Dodging the Bundle - Persistent Healthcare-Associated Rhinovirus Infection throughout the Pandemic.

TitleDodging the Bundle - Persistent Healthcare-Associated Rhinovirus Infection throughout the Pandemic.
Publication TypeJournal Article
Year of Publication2022
AuthorsKitt E, Brennan L, Harrison C, Hei H, Paul E, Satchell L, Wilson K, Smathers S, Handy L, Coffin SE
JournalAm J Infect Control
Date Published2022 May 16

INTRODUCTION: Healthcare-associated viral infections (HAVI) are a common cause of patient harm in the pediatric population. We implemented a HAVI prevention bundle in 2015, which included 6 core elements: caregiver screening, symptom-based isolation, personal protective equipment (PPE), hand hygiene, staff illness procedures, and monitoring of environmental cleanliness. Enhanced bundle elements were introduced at the start of the COVID-19 pandemic, which provided an opportunity to observe the effectiveness of the bundle with optimal adherence to prevention practices, and to measure the impact on respiratory HAVI epidemiology.

METHODS: Respiratory HAVIs were confirmed through review of medical records and application of the National Health Safety Network (NHSN) surveillance criteria for upper respiratory infections (URIs) with pre-determined incubation periods for unit attribution. Descriptive statistics of the study population were examined, and comparative analyses were performed on demographic and process metrics. Data analysis was conducted using R statistical software.

RESULTS: We observed an overall decrease in respiratory HAVI of 68%, with pre-pandemic rates of 0.19 infections per 1000 patient significantly decreased to a rate of 0.06 per 1000 patient days in the pandemic period (P<0.01). Rhinovirus made up proportionally more of our respiratory HAVI in the pandemic period (64% vs 53%), with respiratory HAVI secondary only to rhinovirus identified during 8 of 16 months in the pandemic period. Compliance with our HAVI prevention bundle significantly improved during pandemic period.

CONCLUSIONS: Enhancement of our HAVI bundle during the COVID-19 pandemic contributed toward significant reduction in nosocomial transmission of respiratory HAVI. Even with prevention practices optimized, respiratory HAVIs secondary to rhinovirus continued to be reported, likely due to the capacity of rhinovirus to evade bundle elements in hospital, and infection prevention efforts at large in the community, leaving vulnerable patients at continued risk.

Alternate JournalAm J Infect Control
PubMed ID35588914