of Bronchiolitis (2006) Diagnosis and management of bronchiolitis. Pediatrics 118:1774–1793
Ampofo K, Bender J, Sheng X, Korgenski K, Daly J, Pavia AT, Byington CL (2008) Seasonal invasive pneumococcal disease in children: role of preceding respiratory viral infection. Pediatrics 122:229–237
Dadlez NM, Esteban-Cruciani N, Khan A, Douglas LC, Shi Y, Southern WN (2017) Risk factors for respiratory decompensation among healthy infants with bronchiolitis. Hosp Pediatr 7:530–535
GBD 2015 LRI Collaborators (2017) Estimates of the global, regional, and national morbidity, mortality, and aetiologies of lower respiratory tract infections in 195 countries: a systematic analysis for the Global Burden of Disease Study 2015. Lancet Infect Dis 17:1133–1161
Hall CB, Douglas RG Jr, Geiman JM, Messner MK (1975) Nosocomial respiratory syncytial virus infections. N Engl J Med 293:1343–1346
Hall CB, Douglas RG Jr, Geiman JM (1980) Possible transmission by fomites of respiratory syncytial virus. J Infect Dis 141:98–102
Hall CB, Weinberg GA, Blumkin AK, Edwards KM, Staat MA, Schultz AF, Poehling KA, Szilagyi PG, Griffin MR, Williams JV, Zhu Y, Grijalva CG, Prill MM, Iwane MK (2013) Respiratory syncytial virus-associated hospitalizations among children less than 24 months of age. Pediatrics 132:e341–e348
Hament JM, Aerts PC, Fleer A, Van Dijk H, Harmsen T, Kimpen JL, Wolfs TF (2004) Enhanced adherence of Streptococcus pneumoniae to human epithelial cells infected with respiratory syncytial virus. Pediatr Res 55:972–978
Karanfil LV, Conlon M, Lykens K, Masters CF, Forman M, Griffith ME, Townsend TR, Perl TM (1999) Reducing the rate of nosocomially transmitted respiratory syncytial virus. Am J Infect Control 27:91–96
Leclair JM, Freeman J, Sullivan BF, Crowley CM, Goldmann DA (1987) Prevention of nosocomial respiratory syncytial virus infections through compliance with glove and gown isolation precautions. N Engl J Med 317:329–334
Liu L, Johnson HL, Cousens S, Perin J, Scott S, Lawn JE, Rudan I, Campbell H, Cibulskis R, Li M, Mathers C, Black RE, Child Health Epidemiology Reference Group of WHO and UNICEF (2012) Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000. Lancet 379:2151–2161
Macartney KK, Gorelick MH, Manning ML, Hodinka RL, Bell LM (2000) Nosocomial respiratory syncytial virus infections: the cost-effectiveness and cost-benefit of infection control. Pediatrics 106:520–526
Madhi SA, Klugman KP, Vaccine Trialist Group (2004) A role for Streptococcus pneumoniae in virus-associated pneumonia. Nat Med 10:811–813
Mansbach JM, McAdam AJ, Clark S, Hain PD, Flood RG, Acholonu U, Camargo CA Jr (2008) Prospective multicenter study of the viral etiology of bronchiolitis in the emergency department. Acad Emerg Med 15:111–118
Mansbach JM, Piedra PA, Teach SJ, Sullivan AF, Forgey T, Clark S, Espinola JA, Camargo CA Jr, MARC-30 Investigators (2012) Prospective multicenter study of viral etiology and hospital length of stay in children with severe bronchiolitis. Arch Pediatr Adolesc Med 166:700–706
McGillivary G, Mason KM, Jurcisek JA, Peeples ME, Bakaletz LO (2009) Respiratory syncytial virus-induced dysregulation of expression of a mucosal beta-defensin augments colonization of the upper airway by non-typeable Haemophilus influenzae. Cell Microbiol 11:1399–1408
Mesquita FDS, Oliveira DBL, Crema D, Pinez CMN, Colmanetti TC, Thomazelli LM, Gilio AE, Vieira SE, Martinez MB, Botosso VF, Durigon EL (2017) Rapid antigen detection test for respiratory syncytial virus diagnosis as a diagnostic tool. J Pediatr 93:246–252
Mills JM, Harper J, Broomfield D, Templeton KE (2011) Rapid testing for respiratory syncytial virus in a paediatric emergency department: benefits for infection control and bed management. J Hosp Infect 77:248–251
