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Sang L, Gong X, Huang Y, Zhang L, Sun J. Immunotherapeutic implications on targeting the cytokines produced in rhinovirus-induced immunoreactions. FRONTIERS IN ALLERGY 2024; 5:1427762. [PMID: 38859875 PMCID: PMC11163110 DOI: 10.3389/falgy.2024.1427762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Accepted: 05/13/2024] [Indexed: 06/12/2024] Open
Abstract
Rhinovirus is a widespread virus associated with several respiratory diseases, especially asthma exacerbation. Currently, there are no accurate therapies for rhinovirus. Encouragingly, it is found that during rhinovirus-induced immunoreactions the levels of certain cytokines in patients' serum will alter. These cytokines may have pivotal pro-inflammatory or anti-inflammatory effects via their specific mechanisms. Thus far, studies have shown that inhibitions of cytokines such as IL-1, IL-4, IL-5, IL-6, IL-13, IL-18, IL-25, and IL-33 may attenuate rhinovirus-induced immunoreactions, thereby relieving rhinovirus infection. Furthermore, such therapeutics for rhinovirus infection can be applied to viruses of other species, with certain practicability.
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Affiliation(s)
- Le Sang
- Department of Medicine, Shaoxing University, Shaoxing City, Zhejiang Province, China
| | - Xia Gong
- Department of Medicine, Shaoxing University, Shaoxing City, Zhejiang Province, China
| | - Yunlei Huang
- Department of Medicine, Shaoxing University, Shaoxing City, Zhejiang Province, China
| | - Linling Zhang
- Department of Respiratory Medicine, Shaoxing People’s Hospital, Shaoxing City, Zhejiang Province, China
| | - Jian Sun
- Department of Respiratory Medicine, Shaoxing People’s Hospital, Shaoxing City, Zhejiang Province, China
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Thampi N, Guzman-Cottrill J, Bartlett AH, Berg W, Cantey JB, Kitt E, Ravin K, Zangwill KM, Elward A. SHEA NICU white paper series: Practical approaches for the prevention of viral respiratory infections. Infect Control Hosp Epidemiol 2024; 45:267-276. [PMID: 37877172 DOI: 10.1017/ice.2023.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023]
Abstract
This white paper provides clinicians and hospital leaders with practical guidance on the prevention and control of viral respiratory infections in the neonatal intensive care unit (NICU). This document serves as a companion to Centers for Disease Control and Prevention Healthcare Infection Control Practices Advisory Committee (HICPAC)'s "Prophylaxis and Screening for Prevention of Viral Respiratory Infections in Neonatal Intensive Care Unit Patients: A Systematic Review." It provides practical, expert opinion and/or evidence-based answers to frequently asked questions about viral respiratory detection and prevention in the NICU. It was developed by a writing panel of pediatric and pathogen-specific experts who collaborated with members of the HICPAC systematic review writing panel and the SHEA Pediatric Leadership Council to identify questions that should be addressed. The document has been endorsed by SHEA, the American Hospital Association (AHA), The Joint Commission, the Pediatric Infectious Diseases Society (PIDS), the Association for Professionals in Infection Control and Epidemiology (APIC), the Infectious Diseases Society of America (IDSA), and the National Association of Neonatal Nurses (NANN).
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Affiliation(s)
- Nisha Thampi
- Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | | | - Allison H Bartlett
- University of Chicago and Comer Children's Hospital, Chicago, Illinois, USA
| | - Wendy Berg
- Children's Minnesota, St. Paul, Minnesota, USA
| | - Joseph B Cantey
- The University of Texas Health Science Center, San Antonio, Texas, USA
| | - Eimear Kitt
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Karen Ravin
- Nemours Children's Health, Wilmington, Delaware, USA
| | | | - Alexis Elward
- Washington University School of Medicine, St. Louis, Missouri, USA
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Zahradnik S, Tsampalieros A, Okeny-Owere J, Webster RJ, Bedard P, Seidman G, Thampi N. Hand hygiene knowledge and practices of family caregivers in inpatient pediatrics. Infect Control Hosp Epidemiol 2024; 45:253-256. [PMID: 37728055 DOI: 10.1017/ice.2023.204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
Family caregivers are essential inpatient pediatric care partners, yet their handwashing knowledge and compliance are rarely studied. Through hand hygiene audits and self-administered questionnaires, we observed 9% compliance, significantly lower than self-reported practice. We suggest interventions to improve caregiver handwashing behaviors to decrease infection transmission risk to hospitalized children.
