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Bayesian evidence and epidemiological implications of environmental contamination from acute respiratory infection in long-term care facilities

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  • Bayesian evidence and epidemiological implications of environmental contamination from acute respiratory infection in long-term care facilities

    Epidemiol Infect. 2018 Apr 10:1-7. doi: 10.1017/S0950268818000729. [Epub ahead of print]
    Bayesian evidence and epidemiological implications of environmental contamination from acute respiratory infection in long-term care facilities.

    Diaz-Decaro JD1, Launer B2, Mckinnell JA2, Singh R3, Dutciuc TD3, Green NM1, Bolaris M2, Huang SS3, Miller LG2.
    Author information

    Abstract

    Skilled nursing home facilities (SNFs) house a vulnerable population frequently exposed to respiratory pathogens. Our study aims to gain a better understanding of the transmission of nursing home-acquired viral respiratory infections in non-epidemic settings. Symptomatic surveillance was performed in three SNFs for residents exhibiting acute respiratory symptoms. Environmental surveillance of five high-touch areas was performed to assess possible transmission. All resident and environmental samples were screened using a commercial multiplex polymerase chain reaction platform. Bayesian methods were used to evaluate environmental contamination. Among nursing home residents with respiratory symptoms, 19% had a detectable viral pathogen (parainfluenza-3, rhinovirus/enterovirus, RSV, or influenza B). Environmental contamination was found in 20% of total room surface swabs of symptomatic residents. Environmental and resident results were all concordant. Target period prevalence among symptomatic residents ranged from 5.5 to 13.3% depending on target. Bayesian analysis quantifies the probability of environmental shedding due to parainfluenza-3 as 92.4% (95% CI: 86.8-95.8%) and due to rhinovirus/enterovirus as 65.6% (95% CI: 57.9-72.5%). Our findings confirm that non-epidemic viral infections are common among SNF residents exhibiting acute respiratory symptoms and that environmental contamination may facilitate further spread with considerable epidemiological implications. Findings further emphasise the importance of environmental infection control for viral respiratory pathogens in long-term care facilities.


    KEYWORDS:

    Bayes’ Theorem; environment; healthcare-associated infections; long-term care; viral respiratory infections

    PMID: 29633685 DOI: 10.1017/S0950268818000729
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