Strategies for prevention of RSV nosocomial infection.
OBJECTIVE
To review the literature on respiratory syncytial virus (RSV) as a cause of nosocomial infections (NI) on neonatal intensive care units (NICUs) and pediatric wards, and the effectiveness of various containment strategies.


METHODS
We conducted a literature review to define characteristics of RSV NI, and to evaluate the relative effectiveness of various infection containment programs, including the use of palivizumab on the reported incidence of RSV NI on NICUs and pediatric wards.


RESULTS
Highly variable rates of RSV NI have not significantly changed since RSV was first identified. The evaluation of the effectiveness of containment strategies has relied on before/after study designs. Focus on rapid patient diagnosis, compliance of acceptable handwashing techniques and cohorting of patients and staff appears to form the backbone of most prevention and containment programs. When these or other measures have failed, the administration of palivizumab has been useful in halting the spread of RSV NI in children.


CONCLUSIONS
RSV NI continues to be prevalent in the NICU despite adoption of infection control programs. Preventive measures should be employed to lower the risk of RSV NI and, if identified, appropriate containment strategies should be rapidly implemented.
Groothuis
J
J
Medical/Scientific Affairs, MedImmune Inc., Gaithersburg, MD 20878, USA.
Bauman
J
J
Malinoski
F
F
Eggleston
M
M
D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized; D000998:Antiviral Agents / Q000008:administration & dosage*; D003428:Cross Infection / Q000517:prevention & control* / Q000635:transmission; D006235:Hand Disinfection; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000175:diagnosis / Q000517:prevention & control*; D007363:Intensive Care Units, Neonatal; D007396:Internship and Residency; D008403:Mass Screening; D000069455:Palivizumab; D011481:Protective Clothing; D018357:Respiratory Syncytial Virus Infections / Q000175:diagnosis / Q000517:prevention & control* / Q000635:transmission; D012307:Risk Factors; D014789:Visitors to Patients
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000998:Antiviral Agents; D000069455:Palivizumab