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Affiliation(s)
- Stephanie Zahradnik
- Department of Pediatrics, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
| | - Anne Tsampalieros
- Children's Hospital of Eastern Ontario, Clinical Research Unit, Ottawa, Ontario, Canada
| | - James Okeny-Owere
- Department of Chemistry and Biomolecular Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Richard J Webster
- Children's Hospital of Eastern Ontario, Clinical Research Unit, Ottawa, Ontario, Canada
| | - Pat Bedard
- Infection Prevention and Control Program, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Gillian Seidman
- Department of Pediatrics, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
- Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Nisha Thampi
- Department of Pediatrics, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
- Infection Prevention and Control Program, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
- Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
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Kitt E, Handy LK, Coffin SE. Response to: What will be the precaution for healthcare-associated rhinovirus infection outbreaks? Am J Infect Control 2023; 51:359. [PMID: 36804102 DOI: 10.1016/j.ajic.2022.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 10/28/2022] [Indexed: 02/18/2023]
Affiliation(s)
- Eimear Kitt
- Division of Infectious Diseases, Children's Hospital of Philadelphia, PA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Department of Infection Prevention and Control, Children's Hospital of Philadelphia, PA.
| | - Lori K Handy
- Division of Infectious Diseases, Children's Hospital of Philadelphia, PA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Department of Infection Prevention and Control, Children's Hospital of Philadelphia, PA
| | - Susan E Coffin
- Division of Infectious Diseases, Children's Hospital of Philadelphia, PA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Department of Infection Prevention and Control, Children's Hospital of Philadelphia, PA
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Perform hand hygiene and the doors will open - the effectiveness of new system implementation on Paediatric Intensive Care Unit visitors' handwashing compliance. Epidemiol Infect 2021; 150:e3. [PMID: 34915960 PMCID: PMC8755529 DOI: 10.1017/s0950268821002582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Hand hygiene (HH) performance on entering intensive care units (ICUs) is commonly accepted but often inadequately performed. We developed a simple, inexpensive module that connects touchless dispensers of alcohol sanitiser (TDAS) to the automatic doors of a paediatric ICU, and assessed the impact of this intervention on HH compliance of hospital staff and visitors. A prospective observational study was conducted over a 3-week period prior to the intervention, followed by a 4-week period post intervention. HH performance was monitored by a research assistant whose office location enabled direct and video-assisted observation of the ICU entrance. A total of 609 entries to the ICU was recorded. Overall HH performance was 46.9% (92/196) before and 98.5% (406/413) after the intervention. Our findings suggest that HH performance on entering an ICU can be improved via a mechanism that makes operation of an automatic door dependent on use of a TDAS system, and thus contribute to infection control.
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Abstract
Although many aspects of infection prevention and control (IPC) mirror institutional efforts, optimization of IPC practices in the neonatal intensive care unit requires careful consideration of its unique population and environment, addressed here for key IPC domains. In addition, innovative mitigation efforts to address challenges specific to limited resource settings are discussed.
