Visitor Restriction Policy on Pediatric Wards During Novel Coronavirus (COVID-19) Outbreak: A Survey Study Across North America.

Visitor restriction policies in pediatric wards during the novel coronavirus (COVID-19) outbreak are variable. Among 36 hospitals that responded to our survey, 97% allowed at least 1 visitor, with 67% restricting to 1 caregiver. Sixty-nine percent required the visitor to wear personal protective equipment and only 19% allowed non-household visitors.

An outbreak of vancomycin-resistant Enterococcus faecium in an acute care pediatric hospital: Lessons from environmental screening and a case-control study.

BACKGROUND: The present study describes a vancomycin-resistant enterococci (VRE) outbreak investigation and a case-control study to identify risk factors for VRE acquisition in a tertiary care pediatric hospital. OBJECTIVE: To report an outbreak investigation and a case-control study to identify risk factors for VRE colonization or infection in hospitalized children. METHODS: Screening for VRE cases was performed by culture or polymerase chain reaction. A case-control study of VRE-colonized patients was undertaken. Environmental screening was performed using standard culture and susceptibility methods, with pulsed-field gel electrophoresis to determine relationships between VRE isolates. Statistical analysis was performed using SAS version 9.0 (SAS Institute Inc, USA). RESULTS: Thirty-four VRE-positive cases were identified on 10 wards between February 28, 2005, and May 27, 2005. Pulsed-field gel electrophoresis analysis confirmed a single outbreak strain that was also isolated from a video game found on one affected ward. Multivariate analysis identified cephalosporin use as the major risk factor for VRE colonization. CONCLUSIONS: In the present study outbreak, VRE colonization was significantly associated with cephalosporin use. Because shared recreational items and environmental surfaces may be colonized by VRE, they warrant particular attention in housekeeping protocols, particularly in pediatric institutions.

Survey of isolation practices at a tertiary care pediatric hospital.

BACKGROUND: Although isolation precautions are an important aspect of hospital infection control, current rates of isolation in a pediatric hospital and rates of compliance with established precautions are unknown. We therefore initiated hospital-wide point prevalence studies to determine unit-specific rates of patient isolation and compliance with proper isolation requirements focusing on communication of isolation status and availability of personal protective equipment. In this report, we present data from the first 14 months of the study. METHODS: This was a prospective observational study. Twice monthly, between January 2004 and February 2005, infection control professionals reviewed the types and appropriateness of isolation of all hospitalized patients, except for those on the psychiatry unit. RESULTS: Seventeen percent of patients in the hospital during the study period were isolated, most frequently for community-acquired infections. Droplet isolation precautions were the most common form of isolation. Overall, only 74.6% of patients were isolated appropriately. The solid organ transplantation, hematology/oncology, and bone marrow transplantation units were those with the highest rates of inappropriate isolation. CONCLUSION: At our hospital, community-acquired infections, in particular respiratory infections, were the most common reasons for patient isolation. Monitoring of the appropriateness of isolation precautions offers the opportunity to reduce health care-related transmission of infection and identify specific target areas for improvement.

Enteral tube hub as a reservoir for transmissible enteric bacteria.

Enteral feeding is a risk factor for cross transmission of microbes. Administration set tubing can be colonized by organisms present in the enteral tube hub; molecular typing has demonstrated genetic relatedness of enteric bacteria isolated from both sites. Strict attention to infection control measures is imperative when handling enteral feed apparatuses.

Microbial contamination of enteral feed administration sets in a pediatric institution.

BACKGROUND: Enteral feeding tubes have been associated with outbreaks of antimicrobial-resistant organisms, but the pathogenesis of this association has not been investigated. We hypothesized that the enteral feed administration sets become colonized externally by microbes grown from the enteral tube hub, and therefore serve as a reservoir of organisms that can be crosstransmitted. METHODS: We conducted a prospective observational cohort pilot study, obtaining bacterial cultures from the external enteral feed administration set and from the hub of nasogastric, gastric, or gastrojejunal tubes in children receiving enteral feeding while hospitalized in a tertiary care pediatric hospital. RESULTS: Thirty-six of 37 hubs cultured had bacterial growth. Twenty-nine of 36 administration sets (78%) sampled had at least 1 microbe isolated that was also cultured from the hub. No significant risk factors for colonization were identified. CONCLUSIONS: Enteral feed administration sets are frequently colonized by organisms in the enteral tube hub. These sets can serve as a reservoir of organisms that can be crosstransmitted between patients. Adherence to Standard Precautions is critical when handling enteral feeding apparatuses.