Risk of nosocomial respiratory syncytial virus infection and effectiveness of control measures to prevent transmission events: a systematic review

Autor: Subhadra Rajanaidu, Karthik Paranthaman, Charles R. Beck, Bruce C. McKenzie, Caroline Coope, Richard Pebody, Clare E French, Julian P T Higgins, Jonathan S. Nguyen-Van-Tam
Jazyk: angličtina
Rok vydání: 2016
Předmět:
Zdroj: Influenza and Other Respiratory Viruses
French, C E, McKenzie, B, Coope, C M, Rajanaidu, S, Paranthaman, K, Pebody, R, Nguyen-Van-Tam, J, Higgins, J P T & Beck, C R 2016, ' Risk of nosocomial respiratory syncytial virus infection and effectiveness of control measures to prevent transmission events : a systematic review ', Influenza and Other Respiratory Viruses, vol. 10, no. 4, pp. 268-290 . https://doi.org/10.1111/irv.12379
ISSN: 1750-2640
1750-2659
DOI: 10.1111/irv.12379
Popis: AimRespiratory syncytial virus (RSV) causes a significant public health burden, and outbreaks among vulnerable patients in hospital settings are of particular concern. We reviewed published and unpublished literature from hospital settings to assess: 1) nosocomial RSV transmission risk (attack rate) during outbreaks, 2) effectiveness of infection control measures.MethodWe searched the following databases: MEDLINE, EMBASE, CINAHL, Cochrane Library, together with key websites, journals and grey literature, to end of 2012. Risk of bias was assessed using the Cochrane risk of bias tool or Newcastle-Ottawa scale. A narrative synthesis was conducted.ResultsForty studies were included (19 addressing research question one, 21 addressing question two). RSV transmission risk varied by hospital setting; 6%–56% (median: 28.5%) in neonatal/paediatric settings (n=14), 6–12% (median: 7%) in adult haematology and transplant units (n=3), and 30–32% in other adult settings (n=2). For question two, most studies (n=13) employed multi-component interventions (e.g. cohort nursing, personal protective equipment (PPE), isolation), and these were largely reported to be effective in reducing nosocomial transmission. Four studies examined staff PPE; eye protection appeared more effective than gowns and masks. One study reported on RSV prophylaxis for patients (RSV-Ig/palivizumab); there was no statistical evidence of effectiveness although the sample size was small. Overall, risk of bias for included studies tended to be high.ConclusionRSV transmission risk varies widely during hospital outbreaks. Although multi-component control strategies appear broadly successful, further research is required to disaggregate the effectiveness of individual components including the potential role of palivizumab prophylaxis.
Databáze: OpenAIRE
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