International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2026
Incidence and viral etiology of hospital-acquired respiratory illness in tertiary care hospitals in Bangladesh.
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Hassan Md Zakiul, Bhuiyan Mejbah Uddin, Mah-E-Muneer Syeda, Shoshi Homayra Rahman, Abedin Jainal, Rahman Mustafizur, Rahman Mahmudur, Chowdhury Fahmida, Luby Stephen P, Gurley Emily S
Аннотация
INTRODUCTION: Hospital-acquired respiratory illness (HARIs) contribute to morbidity and mortality among hospitalized patients, but their viral etiology is poorly characterized in Bangladesh. This analysis estimated the incidence, viral etiology, and outcomes of HARI among hospitalized patients.
METHODOLOGY: From May 2008 to February 2017, we conducted surveillance in adult medicine and pediatric wards of three tertiary hospitals in Bangladesh. Patients who developed respiratory symptoms >72 hours after hospitalization were enrolled and tested for influenza (A and B), respiratory syncytial virus (RSV), human parainfluenza virus, and human metapneumovirus by real-time reverse transcription polymerase chain reaction. Incidence was calculated per 1000 patient-days at risk using Poisson-based distribution.
RESULT: During 187,757 patient-days, 1243 HARI cases were identified (6.6 per 1000 patient-days; 95% confidence interval: 6.2-7.0), representing 2.6% of admissions. Respiratory viruses were detected in 23% of cases. Incidence was higher in children than adults (29.7 vs 9.5 per 10,000 patient-days). Influenza (6% of adults, 6% of children) and RSV (4.5% of adults, 10% of children) were the most frequently detected viruses. Overall, 3.9% HARI patients died. Clusters accounted for 27% of influenza and 21% of RSV-associated cases.
CONCLUSION: Detection of respiratory viruses in HARI cases and their temporal clustering is consistent with possible in-hospital transmission, warranting strengthened infection prevention and improved diagnostic surveillance.
METHODOLOGY: From May 2008 to February 2017, we conducted surveillance in adult medicine and pediatric wards of three tertiary hospitals in Bangladesh. Patients who developed respiratory symptoms >72 hours after hospitalization were enrolled and tested for influenza (A and B), respiratory syncytial virus (RSV), human parainfluenza virus, and human metapneumovirus by real-time reverse transcription polymerase chain reaction. Incidence was calculated per 1000 patient-days at risk using Poisson-based distribution.
RESULT: During 187,757 patient-days, 1243 HARI cases were identified (6.6 per 1000 patient-days; 95% confidence interval: 6.2-7.0), representing 2.6% of admissions. Respiratory viruses were detected in 23% of cases. Incidence was higher in children than adults (29.7 vs 9.5 per 10,000 patient-days). Influenza (6% of adults, 6% of children) and RSV (4.5% of adults, 10% of children) were the most frequently detected viruses. Overall, 3.9% HARI patients died. Clusters accounted for 27% of influenza and 21% of RSV-associated cases.
CONCLUSION: Detection of respiratory viruses in HARI cases and their temporal clustering is consistent with possible in-hospital transmission, warranting strengthened infection prevention and improved diagnostic surveillance.