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Wee LEI, Conceicao EP, Tan JY, Magesparan KD, Amin IBM, Ismail BBS, Toh HX, Jin P, Zhang J, Wee EGL, Ong SJM, Lee GLX, Wang AEM, How MKB, Tan KY, Lee LC, Phoon PC, Yang Y, Aung MK, Sim XYJ, Venkatachalam I, Ling ML. Unintended consequences of infection prevention and control measures during COVID-19 pandemic. Am J Infect Control 2021; 49:469-477. [PMID: 33157180 PMCID: PMC7610096 DOI: 10.1016/j.ajic.2020.10.019] [Citation(s) in RCA: 79] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 10/26/2020] [Accepted: 10/26/2020] [Indexed: 01/02/2023]
Abstract
BACKGROUND In the current COVID-19 pandemic, aggressive Infection Prevention and Control (IPC) measures have been adopted to prevent health care-associated transmission of COVID-19. We evaluated the impact of a multimodal IPC strategy originally designed for the containment of COVID-19 on the rates of other hospital-acquired-infections (HAIs). METHODOLOGY From February-August 2020, a multimodal IPC strategy was implemented across a large health care campus in Singapore, comprising improved segregation of patients with respiratory symptoms, universal masking and heightened adherence to Standard Precautions. The following rates of HAI were compared pre- and postpandemic: health care-associated respiratory-viral-infection (HA-RVI), methicillin-resistant Staphylococcus aureus, and CP-CRE acquisition rates, health care-facility-associated C difficile infections and device-associated HAIs. RESULTS Enhanced IPC measures introduced to contain COVID-19 had the unintended positive consequence of containing HA-RVI. The cumulative incidence of HA-RVI decreased from 9.69 cases per 10,000 patient-days to 0.83 cases per 10,000 patient-days (incidence-rate-ratio = 0.08; 95% confidence interval [CI] = 0.05-0.13, P< .05). Hospital-wide MRSA acquisition rates declined significantly during the pandemic (incidence-rate-ratio = 0.54, 95% CI = 0.46-0.64, P< .05), together with central-line-associated-bloodstream infection rates (incidence-rate-ratio = 0.24, 95% CI = 0.07-0.57, P< .05); likely due to increased compliance with Standard Precautions. Despite the disruption caused by the pandemic, there was no increase in CP-CRE acquisition, and rates of other HAIs remained stable. CONCLUSIONS Multimodal IPC strategies can be implemented at scale to successfully mitigate health care-associated transmission of RVIs. Good adherence to personal-protective-equipment and hand hygiene kept other HAI rates stable even during an ongoing pandemic where respiratory infections were prioritized for interventions.
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Affiliation(s)
- Liang En Ian Wee
- Singhealth Infectious Diseases Residency, Singapore; Department of Infectious Diseases, Singapore General Hospital, Singapore.
| | - Edwin Philip Conceicao
- Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore
| | - Jing Yuan Tan
- Department of Internal Medicine, Singapore General Hospital, Singapore
| | - Kamini Devi Magesparan
- Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore
| | | | | | - Hui Xian Toh
- Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore
| | - Pinhong Jin
- Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore
| | - Jing Zhang
- Department of Nursing Speciality Care Unit, National Heart Centre, Singapore
| | - Elaine Geok Ling Wee
- Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore
| | - Sheena Jin Min Ong
- Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore
| | - Gillian Li Xin Lee
- Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore
| | - Amanda En-Min Wang
- Department of Nursing Speciality Care Unit, National Heart Centre, Singapore
| | - Molly Kue Bien How
- Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore
| | - Kwee Yuen Tan
- Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore
| | - Lai Chee Lee
- Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore
| | - Poh Choo Phoon
- Department of Nursing Speciality Care Unit, National Heart Centre, Singapore
| | - Yong Yang
- Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore
| | - May Kyawt Aung
- Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore
| | - Xiang Ying Jean Sim
- Department of Infectious Diseases, Singapore General Hospital, Singapore; Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore
| | - Indumathi Venkatachalam
- Department of Infectious Diseases, Singapore General Hospital, Singapore; Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore
| | - Moi Lin Ling
- Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore.
