Table 3.
Frequency of Reported Criteria from CDC’s Surveillance Definitions for Healthcare-Associated Upper Respiratory Tract Infections and Pneumonia in Children ≤12 Months Versus >12 months With HA-RSV Infections (Criterion Included in Surveillance Definitions are Gray and Bolded)
| All HA-RSV, N = 122 | ≤12 months, N = 53 | >12 months, N = 69 | |
|---|---|---|---|
| Upper respiratory tract infection criteria | |||
| Vital signs | |||
| Fever (>38°C) | 57 (46.7%) | 20 (37.7%) | 37 (53.6%) |
| Tachypnea for agea | 52 (42.6%) | 24 (45.3%) | 28 (40.6%) |
| Bradycardia < 100 | 4 (3.3%) | 2 (3.8%) | 2 (2.9%) |
| Hypothermia (<36°C) | 3 (2.5%) | 3 (5.7%) | 0 (0.0%) |
| Apnea | 1 (0.8%) | 1 (1.9%) | 0 (0.0%) |
| Respiratory symptoms | |||
| Cough | 55 (45.1%) | 19 (35.8%) | 36 (52.2%) |
| Congestion | 42 (34.4%) | 23 (43.4%) | 19 (27.5%) |
| Nasal discharge/runny nose | 24 (19.7%) | 8 (15.1%) | 16 (23.2%) |
| Sore throat | 1 (0.8%) | 0 (0.0%) | 1 (1.4%) |
| Erythema of pharynx | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) |
| Purulent exudate in throat | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) |
| Hoarseness | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) |
| Pneumonia criteria | |||
| Vital signs | |||
| Apnea or tachypnea or retractions | 58 (47.5%) | 28 (52.8%) | 30 (43.5%) |
| Fever (>38°C)a | 57 (46.7%) | 20 (37.7%) | 37 (53.6%) |
| Tachypnea by ageb | 52 (42.6%) | 24 (45.3%) | 28 (40.6%) |
| Tachycardia >170 | 32 (26.2%) | 19 (35.8%) | 13 (18.8%) |
| Bradycardia <100 | 4 (3.3%) | 2 (3.8%) | 2 (2.9%) |
| Hypothermia (<36°C) | 3 (2.5%) | 3 (5.7%) | 0 (0.0%) |
| Apnea | 1 (0.8%) | 1 (1.9%) | 0 (0.0%) |
| Respiratory symptoms | |||
| Cough | 55 (45.1%) | 19 (35.8%) | 36 (52.2%) |
| Shortness of breath | 31 (25.4%) | 14 (26.4%) | 17 (24.6%) |
| Physical findings | |||
| Rales/ crackles or rhonchi/ coarse breath sounds | 16 (13.1%) | 9 (17.0%) | 7 (10.1%) |
| Rales/ crackles or rhonchi/ coarse breath sounds or wheezing | 19 (15.6% | 10 (18.9%) | 9 (13.0%) |
| Retractions | 18 (14.8%) | 11 (20.8%) | 7 (10.1%) |
| Rales/crackles | 9 (7.4%) | 5 (9.4%) | 4 (5.8%) |
| Rhonchi/coarse breath soundsc | 9 (7.4%) | 5 (9.4%) | 4 (5.8%) |
| Wheezing | 4 (3.3%) | 2 (3.8%) | 2 (2.9%) |
| White blood cell count | |||
| Leukopenia ≤ 4000 WBC | 26 (21.3%) | 3 (5.7%) | 23 (33.3%) |
| Leukocytosis ≥ 12 000 WBC | 18 (14.8%) | 11 (20.8%) | 7 (10.1%) |
| Leukocytosis ≥ 15 000 WBCa | 8 (6.6%) | 5 (9.4%) | 3 (4.3%) |
| Other | |||
| New or increased sputum or increased suctioning requirements or change in character of sputum or purulent sputum | 21 (17.2%) | 13 (24.5%) | 8 (11.6%) |
| Increased oxygen requirementa | 25 (20.5%) | 14 (26.4%) | 11 (15.9%) |
| New or increased sputum | 14 (11.5%) | 8 (15.1%) | 6 (8.7%) |
| Increased suctioning requirements | 10 (8.2%) | 7 (13.2%) | 3 (4.3%) |
| Change in character of sputum or purulent sputum | 1 (0.8%) | 0 (0.0%) | 1 (1.4%) |
aThe following criteria in the CDC surveillance definition were not collected: temperature instability in children ≤12 months, left shift for leukocytosis ≥ 15,000, nasal flaring with retractions or grunting, and increased ventilator demand.
bAge <2 months, respiratory rate (RR) ≥60; 2–12 months, RR ≥50; 13 months –5 years, RR ≥40; > 5 years, RR ≥ 30 [14].
cRhonchi or coarse breath sounds were collected rather than the CDC NHSN criterion bronchial breath sounds.