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Infection control measures prevented nosocomial transmission of norovirus
Cheng VC. Infect Control Hosp Epidemiol. 2011;32(3):00-00 [Epub ahead of print Feb. 15, 2011].
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The implementation of strategic infection control measures prevented nosocomial outbreaks of norovirus infection and reduced the incidence for hospital-acquired infection in China, according to new findings published in Infection Control and Hospital Epidemiology.
Vincent C. C. Cheng, MD, of the department of microbiology at Queen Mary Hospital in Hong Kong, and colleagues set out to assess the use of strategic infection control measures, including timely staff education, promotion of observed hand hygiene and reverse transcription-polymerase chain reaction for norovirus, for all fecal specimens.
Confirmed cases were followed up by an infection control team between Nov. 1, 2009, and Feb. 28, 2010. The incidence for hospital-acquired norovirus infection per 1,000 potentially infectious patient-days was then compared with the previous year. Phylogenetic analysis of norovirus isolates was also performed. The other six hospital networks in Hong Kong served as the concurrent control.
Results indicated that 242 (25%) of 988 patients tested positive for norovirus, 114 (47%) of which were detected by strategic infection-control measures. Forty-three (93%) of 46 norovirus isolates sequenced belonged to the II.4 variant.
Of the 242 patients with confirmed norovirus infection, 100 patients were male vs. 142 females, with a median age of 57 years; 31% were aged 3 years or younger and 44% were aged 70 years or older
Hospital-acquired norovirus infection decreased from 131 cases per 1,000 potentially infectious patient-days to 16 cases per 1,000 potentially infectious patient-days (P<.001) compared with the preceding year.
Compared with the concurrent control (0.06 cases per 1,000 patient-days), the incidence for hospital-acquired norovirus infection was significantly lower (P=.015).
“The concept of using an added test for early recognition of any index case was simple but innovative,” the researchers wrote. “Without affecting the clinical workflow of the frontline medical and nursing staff, all fecal specimens referred to the microbiology laboratory were tested for norovirus [reverse transcription-polymerase chain reaction], regardless of the clinician’s request. The provision of rapid laboratory diagnostic testing facilitated timely intervention by our infection control team, who provided advice as to patient placement, isolation precautions, and thorough environmental disinfection with sodium hypochlorite, thus preventing an outbreak.”
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