PMID- 35588914
OWN - NLM
STAT- MEDLINE
DCOM- 20220928
LR  - 20230124
IS  - 1527-3296 (Electronic)
IS  - 0196-6553 (Linking)
VI  - 50
IP  - 10
DP  - 2022 Oct
TI  - Dodging the bundle-Persistent healthcare-associated rhinovirus infection 
      throughout the pandemic.
PG  - 1140-1144
LID - S0196-6553(22)00406-0 [pii]
LID - 10.1016/j.ajic.2022.04.016 [doi]
AB  - 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 predetermined 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 prepandemic rates of 0.19 
      infections per 1,000 patient significantly decreased to a rate of 0.06 per 1,000 
      patient days in the pandemic period (P < .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.
CI  - Copyright (c) 2022 Association for Professionals in Infection Control and 
      Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
FAU - Kitt, Eimear
AU  - Kitt E
AD  - Division of Infectious Diseases, Children's Hospital of Philadelphia, 
      Philadelphia, PA; Department of Pediatrics, Perelman School of Medicine, 
      University of Pennsylvania, Philadelphia, PA; Department of Infection Prevention 
      and Control, Children's Hospital of Philadelphia, Philadelphia, PA. Electronic 
      address: kitte@chop.edu.
FAU - Brennan, Lauren
AU  - Brennan L
AD  - Center for Healthcare Quality and Analytics, Children's Hospital of Philadelphia, 
      Philadelphia, PA.
FAU - Harrison, Cecelia
AU  - Harrison C
AD  - Department of Infection Prevention and Control, Children's Hospital of 
      Philadelphia, Philadelphia, PA.
FAU - Hei, Hillary
AU  - Hei H
AD  - Department of Infection Prevention and Control, ECRI, Plymouth Meeting, PA.
FAU - Paul, Elina
AU  - Paul E
AD  - Department of Infection Prevention and Control, Children's Hospital of 
      Philadelphia, Philadelphia, PA.
FAU - Satchell, Lauren
AU  - Satchell L
AD  - Department of Infection Prevention and Control, Children's Hospital of 
      Philadelphia, Philadelphia, PA.
FAU - Wilson, Kimberly B
AU  - Wilson KB
AD  - Department of Infection Prevention and Control, Children's Hospital of 
      Philadelphia, Philadelphia, PA.
FAU - Smathers, Sarah
AU  - Smathers S
AD  - Department of Infection Prevention and Control, Children's Hospital of 
      Philadelphia, Philadelphia, PA.
FAU - Handy, Lori
AU  - Handy L
AD  - Division of Infectious Diseases, Children's Hospital of Philadelphia, 
      Philadelphia, PA; Department of Pediatrics, Perelman School of Medicine, 
      University of Pennsylvania, Philadelphia, PA; Department of Infection Prevention 
      and Control, Children's Hospital of Philadelphia, Philadelphia, PA.
FAU - Coffin, Susan E
AU  - Coffin SE
AD  - Division of Infectious Diseases, Children's Hospital of Philadelphia, 
      Philadelphia, PA; Department of Pediatrics, Perelman School of Medicine, 
      University of Pennsylvania, Philadelphia, PA; Department of Infection Prevention 
      and Control, Children's Hospital of Philadelphia, Philadelphia, PA.
LA  - eng
PT  - Journal Article
DEP - 20220516
PL  - United States
TA  - Am J Infect Control
JT  - American journal of infection control
JID - 8004854
SB  - IM
MH  - *COVID-19/epidemiology/prevention & control
MH  - Child
MH  - *Cross Infection/epidemiology/prevention & control
MH  - Delivery of Health Care
MH  - Humans
MH  - Pandemics/prevention & control
MH  - Rhinovirus
OTO - NOTNLM
OT  - harm prevention
OT  - health-care associated viral infection
OT  - nosocomial
OT  - pediatric
EDAT- 2022/05/20 06:00
MHDA- 2022/09/28 06:00
CRDT- 2022/05/19 20:04
PHST- 2022/01/28 00:00 [received]
PHST- 2022/04/19 00:00 [revised]
PHST- 2022/04/19 00:00 [accepted]
PHST- 2022/05/20 06:00 [pubmed]
PHST- 2022/09/28 06:00 [medline]
PHST- 2022/05/19 20:04 [entrez]
AID - S0196-6553(22)00406-0 [pii]
AID - 10.1016/j.ajic.2022.04.016 [doi]
PST - ppublish
SO  - Am J Infect Control. 2022 Oct;50(10):1140-1144. doi: 10.1016/j.ajic.2022.04.016. 
      Epub 2022 May 16.