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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
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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

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