Velde, E. ten (Eline) (2015) Bronchiolitis. Het belang van cohort isolatie. thesis, Medicine.
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Abstract
Introduction: Bronchiolitis is an acute viral inflammation of the lower respiratory tract in children under 2 years of age, occurring mainly during the winter season. The main causative agents are RS (respiratory syncytial) virus, human metapneumovirus, (para)influenza virus, adenovirus and rhinovirus. Therapy exists mainly of supportive measures, like oxygen administration and drip feeding. Children with bronchiolitis, when administered in hospital, are commonly nursed separately and in cohorts of RSV-positive and RSV-negative patients, to prevent cross-infection. The downside of cohort isolation are the higher costs and higher workload during the winter season. The question that rises is; is it beneficial to prevent cross-infection and to apply cohort isolation. Material en methods: A prospective observational cohort study, in children under 2 years of age, hospitalized with acute bronchiolitis, from October 2012 to March 2015. The children are hospitalized and nursed in the same room, during admission. We monitored the effect of discontinuing cohort isolation on the numbers of cross-infections and the severance of disease symptoms. At admission, every 4th day and at discharge nose-flushings were taken of each patient. Throat swabs were taken of parents and daily of medical personnel and other visitors. Examiners and physicians were blinded for results of viral diagnostics. Results: We included 161 patients (83% RSV-positive). 37 of these patients (23%) were co-infected at admission, a cross-infection appeared in 16% (n=26). Of the patient that had shared a room (91%, n=147), of whom 79 (53%) had shared a room with a patient that had another virus, 15% (n=22) became cross-infected. Of the patients that did not share a room (n=14), 29% (n=4) was cross-infected. Of the 26 cross-infections that appeared, 15% (n=4) could be explained by the roommates. Discussion/conclusion: Co-infections, including cross-infections, does appear a lot in bronchiolitis, but this does not cause a more severe disease. Nursing the children whit different viruses in the same rooms does not seems to have a role in this infections. This means that it is save to admit patient with bronchiolitis in the same room and to just apply contact isolation, despite of the causative virus. This leads to lesser logistic problems at the nursing department in the busy winter season. In addition the viral diagnostics for this purpose will not be necessary.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Bekhof, Dr. Jolita and ISALA klinieken Zwolle and Amalia kinderziekenhuis |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:56 |
| Last Modified: | 25 Jun 2020 10:56 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1634 |
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