title: The impact of infection control upon hospital-acquired influenza and respiratory syncytial virus.
abstract: BACKGROUND
  Respiratory syncytial virus (RSV) and influenza are important pediatric community-acquired (CA) and hospital-acquired (HA) pathogens. The occurrence of pandemic (H1N1) 2009 influenza resulted in additional efforts to intensify infection control (IC) strategies. We detail the impact of IC strategies between 2003 and 2010 on influenza and RSV.
  
  
  METHODS
  We assessed the rates of CA infections per 100 admissions and HA infections per 1000 patient-days for both RSV and influenza at Children's Memorial Hospital during the winter seasons (September through May) 2003-2010. The season of 2009, however, was extended through June due to ongoing admissions as a result of pandemic (H1N1) 2009 influenza. IC strategies implemented in response to pandemic (H1N1) 2009 influenza are described. The transmission ratio (HA cases/CA cases) was determined and correlated with IC efforts.
  
  
  RESULTS
  Substantial season- to-season variability exists for CA RSV and CA influenza rates. The rates of HA RSV and HA influenza and the transmission ratios for these viruses remained unchanged in 2009-10 in comparison to the prior year (at 0.02 and 0.01, respectively) despite implementation of multiple IC strategies. In contrast, since 2005 an inverse association was noted between hand hygiene compliance and the transmission ratio of both RSV and influenza, with Spearman correlation coefficients of -0.84 (p = 0.051) and -0.89 (p = 0.008), respectively.
  
  
  CONCLUSIONS
  We observed that improvements in hand hygiene compliance correlated with less transmission of RSV and influenza in the hospital. The important role of hand hygiene in preventing transmission of RSV and influenza to hospitalized children should be emphasized.
authors.affiliation: Department of Pediatrics, Children's Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Weedon
authors.forename: Angela H
authors.initials: AH
authors.lastname: Rupp
authors.forename: Annie C
authors.initials: AC
authors.lastname: Heffron
authors.forename: Sinead Forkan
authors.initials: SF
authors.lastname: Kelly
authors.forename: Xiaotian
authors.initials: X
authors.lastname: Zheng
authors.forename: Stanford T
authors.initials: ST
authors.lastname: Shulman
authors.forename: Peggy
authors.initials: P
authors.lastname: Gutman
authors.forename: Deli
authors.initials: D
authors.lastname: Wang
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhou
authors.forename: Gary A
authors.initials: GA
authors.lastname: Noskin
authors.forename: Evan J
authors.initials: EJ
authors.lastname: Anderson
mesh_terms: D002641:Chicago / Q000453:epidemiology; D002648:Child; D015331:Cohort Studies; D017714:Community-Acquired Infections / Q000453:epidemiology; D003428:Cross Infection / Q000453:epidemiology* / Q000821:virology; D006801:Humans; D017053:Infection Control / Q000379:methods / Q000706:statistics & numerical data*; D053118:Influenza A Virus, H1N1 Subtype / Q000302:isolation & purification*; D007251:Influenza, Human / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission / Q000821:virology; D058873:Pandemics; D016012:Poisson Distribution; D018357:Respiratory Syncytial Virus Infections / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission / Q000821:virology; D012136:Respiratory Syncytial Viruses / Q000302:isolation & purification*