title: Burden of Healthcare-Associated Viral Respiratory Infections in Children's Hospitals.
abstract: OBJECTIVE
  Although healthcare-associated (HA) viral respiratory infections (VRIs) are common in pediatrics, no benchmark for comparison exists. We aimed to determine, compare, and assess determinants of unit-specific HA-VRI incidence rates in 2 children's hospitals.
  
  
  METHODS
  This study was a retrospective comparison of prospective cohorts. The Montreal Children's Hospital and the Cohen Children's Medical Center of New York perform prospective surveillance for HA-VRI using standardized definitions that require the presence of symptoms compatible with VRI and virus detection. Cases detected between April 1, 2010, and March 31, 2013, were identified using surveillance databases. Annual incidence rates were calculated, and a generalized estimating equation model was used to assess determinants of HA-VRI rates.
  
  
  RESULTS
  The overall HA-VRI rate during the 3-year study period was significantly higher at Montreal Children's Hospital than that at Cohen Children's Medical Center of New York (1.91 vs 0.80 per 1000 patient-days, respectively; P < .0001). Overall, the HA-VRI incidence rate was lowest in the neonatal intensive care unit. Rates in the pediatric intensive care, oncology, and medical/surgical units were similar. The most common etiology of HA-VRI at both institutions was rhinovirus (49% of cases), followed by parainfluenza virus and respiratory syncytial virus. Hospitals with less than 50% single rooms had HA-VRI rates 1.33 (95% confidence interval, 1.29-1.37) times higher than hospitals with more than 50% single rooms for a given unit type.
  
  
  CONCLUSIONS
  HA-VRI rates were substantial but different among 2 children's hospitals. Future studies should examine the effect of HA-VRI and evaluate best practices for preventing such infections.
authors.affiliation: Montreal Children's Hospital, McGill University Health Centre, Quebec, Canada.|Departments of Pediatrics and Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.|Infection Prevention & Control Unit, CHU Sainte-Justine, Quebec, Canada.|Department of Microbiology, Infectious Disease and Immunology, University of Montreal, Quebec, Canada.
authors.forename: Caroline
authors.initials: C
authors.lastname: Quach
authors.affiliation: Steven and Alexandra Cohen Children's Medical Center of New York of Northwell Health, New Hyde Park, New York.
authors.forename: Rita
authors.initials: R
authors.lastname: Shah
authors.affiliation: Infection Prevention & Control Unit, CHU Sainte-Justine, Quebec, Canada.|Steven and Alexandra Cohen Children's Medical Center of New York of Northwell Health, New Hyde Park, New York.|Hofstra Northwell School of Medicine, Hempstead, New York.
authors.forename: Lorry G
authors.initials: LG
authors.lastname: Rubin
mesh_terms: D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D003428:Cross Infection / Q000453:epidemiology* / Q000821:virology; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007223:Infant; D009519:New York City / Q000453:epidemiology; D018184:Paramyxoviridae Infections / Q000453:epidemiology; D010850:Picornaviridae Infections / Q000453:epidemiology; D011792:Quebec / Q000453:epidemiology; D018357:Respiratory Syncytial Virus Infections / Q000453:epidemiology; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000821:virology; D012189:Retrospective Studies; D012229:Rhinovirus