BACKGROUND Nosocomial infections by respiratory viruses undetected by rapid tests are not often diagnosed. For paediatric patients with background diseases, nosocomial infection could be fatal. AIM To determine the relationship between developing symptoms by respiratory viruses undetectable by rapid tests and respiratory risks and to improve the management of infection control. METHODS Two episodes of nosocomial infection by human bocavirus (HBoV) and human rhinovirus (HRV) were retrospectively investigated in a tertiary hospital paediatric ward in Japan. Viruses were identified by polymerase chain reaction to determine infection control management. When viruses of the same species were detected from different patients, the virus homology was investigated. The relationship between respiratory risks and developing symptoms was statistically investigated. FINDINGS Three and four patients with respiratory risks in the HBoV and HRV outbreaks, respectively, developed respiratory symptoms. The nucleotide sequences of two patients in the HBoV outbreak and all four patients in the HRV outbreak were phylogenetically close. In both outbreaks, the patients with respiratory risks developed significantly more symptoms than those without any risk (P = 0.035 and 0.018, respectively). After the patients with respiratory infection were separated from those with respiratory risks, no additional nosocomial infection occurred. CONCLUSION Patients with respiratory risks easily develop respiratory symptoms and acquire severe symptoms of nosocomial infection by those viruses. In a paediatric ward, we should adopt not only standard precautions but also isolation management of the patients with respiratory symptoms, even if they have negative results in rapid tests.

中文翻译：

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患呼吸道疾病的小儿患者的人博卡病毒和人鼻病毒的医院感染。

背景技术由快速检测未发现的呼吸道病毒引起的医院感染很少被诊断出来。对于有背景疾病的小儿患者，医院内感染可能是致命的。目的确定快速测试无法检测到的呼吸道病毒所产生的症状与呼吸道风险之间的关系，并改善感染控制的管理。方法回顾性研究了日本三级医院儿科病房中两次人感染博卡病毒（HBoV）和人鼻病毒（HRV）的医院感染情况。通过聚合酶链反应鉴定病毒以确定感染控制管理。当从不同患者中检测到相同物种的病毒时，将研究病毒的同源性。呼吸风险和发展中的症状之间的关系进行了统计调查。研究结果分别在HBoV和HRV暴发中有3例和4例具有呼吸风险的患者出现了呼吸道症状。HBOV暴发中的两名患者和HRV暴发中的所有四名患者的核苷酸序列在系统发育上接近。在这两次暴发中，有呼吸风险的患者出现的症状明显多于无风险的患者（分别为P = 0.035和0.018）。将患有呼吸道感染的患者与具有呼吸道感染风险的患者区分开后，没有再发生医院内感染。结论具有呼吸风险的患者容易出现呼吸道症状，并获得这些病毒引起的医院内感染的严重症状。在儿科病房