Reducing Unnecessary Nasopharyngeal Virus Testing at A tertiary Care Paediatric Centre – A choosing Wisely Initiative

Ostrow, Olivia; Savlov, Deena; Petrich, Adam M.; Richardson, SE; Friedman, JN

doi:10.1093/pch/pxx086.042

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“…Abolishing routine viral testing in children admitted for bronchiolitis will contribute to the reduction of high costs associated with this pediatric disease and would fit in well with the Choosing Wisely Initiative. 28,29,30 Moreover, it will contribute to the patient' s well-being because sampling can be uncomfortable.…”

Section: Discussionmentioning

confidence: 99%

Room Sharing in Hospitalized Children With Bronchiolitis and the Occurrence of Hospital-Acquired Infections: A Prospective Cohort Study

Bekhof

Wessels

Velde

et al. 2019

Hospital Pediatrics

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OBJECTIVES: To determine the prevalence and severity of hospital-acquired infections (HAIs) in children hospitalized for bronchiolitis when patients share a room, irrespective of the causative virus. METHODS: A prospective cohort study during 4 winter seasons (2012–2016) was conducted in a Dutch general pediatric ward including otherwise healthy children <2 years of age hospitalized for bronchiolitis. Patients shared a 1-to-4–bed hospital room irrespective of virological diagnosis. The main outcome measures were HAIs assessed through multiplex polymerase chain reaction and disease severity. RESULTS: HAIs occurred in 28 of 218 included patients (12.8%), most frequently with rhinovirus (17 of 28; 60.7%). In 3 (10.7%) of 28 HAIs, the same virus was identified in roommates. Only 1 patient became cross-infected with respiratory syncytial virus, although this patient never shared a room with a patient infected with respiratory syncytial virus. HAI was not associated with more severe disease. The median length of hospitalization was 3.5 days (interquartile range [IQR] 1–6) compared with 3 days (IQR 2–6; P = .86); the number of PICU admissions was 0% versus 5.3% (P = .21); the median days of oxygen supplementation was 2.5 (IQR 1–4) versus 2 (IQR 1–4; P = .58); the median days of tube feeding was 2 (IQR 0–5) versus 2 (interquartile range: 0–5; P = .77); and the readmission rate was 0% versus 5.8% (P = .19) in patients with and without HAI, respectively. CONCLUSIONS: HAIs among patients with bronchiolitis are common but not associated with more severe disease. Room sharing with appropriate hygiene does not play a relevant role in the transmission of viruses between patients with bronchiolitis, regardless of the viruses involved. On the basis of these findings, we suggest that room sharing of patients with bronchiolitis is safe.

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Section: Discussionmentioning

confidence: 99%