Highlights
- •The estimated incidence of neonatal RSV nosocomial infection (RSVNI) was 23.8%.
- •RSVNI outbreaks are mainly managed by hand hygiene, isolation, and patient cohorting.
- •Palivizumab controlled RSVNI in 10 studies after containment strategies failed.
- •RSVNI mortality was 8.0% (7/87) when infection control was solely employed.
- •Overall RSVNI-related mortality across the review of 17 articles was 8.5% (15/177).
Background
The main objective was to determine the incidence, management, and outcomes of respiratory
syncytial virus nosocomial infection (RSVNI) outbreaks in neonatal intensive care
units.
Methods
A comprehensive search of RSVNI in 9 databases was conducted from January 1, 2000
to May 1, 2021, of which the Cochrane Library comprised the Cochrane central register
of controlled trials and the Cochrane database of systematic reviews. Two hundred
and twenty-eight articles were retrieved and 17 were retained. A descriptive analysis
was performed, and frequencies are reported as mean, median, and range where pertinent.
Results
One hundred and seventeen infants were analyzed and comprised preterms (88.1%) and
those with pre-existing co-morbidities. The estimated proportional incidence of RSVNI
was 23.8% (177/744) infants. Outbreaks were principally managed by conventional protective
measures, neonatal intensive care unit closure, and visitor restriction. Palivizumab
was used to control RSVNI in 10 studies. RSVNI-related mortality was 8.5% (15/177)
and 8.0% (7/87) among infants where infection control was solely employed.
Conclusion
RSVNI is associated with significant morbidity and mortality. The use of palivizumab
should be a multidisciplinary decision, based on rapidly spreading infection. Prospective
studies are essential to determine the cost-benefit of palivizumab versus standard
prevention control for an RSVNI outbreak.
Key Words
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Article Info
Publication History
Published online: November 01, 2021
Footnotes
Conflicts of interest: BP has received compensation in the past as part of the speaker's bureau for AbbVie Corporation, Montreal, Canada. The rest of the authors (SAA, WK, STA, AA, AB) report no conflicts of interest.
Identification
Copyright
© 2021 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
