Hospital characteristics associated with healthcare-associated viral respiratory infection rates in a Canadian acute care network

Objective: To determine if hospital characteristics were associated with rates of healthcare-associated (HA) viral respiratory infections (VRIs) in a large Canadian acute care hospital network. Design: Survey of hospital characteristics and prospective surveillance of HA-VRI. Setting: The Canadian Nosocomial Infection Surveillance Program is a sentinel surveillance system with 89 hospitals participating in adult and pediatric VRI surveillance. Patients Patients with laboratory confirmed infection from SARS-CoV-2, Influenza A/B or RSV associated with their hospitalization from participating hospitals between January 1-December 31, 2024. Methods: A 15-item survey was distributed to hospitals to collect information on hospital infrastructure, infection prevention and control practices, and occupational health measures for healthcare workers. HA-VRI rates/10,000 patient-days were analyzed alongside survey responses using univariable and multivariable negative binomial regression models in R to determine associations. Hospitals without case data were excluded. Results: Of 89 hospitals, 93% (n = 83) responded to the survey, with 79 included in the analysis. The national HA-VRI rate was 8.15/10,000 patient-days. Pediatric hospitals had a 56% lower HA-VRI rate than adult/mixed hospitals ( P < .001) that increased with the exclusion of SARS-CoV-2. Each 10% increase in the percentage of single-bed rooms corresponded to a 12% reduction in infection rate ( P < .001). Teaching vs. Non-teaching hospitals were associated with a 32% lower HA-VRI rate. Universal masking was not associated with a statistically significant reduction in HA-VRI rates (RR 0.82, 95% CI: 0.56–1.19). Conclusions: In a large surveillance network, lower HA-VRI rates were seen in pediatric hospitals, teaching hospitals, and in hospitals with higher proportions of single-bed rooms.