ABSTRACT
PURPOSE/OBJECTIVES: To determine if children or the number of contacts living in an immediate household increases the risk of community respiratory virus (CRV) acquisition in hematopoietic stem cell transplantation (HSCT) recipients. DESIGN: Retrospective, exploratory study. SETTING: National Cancer Institute-designated comprehensive cancer center located in the Southeast. SAMPLE: 720 adult outpatients post-autologous or allogeneic HSCT. METHODS: Data were gathered using a retrospective medical record review from July 1, 2006, to December 31, 2009. Summary statistics were used to describe sample characteristics. Binary logistic regression was used to determine whether the number of household member contacts or number of children in each age group was a significant predictor of CRV infection. Multivariate linear regression was used to investigate predictors of the number of CRV infections. MAIN RESEARCH VARIABLES: The dependent variable was acquisition of CRV infection. Independent variables included the number of children in the household and the number of household members. FINDINGS: Across all HSCT recipients, children aged 0-4 years (p = 0.01) and 5-12 years (p = 0.001) predicted CRV infection. The allogeneic group had the greatest incidence of CRV infection and was most sensitive to the presence of young children. The total number of household members was not a predictor of CRV infection. CONCLUSIONS: Households with children aged 12 years and younger more than doubled the risk of an HSCT recipient acquiring CRV infection. Additional studies are needed to test interventions designed to interrupt household transmission of CRV infection from children to vulnerable HSCT recipients. IMPLICATIONS FOR NURSING: Household contacts, particularly children, should be included in HSCT teaching. As indicated by the potentially high number of days from transplantation to acquisition of CRV infection, re-education and continuing focus on prevention of CRV infection should be reinforced throughout the lengthy transplantation period.
Subject(s)
Family Health , Hematopoietic Stem Cell Transplantation , Postoperative Complications/virology , Respiratory Tract Infections/virology , Adolescent , Child , Child, Preschool , Community-Acquired Infections/epidemiology , Community-Acquired Infections/virology , Female , Humans , Infant , Male , Middle Aged , Postoperative Complications/epidemiology , Respiratory Tract Infections/epidemiology , Retrospective StudiesABSTRACT
Klebsiella producing carbapenemase is an emerging pathogen. We report transmission of this organism by contaminated endoscopic instruments. Quick identification of source, staff education, contact precautions, and emphasis on hand and environmental hygiene led to case control and prevention of outbreak.
