Hospital-Acquired Respiratory Viral Infections: Incidence, Morbidity, and Mortality in Pediatric and Adult Patients

Chow, Eric J.; Mermel, Leonard A.

Unfortunately, many community hospitals may not perform testing for respiratory viruses beyond rapid influenza testing. Thus, cases of nosocomial respiratory viral infections are often unrecognized. In addition, healthcare providers may not have a high index of suspicion for such hospital-acquired viral infections. As more hospitals use improved laboratory testing for such viruses, there will be a greater appreciation of the risk of such infections in hospitalized patients, a better understanding of their modes of transmission, and ultimately fewer such cases in the future [21] . Educating healthcare providers regarding the risk they pose to their patients when they are infected with respiratory viruses is vitally important, as well as changes in the culture of healthcare providers by dealing with the guilt they feel when they do not report to work with symptoms of a respiratory viral infection [22] . Our study has several potential limitations. It is unclear whether all of the viruses identified were the cause of active infection, or whether their presence in some cases reflected respiratory tract colonization or recent respiratory viral infection. Although diagnostic testing is recommended in our hospital policy for patients admitted with suspected respiratory viral infections, we do not know the compliance with this policy, and we may have underestimated the incidence of such infections. We also may have missed cases in patients who had symptom onset after hospital discharge. Our data was collected over 1 year on 1 hospital campus in the Northeastern United States, and it may not reflect the risk of such infections in different geographic regions, in hospitals with different patient populations, or those with different infection control and occupational health policies. Finally, the retrospective nature of our study required us to rely on established documentation in the patient's medical record. Despite these limitations, we hope our findings will lead to a greater awareness of such infections and changes in hospital infection control policies regarding testing of patients with suggestive symptomatology, assessment of visitor restriction policies, and review of sick leave policies to potentially mitigate risk of such infections in future patients.