Community respiratory viruses and healthcare-associated infections: epidemiological and clinical aspects.

ABSTRACT

BACKGROUND: Healthcare-associated infections (HAIs) impact morbidity, mortality, and hospitalization costs. The contribution of viruses to the overall burden of HAIs is not well described. AIM: To evaluate the prevalence and clinical findings in patients with HAIs caused by respiratory viruses. METHODS: An observational, analytical, cross-sectional study was conducted to evaluate patients with a viral nosocomial respiratory infection, occurring between January 2013 and December 2019. Outcomes, comorbidities, cause of hospitalization, seasonality, and presence of bacterial co-infection were assessed. FINDINGS: In all, 161 cases of HAIs with community respiratory viruses (CRVs) were identified through six years; 76.4% of patients had a median age of 2.8 years (interquartile range 0.28-15.4 years). The main comorbidities in immunosuppressed patients were haematologic neoplasia (46.5%), myelodysplastic syndrome (33.8%), and haematopoietic stem cell transplantation (18.3%). In non-immunosuppressed patients, the most prevalent comorbidities were prematurity (49.1%), respiratory tract diseases (21.0%), and congenital malformations (19.3%). The viruses detected were human rhinovirus (36.6%), respiratory syncytial virus (21.7%), and the parainfluenza group (18.6%). The fatality rate was low (4.6%), and a higher incidence of HAIs occurred in the CRV seasonality period in southern Brazil. CONCLUSION: CRV circulation in the hospital environment is frequent, and likely involves healthcare workers and visitors as well as patients. More guidance on preventive measures in healthcare settings is required. In addition, care teams should consider these aetiologic agents in the differential diagnosis of patients with nosocomial pneumonia, giving opportunities to limit antibiotic use.