Impact of enhanced public health and infection control measures on pediatric hospital-acquired respiratory viral infections during the SARS-CoV-2 pandemic

Abstract

BACKGROUND: Visitor restrictions and mask-wearing may reduce hospital-acquired infections (HAI) as part of infection control bundles. The impact of a strict visitor policy and compulsory surgical mask wearing implemented during the SARS-CoV-2 pandemic, but prior to any local community circulating SARS-CoV-2, on the rates of hospital-acquired respiratory viral infections (HA-RVI) was assessed. METHODS: Retrospective audit of a local HAI database for HA-RVI from 1st April 2019 to 29th March 2021 in a tertiary children's hospital. HA-RVI were standardized against occupied bed days (OBD) and admitted community acquired infections (CAI). Rates of HA-RVI were compared during 52 weeks of SARS-CoV-2-associated enhanced control periods (visitor restrictions with and without universal surgical masking), against 52 weeks standard practice. Total respiratory virus infections, respiratory syncytial virus (RSV), and rhinovirus infections were analysed. RESULTS: Comparing standard practice with enhanced measures, 42 v 15 HA-RVI and 1517 v 691 CAI were noted. Enhanced infection controls resulted in significant reductions in total HA-RVI when adjusted for OBD (p = 0.0038) and CAI (p = 0.0122). Non-significant decreases were seen in hospital-acquired respiratory syncytial virus (HA-RSV) adjusted for both CAI and OBD. Visitor restrictions combined with universal surgical masks significantly decreased adjusted total HA-RVI compared with visitor restrictions alone (adjusted for OBD p = 0.0123; adjusted for CAI p = 0.0429). HA-RSV decreased non-significantly when mask wearing was combined with visitor restrictions compared with visitor restrictions alone. HA-rhinovirus infections did not decrease with the addition of masks to visitor restrictions. CONCLUSION: Enhanced infection control measures introduced with SARS-CoV-2 pandemic decreased some HA-RVI. Universal surgical mask wearing decreased HAI rates more than visitor restrictions alone, except for rhinovirus where the HAI rate remained unchanged.