Nosocomial Respiratory Syncytial Virus Infections Prevention and Control in Bone Marrow Transplant Patients

Abstract

Institution of a multifaceted infection control strategy significantly reduced the frequency of nosocomial RSV infection in a high-risk group of adult BMT recipients.

Successful prevention of respiratory syncytial virus nosocomial transmission following an enhanced seasonal infection control program

“…A similar strategy was shown to be efficient at controlling RSV outbreaks by Jones et al 19 This prompted the CDC to adopt these preventive strategies, adding URTI screening in visitors and health care workers, as well as a daily surveillance of upper and lower respiratory tract infection signs and symptoms in patients. 23 The TICP applied in our unit until 2001 was comparable with the measures adopted by Garcia et al, 18 with the significant differences being that TICP was applied all year round, reverse isolation was applied only in neutropenic patients (rather than in all HSCT recipients) and we did not cohort infected patients because each was already in a private room. Despite rigorous implementation and high compliance to TICP, we still observed occasional nosocomial transmission of RSV with dismal consequence for the infected patient.…”

“…Garcia et al 18 reported the first intervention field study on the prevention and control of nosocomial RSV on two dedicated HSCT wards from December to March. The program included rapid diagnosis (antigen detection), adequate handwashing and patient cohorting of documented RSV infection (transfer to another unit, cohort and contact isolation precautions with gloves, gowns and masks).…”

“…The mode of transmission was classified as nosocomial if symptoms were observed after 5 days of admission. 18 RSV was identified by direct immunofluorescence on respiratory specimens (nasopharyngeal aspirates and/or bronchoalveolar lavages).…”

“…14 This multifaceted targeted infection control program (TICP) has been reported to be efficacious in controlling outbreaks and reducing RSV nosocomial transmission in the hematologyoncology population but has failed to eliminate RSV-related morbidity and mortality. [18][19][20][21] We therefore questioned whether an enhanced seasonal infection control program (ESICP) applied systematically to all patients during RSV season could provide superior protection against RSV nosocomial transmission.…”

HETA 98-0048-2688, The Children's Hospital, Denver, Colorado.

“…1 However, ribavirin continues to be prescribed for treatment and prophylaxis of RSV in bone marrow transplant patients because of its reported clinical efficacy in this application. 2 Approximately six children per year receive ribavirin at Children's Hospital, and it is usually administered for 3-4 months at a time. The children receiving ribavirin at Denver Children's Hospital are typically several years old (average age: 7 years old).…”