Surveillance for healthcare-acquired febrile respiratory infection in pediatric hospitals participating in the Canadian Nosocomial Infection Surveillance Program.

OBJECTIVE

To determine the rates of healthcare-acquired febrile respiratory infection (HA-FRI) in Canadian pediatric hospitals and to determine the vaccination status of patients with healthcare-acquired respiratory syncytial virus (RSV) infection, influenza, or pneumococcal infection who were also eligible for immunoprophylaxis.

METHODS

Prospective surveillance was conducted in 8 hospitals from January 1 to April 30, 2005. All hospitalized patients less than 18 years of age were eligible, except for patients housed in standard newborn nurseries or psychiatric units. Infection control professionals reviewed laboratory reports, conducted ward rounds, and reviewed medical records to identify case patients. Descriptive analyses were completed, as well.

RESULTS

A total of 96 case patients were identified; 52 (54%) were male, and 48 (50%) were aged 1 year or less. Seventy-two patients (75%) had chronic medical conditions. Respiratory viruses accounted for 72 (71%) of 101 pathogens identified, and RSV was the virus most frequently identified. Of these 96 patients, 9 (9%) died, and 3 (3%) of the deaths were related to the patient's HA-FRI. The mean incidence rate was 0.97 infections/1,000 patient-days (range, 0.29-1.50 infections/1,000 patient-days). Only 2 (15%) of 13 influenza vaccine-eligible children who acquired influenza while hospitalized were reported to have been vaccinated, but influenza vaccination status was unknown for most children. However, 4 (80%) of 5 RSV prophylaxis-eligible children who had healthcare-acquired RSV infection had received immunoprophylaxis with anti-RSV monoclonal antibody.

CONCLUSIONS

HA-FRI is mainly caused by viruses such as RSV, and it primarily affects children under 1 year of age and those with chronic medical conditions.