Murphy TF, Bakaletz LO, Smeesters PR (2009) Microbial interactions in the respiratory tract. Pediatr Infect Dis J 28:S121–S126
Nair H, Nokes DJ, Gessner BD, Dherani M, Madhi SA, Singleton RJ, O’Brien KL, Roca A, Wright PF, Bruce N, Chandran A, Theodoratou E, Sutanto A, Sedyaningsih ER, Ngama M, Munywoki PK, Kartasasmita C, Simões EA, Rudan I, Weber MW, Campbell H (2010) Global burden of acute lower respiratory infections due to respiratory syncytial virus in young children: a systematic review and meta-analysis. Lancet 375:1545–1555
Peters RM, Schnee SV, Tabatabai J, Schnitzler P, Pfeil J (2017) Evaluation of Alere I RSV for rapid detection of respiratory syncytial virus in children hospitalized with acute respiratory tract infection. J Clin Microbiol 55:1032–1036
Prendergast C, Papenburg J (2013) Rapid antigen-based testing for respiratory syncytial virus: moving diagnostics from bench to bedside? Future Microbiol 8(4):435–444
Ralston SL, Lieberthal AS, Meissner HC, Alverson BK, Baley JE, Gadomski AM, Johnson DW, Light MJ, Maraqa NF, Mendonca EA, Phelan KJ, Zorc JJ, Stanko-Lopp D, Brown MA, Nathanson I, Rosenblum E, Sayles S 3rd, Hernandez-Cancio S, American Academy of Pediatrics (2014) Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis. Pediatrics 134:e1474–e1502
Stollar F, Alcoba G, Gervaix A, Argiroffo CB (2014) Virologic testing in bronchiolitis: does it change management decisions and predict outcomes? Eur J Pediatr 173:1429–1435
Suárez-Arrabal MC, Mella C, Lopez SM, Brown NV, Hall MW, Hammond S, Shiels W, Groner J, Marcon M, Ramilo O, Mejias A (2015) Nasopharyngeal bacterial burden and antibiotics: influence on inflammatory markers and disease severity in infants with respiratory syncytial virus bronchiolitis. J Infect 71:458–469
Talbot TR, Poehling KA, Hartert TV, Arbogast PG, Halasa NB, Edwards KM, Schaffner W, Craig AS, Griffin MR (2005) Seasonality of invasive pneumococcal disease: temporal relation to documented influenza and respiratory syncytial virus circulation. Am J Med 118:285–291
Techasaensiri B, Techasaensiri C, Mejías A, McCracken GH Jr, Ramilo O (2010) Viral coinfections in children with invasive pneumococcal disease. Pediatr Infect Dis J 29:519–523
Weinberger DM, Givon-Lavi N, Shemer-Avni Y, Bar-Ziv J, Alonso WJ, Greenberg D, Dagan R (2013) Influence of pneumococcal vaccines and respiratory syncytial virus on alveolar pneumonia, Israel. Emerg Infect Dis 19:1084–1091
Weinberger DM, Klugman KP, Steiner CA, Simonsen L, Viboud C (2015) Association between respiratory syncytial virus activity and pneumococcal disease in infants: a time series analysis of US hospitalization data. PLoS Med 12:e1001776
Acknowledgments
This study was supported by CMKP Grant 501-1-020-19-19.
Conflicts of Interest
The authors declare no conflict of interest in relation to this article.
Ethical Approval
This retrospective review of medical files does not contain any experiments with human participants or animals performed by any of the authors.
Informed Consent
There are no identifiable participants included in this retrospective article. Therefore, there was no requirement to obtain individual informed consent.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Wrotek, A., Czajkowska, M., Jackowska, T. (2020). Nosocomial Infections in Patients Hospitalized with Respiratory Syncytial Virus: A Practice Review. In: Pokorski, M. (eds) Medical Research and Development. Advances in Experimental Medicine and Biology(), vol 1271. Springer, Cham. https://doi.org/10.1007/5584_2020_483
Download citation
DOI: https://doi.org/10.1007/5584_2020_483
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-50497-7
Online ISBN: 978-3-030-50498-4
eBook Packages: Biomedical and Life SciencesBiomedical and Life Sciences (R0)