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Bailey J, Dutton T, Hawke C, Illife J, Kirkby M, Smart SL, O'Brien P, Paxton K, Shaban RZ, Thomas L, Wharton S. Exploring rural patients' understanding of the types, risk factors and measures to prevent healthcare-associated infections in Australia. Infect Dis Health 2020; 26:31-37. [PMID: 33051153 DOI: 10.1016/j.idh.2020.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 08/04/2020] [Accepted: 08/09/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND In Australia, there are approximately 165,000 healthcare-associated infections (HAIs) per year. Improving patient knowledge on HAIs and actively involving them in infection prevention is essential. This study assessed patient knowledge on types of and risk factors for HAIs and their perceptions of HAI information provision and hospital infection control practices in rural New South Wales, Australia. METHODS Medical and surgical ward patients in three rural hospitals completed a questionnaire between February and March 2019. Open ended responses were grouped under categories, decided upon by two researchers, one of which is an infection prevention and control nurse. Descriptive analysis was completed. RESULTS A total of 153 patients completed the survey. Most (n = 126, 82%) participants were previously aware of HAIs, with common sources of education/information being family/friends (n = 55, 36%), television (n = 28, 18%), newspapers (n = 27, 18%), and previous experience of a HAI (n = 20, 13%). Satisfaction with infection control measures and hospital cleanliness was high. Over half (n = 83, 54%) of participants thought they received too little information on HAIs, and only 35% (n = 21) of those that had surgery reported receiving information. Participants suggested that more education for the general public (n = 117, 76%) and patients (n = 110, 72%) in both written form and verbally from hospital staff, and education outside of the hospital in various mediums, could help reduce the risk and rates of HAI. CONCLUSION Awareness of HAIs amongst respondents was high, however, education appeared to be lacking. More can be done to inform patient, family and general public education programs in rural and regional Australian hospitals.
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Affiliation(s)
- Jannine Bailey
- Bathurst Rural Clinical School, School of Medicine, Western Sydney University, PO Box 9008, Bathurst NSW 2795, Australia; Western NSW Health Research Network, NSW, Australia
| | - Tegan Dutton
- Bathurst Rural Clinical School, School of Medicine, Western Sydney University, PO Box 9008, Bathurst NSW 2795, Australia; Western NSW Health Research Network, NSW, Australia.
| | - Catherine Hawke
- School of Rural Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Orange, 2800, Australia; Western NSW Health Research Network, NSW, Australia
| | - Jessica Illife
- Dubbo Base Hospital, Western New South Wales Local Health District, NSW, Australia; Western NSW Health Research Network, NSW, Australia
| | - Michelle Kirkby
- Dubbo Base Hospital, Western New South Wales Local Health District, NSW, Australia; Western NSW Health Research Network, NSW, Australia
| | - Suzanne Lovell Smart
- Orange Health Service, Western New South Wales Local Health District, NSW, Australia; Western NSW Health Research Network, NSW, Australia
| | - Peta O'Brien
- School of Rural Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Orange, 2800, Australia; Western NSW Health Research Network, NSW, Australia
| | - Karen Paxton
- School of Rural Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Orange, 2800, Australia; Western NSW Health Research Network, NSW, Australia
| | - Ramon Z Shaban
- Susan Wakil School of Nursing and Midwifery & Marie Bashir Institute for Infectious Diseases and Biosecurity, Faculty of Medicine and Health, University of Sydney, NSW, Australia; Department of Infectious Diseases and Sexual Health, Westmead Hospital, Western Sydney Local Health District, Westmead, NSW, Australia
| | - Linda Thomas
- Bathurst Base Hospital, Western New South Wales Local Health District, NSW, Australia; Western NSW Health Research Network, NSW, Australia
| | - Sandra Wharton
- Western New South Wales Local Health District, Australia; Western NSW Health Research Network, NSW, Australia
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Matienzo N, Youssef MM, Comito D, Lane B, Ligon C, Morita H, Winchester A, Decker ME, Dayan P, Shopsin B, Shaman J. Respiratory viruses in pediatric emergency department patients and their family members. Influenza Other Respir Viruses 2020; 15:91-98. [PMID: 33210476 PMCID: PMC7767945 DOI: 10.1111/irv.12789] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 06/21/2020] [Accepted: 06/29/2020] [Indexed: 01/09/2023] Open
Abstract
