Respiratory syncytial virus outbreak in a tertiary hospital Neonatal Intensive Care Unit

Abstract

Introduction: Investigation and control of a respiratory syncytial virus (RSV) outbreak that affected the Neonatal Intensive Care Unit (NICU) of a university hospital from October to December 2012.Patients and methods: Cohort study of children admitted to the NICU. The infection attack rate was calculated. A descriptive analysis of the cases and a multivariate analysis was performed using the variables that were shown to be risk factors for RSV infection. Preventive measures taken were: contact isolation; hand hygiene training and observation; exclusivity of a health team of nurses and physicians for positive cases, restrictions on visitor numbers; surveillance RSV testing, and palivizumab prophylaxis.Results: The outbreak had three epidemic waves and 20 positive cases out of a total of 48 children admitted. The overall attack rate was 42%. Half of positive cases were children, with a median age of 36 days (p25 = 22, p75 = 58). The independent risk factors for RSV infection were birth weight below 1000 grams (OR = 23.5; P=.002) and to have another nosocomial infection the week before the diagnosis of RSV infection (OR = 19.98; P=.016).Conclusions: It was an outbreak with a high number of cases, due to the delay in notification, prolonged RSV carrier status, and low adherence to hand hygiene practice, which favoured the cross-transmission of infection. The most effective preventive measures were direct observation of hand hygiene and supervision of isolation measures. (C) 2015 Asociacion Espanola de Pediatria. Published by Elsevier Espana, S.L.U. All rights reserved.