Academic journal article International Journal of Child Health and Human Development

Infections in Children with Chronic Illness: Viral and Bacterial Pathogens in Pediatric Long Term Care Facilities

Academic journal article International Journal of Child Health and Human Development

Infections in Children with Chronic Illness: Viral and Bacterial Pathogens in Pediatric Long Term Care Facilities

Article excerpt

Pediatric Long Term Care Facilities (LTCFs) typically care for children with advanced neurodevelopmental disorders. While such facilities differ in size and quality of care, the residents typically require frequent hands-on care that potentiates the transmission of infectious agents. The most prominent infectious morbidity results from viral illness and most published reports have focused on respiratory viral infections. Outbreaks of influenza virus and adenovirus infection in particular can be associated with substantial morbidity and mortality in this population, although recently other viruses, such as human metapneumovirus and rhinovirus, also have been implicated. Children with tracheostomies appear to be at particular risk for acquisition of infection. Concomitant illness in staffmembers is commonly noted. Immunization of staffand residents affords some protection against influenza, and antiviral prophylaxis may help to stem an evolving influenza epidemic within the center, but containment of other respiratory viruses is achieved primarily through stringent handwashing and cohorting. Gastrointestinal viral illness also is encountered in adult and pediatric LTCFs. Recently, norovirus, which its ability to spread rapidly in closed environments, has been especially troublesome.

Pediatric LTCFs also may serve as reservoirs for multiple-drug resistant bacteria. Our group has investigated the epidemiology of antibiotic-resistant Gram negative bacteria at two pediatric LTCFs in Cleveland, Ohio. These investigations were spurred by initial observations that a disproportionate number of children colonization by antibiotic-resistant bacilli in a Cleveland tertiary care pediatric ICU had been transferred from one of the area's pediatric LTCFs. …

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