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

Respiratory 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 We reviewed published and unpublished literature from hospital settings to assess: (i) nosocomial RSV transmission risk (attack rate) d...

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Main Authors: French, Clare E., McKenzie, Bruce C., Coope, Caroline, Rajanaidu, Subhadra, Paranthaman, Karthik, Pebody, Richard, Nguyen-Van-Tam, Jonathan S., Higgins, Julian P.T., Beck, Charles R.
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Published: Wiley 2016
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Online Access:https://eprints.nottingham.ac.uk/37677/
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author French, Clare E.
McKenzie, Bruce C.
Coope, Caroline
Rajanaidu, Subhadra
Paranthaman, Karthik
Pebody, Richard
Nguyen-Van-Tam, Jonathan S.
Higgins, Julian P.T.
Beck, Charles R.
author_facet French, Clare E.
McKenzie, Bruce C.
Coope, Caroline
Rajanaidu, Subhadra
Paranthaman, Karthik
Pebody, Richard
Nguyen-Van-Tam, Jonathan S.
Higgins, Julian P.T.
Beck, Charles R.
author_sort French, Clare E.
building Nottingham Research Data Repository
collection Online Access
description Respiratory 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 We reviewed published and unpublished literature from hospital settings to assess: (i) nosocomial RSV transmission risk (attack rate) during outbreaks, (ii) effectiveness of infection control measures. We 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. Forty 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. We conclude that RSV 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.
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spelling nottingham-376772020-05-04T17:40:39Z https://eprints.nottingham.ac.uk/37677/ Risk of nosocomial respiratory syncytial virus infection and effectiveness of control measures to prevent transmission events: a systematic review French, Clare E. McKenzie, Bruce C. Coope, Caroline Rajanaidu, Subhadra Paranthaman, Karthik Pebody, Richard Nguyen-Van-Tam, Jonathan S. Higgins, Julian P.T. Beck, Charles R. Respiratory 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: (i) nosocomial RSV transmission risk (attack rate) during outbreaks, (ii) effectiveness of infection control measures. We 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. Forty 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. We conclude that RSV 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. Wiley 2016-03-24 Article PeerReviewed French, Clare E., McKenzie, Bruce C., Coope, Caroline, Rajanaidu, Subhadra, Paranthaman, Karthik, Pebody, Richard, Nguyen-Van-Tam, Jonathan S., Higgins, Julian P.T. and Beck, Charles 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, 10 (4). pp. 268-290. ISSN 1750-2659 Infection control nosocomial infections palivizumab personal protective equipment respiratory syncytial virus http://onlinelibrary.wiley.com/doi/10.1111/irv.12379/abstract doi:10.1111/irv.12379 doi:10.1111/irv.12379
spellingShingle Infection control nosocomial infections palivizumab personal protective equipment respiratory syncytial virus
French, Clare E.
McKenzie, Bruce C.
Coope, Caroline
Rajanaidu, Subhadra
Paranthaman, Karthik
Pebody, Richard
Nguyen-Van-Tam, Jonathan S.
Higgins, Julian P.T.
Beck, Charles R.
Risk of nosocomial respiratory syncytial virus infection and effectiveness of control measures to prevent transmission events: a systematic review
title Risk of nosocomial respiratory syncytial virus infection and effectiveness of control measures to prevent transmission events: a systematic review
title_full Risk of nosocomial respiratory syncytial virus infection and effectiveness of control measures to prevent transmission events: a systematic review
title_fullStr Risk of nosocomial respiratory syncytial virus infection and effectiveness of control measures to prevent transmission events: a systematic review
title_full_unstemmed Risk of nosocomial respiratory syncytial virus infection and effectiveness of control measures to prevent transmission events: a systematic review
title_short Risk of nosocomial respiratory syncytial virus infection and effectiveness of control measures to prevent transmission events: a systematic review
title_sort risk of nosocomial respiratory syncytial virus infection and effectiveness of control measures to prevent transmission events: a systematic review
topic Infection control nosocomial infections palivizumab personal protective equipment respiratory syncytial virus
url https://eprints.nottingham.ac.uk/37677/
https://eprints.nottingham.ac.uk/37677/
https://eprints.nottingham.ac.uk/37677/