862 - Impact of Caregiver Health on Pediatric Healthcare-Associated Viral Respiratory Infections (HAVRIs): A Retrospective Study.

Background: The burden of healthcare-associated viral respiratory infections (HAVRIs) in children is significant, with increased healthcare costs and risk of poor outcomes. However, while healthcare workers are the main target of infection prevention measures, little is known about the impact of sick contacts during hospitalization on the incidence of HAVRIs. The objective of our study was to determine the proportion of pediatric HAVRIs following contact with an ill caregiver or visitor. Secondary objectives were to describe the characteristics of affected patients as well as the complications associated with the HAVRI episodes.

Methods: This is a retrospective chart review that took place in a pediatric tertiary care center with both multiple and single-bed rooms. All cases of HAVRIs that occurred between December 2017 and July 2019 in patients aged less than 18 years old were included in the study. HAVRIs were defined as a laboratory confirmed respiratory viral illness occurring after 72 hours of admission.

Results: Forty-four HAVRIs were included in the analysis. The majority (n=32, 72.7%) were among patients aged less than 24 months. Only 2 patients had no comorbidities and almost half (n=21, 47.7%) had multiple complex medical conditions. Rhinovirus was the most frequently isolated virus (n=20, 45.5%). Nine patients (20.5%) had a documented contact with a sick caregiver (n=8, 88.9%) or sick visitor (n=2, 22.2%) in the 7 days prior to the onset of new respiratory symptoms and subsequent HAVRI diagnosis. In the 72 hours prior to HAVRI onset, 18 patients (40.9%) were in a single-bed room and 6 patients (13.6%) were already under droplet/contact precautions. Twelve patients (27.3%) had new or increased O2 requirements and 4 (9.1%) were transferred to the intensive care unit. There were no associated deaths.

Conclusion: Our study suggests that having a contact with a sick caregiver or visitor is a potential risk factor for acquiring a HAVRI. This reinforces the relevance of a strict visitor-screening policy and of educating caregivers on the importance of appropriate hand hygiene when caring for their child. Of note, more than one third of HAVRI cases occurred in patients already in a single-bed room, with or without additional precautions, suggesting that those measures are not entirely protective.