Strategies for prevention of RSV nosocomial infection

Abstract

Objective: To review the literature on respiratory syncytial virus (RSV) as a cause of nosocomial infections (NI) on neonatal intensive care units (NICUs) and pediatric wards, and the effectiveness of various containment strategies.Study Design: We conducted a literature review to define characteristics of RSV NI, and to evaluate the relative effectiveness of various infection containment programs, including the use of palivizumab on the reported incidence of RSV NI on NICUs and pediatric wards.Result: Highly variable rates of RSV NI have not significantly changed since RSV was first identified. The evaluation of the effectiveness of containment strategies has relied on before/after study designs. Focus on rapid patient diagnosis, compliance of acceptable handwashing techniques and cohorting of patients and staff appears to form the backbone of most prevention and containment programs. When these or other measures have failed, the administration of palivizumab has been useful in halting the spread of RSV NI in children.

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

“…27,28 A multifaceted infection control program including rapid diagnosis, adequate handwashing and patient cohorting is considered to be the minimally acceptable strategy to prevent nosocomial RSV transmission. 29 Other less studied measures are often added, such as use of masks, goggles and visit restriction for family members with URTI. In these cases, the potential advantages have to be weighed against unnecessary barriers between patient and caregivers.…”

Recomendaciones de la Conferencia de Consenso de Bronquiolitis Aguda en España: de la evidencia a la práctica

“…Se propone un sistema de jerarquización de los niveles de evidencia basado en cuatro niveles con criterios relacionados con el volumen, el tipo de diseño y la calidad de los estudios disponibles. Estos criterios se han adaptado de otros sistemas de jerarquización propuestos [33][34][35][36][37] . Partiendo del nivel asignado en el sistema de clasificación previo, se propone un ajuste del nivel inicial siguiendo las recomendaciones de la propuesta GRADE [38][39][40][41] : -Disminuir el nivel de evidencia (principalmente en ensayos clíni-cos) si: 1) existen limitaciones importantes en la calidad de los estudios; 2) existen inconsistencias importantes entre estudios; 3) existen dudas sobre si la evidencia es directa o indirecta; 4) la información disponible es imprecisa o escasa; 5) es muy probable que los resultados tengan sesgos importantes.…”

Prevention of Respiratory Syncytial Virus Infection: From Vaccine to Antibody

“…In certain settings during seasonal RSV outbreaks, such as daycare centers, the attack rate of RSV approaches 100% (23). In addition, RSV is considered a major nosocomial problem for already hospitalized infants (24). Reinfection is quite common throughout life; however, it is typically less severe than the primary infection (22,23,25,26).…”