Prevention and Control of viral respiratory infections. Strategies implemented in a tertiary care pediatric hospital to reduce Non-Ventilator Associated Pneumonias
F Ortega-Riosvelasco, A C Guerrero-Díaz, D de la Rosa-Zamboni, A E Gamiño-Arroyo, P A Mejía-Rosales, M Medina-Pelcastre, V E López-Moreno, S A Estrada-Chacón, R Moreno-López, I S Pérez-Campos, M F Guzmán-Racini, M Torres-García, F J Prado-GalbarroAbstract
Background
The COVID-19 pandemic marked a milestone in modern Infection Prevention and Control (IPC) strategies, raising awareness among healthcare personnel about the risk of transmission of respiratory pathogens within hospitals. Although these optimal changes were implemented with the intention to prevent the spread of SARS-CoV-2, many of these strategies also helped prevent other nosocomial respiratory infections.
Methods
Ambispective analytical cohort study that compares the rates of HAIs and Non-Ventilator Associated Pneumonia (NoVAP) before and after the implementation of preventive measures for respiratory infections established as a result of the COVID-19 pandemic. Two periods of time were analyzed: 1) Pre-pandemic measures: 41 months (November 2016–March 2020) and 2) Pandemic measures: 41 months (May 2020–September 2023). April 2020 was not included since the IPC strategies were uneven.
The main implemented measures were: 1) Universal face mask in clinical areas, 2) Screening for respiratory viruses, 3) Increase in medical doctors for epidemiological surveillance, 4) Isolation of patients with respiratory illness in cohorts. Mean and standard deviation or median and interquartile range were used. Student's T test was used for the difference in means. Simple linear regression was performed. A p < 0.05 was significant.
Results
A total of 455,547 patient days (PD) (mean 5,488.5; SD 1,093) and 45,185 hospital discharges were analyzed. HAIs rate decreased by 20% when comparing both periods (<0.001), while the NoVAP rate decreased by 57.3% (<0.001). By including all preventive strategies in a multiple regression model, the strategies explain 40.0% of the prevention of NoVAP (p<0.001).
Conclusions
The main strength of this study was the evaluation of the individual effect of the various infection prevention strategies implemented during the COVID-19 pandemic. On the other side, since HAIs are multifactorial, it is difficult to measure all the risk factors associated with each of them. However, the IPC strategies that had been implemented before the start of the COVID-19 pandemic, such as hand hygiene, cleaning and disinfection of clinical areas, vaccination, among others, have remained constant for several years prior to the start of the COVID-19 pandemic.