QAPI 109 - Impact of sars-cov-2 Related Infection Prevention and Control (IP&C) Measures on Viral Respiratory Hospital Acquired Infections (HAIs) in the Neonatal Intensive Care Unit (NICU)

Background: Infection prevention and control measures (IP&C) within the neonatal intensive care units (NICU) require a targeted approach to improve outcomes and decrease hospital acquired infections (HAIs). HAIs in the NICU population can lead to increased morbidity and mortality rates. The objective of this study is to describe the impact of SARS-CoV-2 IP&C measures on the incidence of viral respiratory hospital acquired infections in the NICU. Enhanced COVID-19 related IP&C measures were focused on hospital wide medical-grade masking, universal eye protection, symptom screening, and improved hand hygiene practices.

Methods: This is a retrospective observational study to assess the incidence of neonatal hospital-acquired viral respiratory infections. Multiplex reverse-transcription polymerase chain reaction (RT-PCR) diagnostic assay was used to identify respiratory viruses in symptomatic patients. Incidence was compared to previous seasons pre-pandemic (2018-2019) and during (2020-2022) the pandemic. The ratio of infections categorized as HAIs were compared. The IP&C measures were ascertained.

Results: A total of 80 rhinovirus/enterovirus HAIs were detected from 2018-2019. This was further reduced to only 40 HAIs during 2020-2022. The incidence of rhinovirus/enterovirus from 2018-2019 was 0.503 and during 2020-2022 was 0.136 infections per 1000 patient days. The incidence of hospital acquired SARS-CoV-2 in 2020 was 0, in 2021 was 0.051, and in 2022 was 0.014 per 1000 patient days.

Conclusions: This study found that enhanced IP&C measures including visitor restrictions, mandated hospital wide medical-grade masking, universal eye protection, symptom screening, and focus on enhanced hand hygiene practices can lead to a significant decrease in respiratory HAIs, specifically rhinovirus/enterovirus. The additional IP&C measures create a positive impact decreasing HAIs for the NICU setting and should be considered to stay in place post-pandemic.