title: Successful prevention of respiratory syncytial virus nosocomial transmission following an enhanced seasonal infection control program.
abstract: Respiratory syncytial virus (RSV) infections can be serious in severely immunocompromised patients. Use of a targeted infection control program (TICP) has been shown to reduce RSV nosocomial transmission. We evaluated the impact of an enhanced seasonal infection control program (ESICP) vs standard TICP in a hematology-oncology ward. TICP was applied from 1999 to 2001 and ESICP applied from 2001 to 2003. ESICP consisted of strict isolation for all patients admitted on the ward during the RSV season. We prospectively evaluated the incidence, related morbidity and mortality of nosocomial RSV in both field interventions. A total of 40 hospitalized RSV infections were documented. The cumulative incidence of nosocomial RSV during TICP and ESICP was respectively of 42.8 and 3.9 cases/1000 admissions (relative risk = 0.09). ESICP needed to be implemented on 26 admitted patients on our ward to prevent one RSV nosocomial case. Furthermore, implementation of ESICP prevented four pneumonias and two deaths per RSV season. We conclude that ESICP is significantly more efficient than TICP to reduce the occurrence of nosocomial RSV infections and its related morbidity and mortality in patients with hematological malignancy and recipients of hematopoietic SCT.
authors.affiliation: Department of Microbiology and Infectious Diseases, Hôpital Sacré-Coeur de Montréal, Montréal, Québec, Canada. valerylavergne@gmail.com
authors.forename: V
authors.initials: V
authors.lastname: Lavergne
authors.forename: M
authors.initials: M
authors.lastname: Ghannoum
authors.forename: K
authors.initials: K
authors.lastname: Weiss
authors.forename: J
authors.initials: J
authors.lastname: Roy
authors.forename: C
authors.initials: C
authors.lastname: Béliveau
mesh_terms: D000328:Adult; D002170:Canada / Q000453:epidemiology; D002487:Centers for Disease Control and Prevention, U.S.; D003428:Cross Infection / Q000150:complications / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control*; D005260:Female; D019337:Hematologic Neoplasms / Q000150:complications; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D016867:Immunocompromised Host; D015994:Incidence; D017053:Infection Control / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010356:Patient Isolation; D011014:Pneumonia / Q000382:microbiology / Q000401:mortality / Q000517:prevention & control; D017410:Practice Guidelines as Topic; D018357:Respiratory Syncytial Virus Infections / Q000150:complications / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control*; D018113:Respiratory Syncytial Virus, Human / Q000302:isolation & purification; D012621:Seasons; D014481:United States