Nosocomial Respiratory Syncytial Virus Infections: The Cost-Effectiveness and Cost-Benefit of Infection Control

Abstract

A targeted infection control intervention was cost-effective in reducing the rate of RSV NI. For every dollar spent on the program, approximately $6 was saved.

Risk of nosocomial respiratory syncytial virus infection and effectiveness of control measures to prevent transmission events: a systematic review

“…Four were from Europe, 15 from the United States and two from Canada. There were 13 experimental or prospective cohort studies15, 16, 18, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53 and seven retrospective cohorts54, 55, 56, 57, 58, 59, 60 (one was an abstract only and there was not enough information to identify the study type) 61. Most ( n  = 18) were conducted in neonatal/paediatric settings,15, 16, 18, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 55, 56, 57, 60, 61 with three in units housing immunocompromised adults 54, 58, 59.…”

“…An additional potential bias is the ascertainment of community‐acquired rather than nosocomial RSV cases. Eleven of the 12 studies investigating the risk of RSV transmission to patients provided a clear definition of a nosocomial case, with most ( n  = 8) defining this as a case occurring at least 5 days after hospital admission (some used a higher cut‐off) 15, 18, 45, 46, 47, 48, 49, 51. In studies assessing the risk of transmission to hospital staff, no such case definition would be possible.…”

“…Nine of the 13 studies presented evidence that nosocomial infections were significantly lower when a multicomponent intervention was implemented and provided supporting statistical data (e.g. P ‐value or risk ratio with confidence intervals) 16, 18, 46, 48, 49, 51, 54, 56, 60. Three studies reported data that were suggestive of a beneficial effect but did not present any supporting statistics (such as a P ‐value) 53, 59, 61.…”

Strategies for prevention of RSV nosocomial infection

“…23 Cohorting of ward staff and limiting family visits Cohorting of nursing staff to care for isolated patients has not been evaluated as a lone infection control practice and is always employed as part of broader management programs. 7,17,25,28 Family members and other visitors who have respiratory symptoms should not be allowed to come in contact with patients. 17,40 Some NICUs limit sibling visits to once per week during the RSV season, in an attempt to reduce RSV exposure.…”

“…3,4 The body of literature throughout each of the past four decades confirms RSV NI is a consistent problem and the most common, and expensive, cause of NI in neonatal intensive care units (NICUs) and pediatric wards. [5][6][7] The purpose of this review is to determine the extent and clinical features of RSV NI in pediatric hospital settings, describe the effectiveness of a range of infection control measures and to provide the most current information on the role of palivizumab in the prevention of further spread of RSV in the NICU and pediatric wards.…”