Introduction: RSV-healthcare associated infection (RSV-HAI) has been associated with poor clinical outcomes for some children however is not routinely captured via hospital surveillance systems. We aimed to describe the epidemiology of RSV-HAI at a major Australian paediatric hospital over a 5-year period, including during the 2020 COVID-19 pandemic lockdown.
Methods: RSV detections between 2016 to 2020 in children aged <16 years were reviewed and classified according to case definitions based on the recognized RSV incubation period of 2-8 days. We described RSV-HAI and community-acquired infections by month and year of detection, age at detection, sex, time from admission to detection and RSV subtype.
Results: We identified 176 RSV-HAI, majority in autumn-winter months (126, 71.6%). Median age at detection was 1.6 years (IQR 0.4-5.8) compared to 0.7 years (0.3-1.7) for community-acquired cases (p=<0.001). Rates of RSV-HAI varied by month and largely reflected seasonal trends. In 2020, an absence of RSV-HAI was observed from January to August followed by an atypical re-emergence in spring, reflecting community RSV transmission patterns.
Conclusion: RSV-HAI appears more frequent than expected and cases occur predominantly, but not exclusively, during seasonal peaks of community-acquired RSV. Optimized, hospital-based RSV surveillance can support timely implementation of targeted interventions. Additionally, it may serve as a useful infection prevention and control quality indicator for paediatric facilities.