Background Respiratory viral infections account for a substantial fraction of pediatric emergency department (ED) visits. We examined the epidemiological patterns of seven common respiratory viruses in children presenting to EDs with influenza‐like illness (ILI). Additionally, we examined the co‐occurrence of viral infections in the accompanying adults and risk factors associated with the acquisition of these viruses. Methods Nasopharyngeal swab were collected from children seeking medical care for ILI and their accompanying adults (Total N = 1315). Study sites included New York Presbyterian, Bellevue, and Tisch hospitals in New York City. PCR using a respiratory viral panel was conducted, and data on symptoms and medical history were collected. Results Respiratory viruses were detected in 399 children (62.25%) and 118 (17.5%) accompanying adults. The most frequent pathogen detected was human rhinovirus (HRV) (28.81%). Co‐infection rates were 14.79% in children and 8.47% in adults. Respiratory syncytial virus (RSV) and parainfluenza infections occurred more often in younger children. Influenza and HRV occurred more often in older children. Influenza and coronavirus were mostly isolated in winter and spring, RSV in fall and winter and HRV in fall and spring. Children with HRV were more likely to have history of asthma. Adults with the same virus as their child often accompanied ≤ 2‐year‐old‐positive children and were more likely to be symptomatic compared to adults with different viruses. Conclusions Respiratory viruses, while presenting the same suite of symptoms, possess distinct seasonal cycles and affect individuals differently based on a number of identifiable factors, including age and history of asthma.
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Affiliation(s)
- Nelsa Matienzo
- Environmental Health Sciences Department, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Mariam M Youssef
- Environmental Health Sciences Department, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Devon Comito
- Environmental Health Sciences Department, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Benjamin Lane
- Environmental Health Sciences Department, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Chanel Ligon
- Environmental Health Sciences Department, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Haruka Morita
- Environmental Health Sciences Department, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Arianna Winchester
- Division of Infectious Diseases, Department of Medicine, NYU School of Medicine, New York, NY, USA
| | - Mary E Decker
- Division of Infectious Diseases, Department of Medicine, NYU School of Medicine, New York, NY, USA
| | - Peter Dayan
- Department of Pediatrics, Columbia University Irving Medical center, New York, NY, USA
| | - Bo Shopsin
- Division of Infectious Diseases, Department of Medicine, NYU School of Medicine, New York, NY, USA
| | - Jeffrey Shaman
- Environmental Health Sciences Department, Mailman School of Public Health, Columbia University, New York, NY, USA
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Beyond personal protective equipment: adjunctive methods for control of healthcare-associated respiratory viral infections. Curr Opin Infect Dis 2020; 33:312-318. [PMID: 32657968 DOI: 10.1097/qco.0000000000000655] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE OF REVIEW Prevention of nosocomial transmission of respiratory viruses is a priority in all healthcare settings and often achieved with the use of personal protective equipment. Several adjunctive infection prevention methods are in common use but their effectiveness in reducing healthcare-associated respiratory viral infections is unclear. In this review, recent advances regarding the effectiveness of several adjunctive infection prevention methods to reduce healthcare-associated respiratory viral infections are discussed. RECENT FINDINGS Training and education on hand hygiene guidelines, mandatory influenza vaccination for healthcare personnel, access to paid sick leave to reduce ill presenteeism, cohorting of patients with the same infection or clinical syndrome, neuraminidase inhibitor chemoprophylaxis during influenza outbreaks, and enhanced visitor restrictions in pediatric hospitals all have shown some degree of effectiveness in observational or quasi-experimental studies. SUMMARY Most of the studies evaluating the effect of adjunctive infection prevention methods on healthcare-associated respiratory viral infections are observational or quasi-experimental and are often combined with other interventions. Therefore, it is difficult to determine the precise effectiveness or efficacy of these interventions and more controlled trials are needed. Multimodal infection prevention policies are likely to be most effective in reducing healthcare-associated respiratory viral infections.
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