A Parainfluenza Virus Type 3 Outbreak at a Residential Aged Care Facility: The role of microbiological testing in early identification

Susan Ryan 1, Elizabeth Gillespie 1, Rhonda Stuart 1,2,3

Monash Health, Clayton, VIC, Australia

Monash University, Clayton, VIC, Australia

National Centre for Antimicrobial Stewardship, Melbourne, VIC, Australia


Introduction: Although outbreaks of respiratory tract infections in residential aged care facilities (RACF) are common, the aetiology is often unknown. The aged care setting has also been identified as an important source of antimicrobial resistance. We report here an outbreak of parainfluenza 3 in a RACF in Melbourne, Australia.

Method: On January 4th the Infection Control Consultant for the RACF noted that six residents had been diagnosed with respiratory infections in the preceding two days. Droplet precautions were immediately implemented. Active surveillance commenced with nasopharyngeal swabs taken from all residents who presented with respiratory symptoms. Antibiotic therapy was reviewed retrospectively.

Results: The attack rate was 30% (10 of 30 residents). 20% required hospitalisation, however there were no deaths. 60% were commenced on antibiotics prior to nasopharyngeal swabs being obtained. 10% ceased antibiotic therapy once a viral aetiology was identified. 20% commenced antibiotic therapy after parainfluenza 3 was identified as the aetiological organism.

Conclusion: This outbreak demonstrated the value of active surveillance and early microbiological testing in the outbreak management. It also highlighted the urgent need for antimicrobial stewardship programs in the RACF setting. RACF antimicrobial stewardship programs could be enhanced by the use of diagnostic tests.

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