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J Infect Public Health . Nosocomial acquisition of influenza is associated with significant morbidity and mortality: Results of a prospective observational study

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  • J Infect Public Health . Nosocomial acquisition of influenza is associated with significant morbidity and mortality: Results of a prospective observational study


    J Infect Public Health


    . 2022 Sep 7;15(10):1118-1123.
    doi: 10.1016/j.jiph.2022.08.021. Online ahead of print.
    Nosocomial acquisition of influenza is associated with significant morbidity and mortality: Results of a prospective observational study


    L B Snell 1 , J P Vink 2 , N Q Verlander 3 , S Miah 3 , A Lackenby 3 , D Williams 3 , H Mitchell 4 , C Beviz 4 , M Kabia 4 , E Cunningham 5 , R Batra 2 , J D Edgeworth 6 , M Zambon 3 , G Nebbia 6



    Affiliations

    Abstract

    Background: Nosocomial acquisition of influenza is known to occur but the risk after exposure to a known case and the outcomes after acquisition are poorly defined.
    Methods: Prospective observational study of patients exposed to influenza from another patient in a multi-site healthcare organisation, with follow-up of 7 days or until discharge, and PCR-confirmation of symptomatic disease. Multivariable analysis was used to investigate association of influenza acquisition with high dependency unit/intensive care unit (HDU/ITU) admission and in-hospital mortality.
    Results: 23/298 (7.7%) contacts of 11 cases were subsequently symptomatic and tested influenza-positive during follow-up. HDU/ITU admission was significantly higher in these secondary cases (6/23, 26%) compared to flu-negative contacts (20/275, 7.2%; p = 0.002). In-hospital mortality was significantly higher in secondary cases (5/23, 21.7%) compared to flu-negative contacts (11/275, 4%; p < 0.001). In multivariable analysis, age (OR 1.25 95% CI: 1.01-1.54, p = 0.02) and being a secondary case (OR 4.77, 95% CI: 1.63-13.9, p = 0.008) were significantly associated with HDU/ITU admission in contacts. Age (OR 1.00, 95% CI: 0.93-1.00, p = 0.02), being a secondary case after exposure to influenza (OR 3.81, 95% CI 1.09-13.3, p = 0.049) and co-morbidity (OR 1.29 per unit increment in the Charlson score, 95% CI 1.02-1.61, p = 0.03) were significantly associated with in-hospital mortality in contacts.
    Conclusions: Nosocomial acquisition of influenza was significantly associated with increased risk of HDU/ITU admission and in-hospital mortality.

    Keywords: Hospital-acquired infection; Infection prevention and control; Influenza.

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