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

Chow, Eric J.; Mermel, Leonard A.

Respiratory viruses are transmitted in the hospital setting from direct contact with infected visitors and family, infected healthcare workers, other infected patients, indirectly through contact with contaminated fomites, or from patient-to-patient spread due to poor hand hygiene practices among healthcare providers. The frequency of specific respiratory viruses causing nosocomial infections reflects their activity in the community [1] . Few studies have assessed the outcomes of nosocomial respiratory viral infections in noncritically ill, non-immunocompromised adult and pediatric patients. In one study, 1 in 5 children admitted to a pediatric intensive care unit (ICU) due to a respiratory viral infection had acquired the infection in the hospital. These children had an approximately 6-fold increased likelihood of mortality compared with those who had community-acquired respiratory viral infections [2] . In another pediatric study, 49% of nosocomial respiratory viral infections occurred in premature infants [3] . One study in adult patients noted that 24% of nonventilated hospital-acquired pneumonias were caused by viruses [4] . These publications suggest that nosocomial respiratory viral infections can lead to significant morbidity and mortality. We investigated such cases in our adult and pediatric hospitals to better understand the magnitude of the problem and the outcomes of such infections.