Nosocomial respiratory syncytial virus infectionsin Zagreb hospitals

Nosocomial infections caused by the respiratory syncytial virus (RSV) are very common in children’s wards. In the 1985-94 period in several separate studies we examined intrahospital RSV infections in the children’s wards of Zagreb hospitals. RSV infection was documented by the detection of the virus in nasopharyngeal secretions using specific antibodies in immunofluorescent test and subsequently confirmed by isolation of the virus in cell culture using standard techniques. We thus found viral nosocomial infections to account for 42/173 (24.3%) of acute respiratory ill inpatients aged up to 3 years in 1985. Nosocomial RSV infections constituted 17/84 (20.2%) of the demonstrated respiratory viral infections. In the 1986/87 season, 20 of the 44 (45.5%) neonates were affected by a proved nosocomial RSV infection. Among RSV-positive neonates 9/20 (45%) had upper respiratory tract infections, 2/20 (10%) bronchiolitis, 4/20 (20%) pneumonia and 4/20 (20%) bronchitis. In the period 1988-94 we studied RSV lower respiratory tract infections (LRTI) which showed 42 patients of the 201 (21%) to have a hospital-acquired RSV- LRTI. Bronchitis was the most common diagnosis, in 20/42 (47.6%). The largest number of nosocomial infections 19/42 (45.2%) were observed in infants aged up to 6 months.
Guidelines for the prevention of RSV nosocomial infection are given.