tetano
Editor, Senior Moderator
J Hosp Infect. 2016 Dec 30. pii: S0195-6701(16)30588-6. doi: 10.1016/j.jhin.2016.12.017. [Epub ahead of print]
[h=1]Characteristics of patients with hospital-acquired influenza A (H1N1)pdm09 virus admitted to the intensive care unit.[/h] ?lvarez-Lerma F[SUP]1[/SUP], Mar?n-Corral J[SUP]2[/SUP], Vil? C[SUP]3[/SUP], Masclans JR[SUP]4[/SUP], Loeches IM[SUP]5[/SUP], Barbadillo S[SUP]6[/SUP], Gonz?lez de Molina FJ[SUP]7[/SUP], Rodr?guez A[SUP]8[/SUP]; H1N1 GETGAG/SEMICYUC Study Group.
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] Influenza A (H1N1)pdm09 virus infection acquired in the hospital and in critically ill patients admitted to the intensive care unit (ICU) has been poorly characterized.
[h=4]AIM:[/h] To assess the clinical impact of hospital-acquired infection with influenza A (H1N1)pdm09 virus in critically ill patients.
[h=4]METHODS:[/h] Analysis of a prospective database of the Spanish registry (2009-2015) of patients with severe influenza A admitted to the ICU. Infection was defined as hospital-acquired when diagnosis and starting of treatment occurred from the seventh day of hospital stay with no suspicion on hospital admission, and community-acquired when diagnosis was established within the first 48 h of admission.
[h=4]FINDINGS:[/h] Of 2421 patients with influenza A (H1N1)pdm09 infection, 224 (9.3%) were classified as hospital-acquired and 1103 (45.6%) as community-acquired (remaining cases unclassified). Intra-ICU mortality was higher in the hospital-acquired group (32.9% vs 18.8%, P < 0.001). Independent factors associated with mortality were hospital-acquired influenza A (H1N1)pdm09 infection (odds ratio: 1.63, 95% confidence interval: 1.37-1.99), APACHE II score on ICU admission (1.09; 1.06-1.11), underlying haematological disease (3.19; 1.78-5.73), and need of extrarenal depuration techniques (4.20; 2.61-6.77) and mechanical ventilation (4.34; 2.62-7.21).
[h=4]CONCLUSION:[/h] Influenza A (H1N1)pdm09 infection acquired in the hospital is an independent factor for death in critically ill patients admitted to the ICU.
Copyright ? 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.
[h=4]KEYWORDS:[/h] Community-acquired infections; Critically ill; H1N1 subtype; Infuenza A virus; Mortality; Nosocomial infection
PMID: 28153560 DOI: 10.1016/j.jhin.2016.12.017
[PubMed - as supplied by publisher]
[h=1]Characteristics of patients with hospital-acquired influenza A (H1N1)pdm09 virus admitted to the intensive care unit.[/h] ?lvarez-Lerma F[SUP]1[/SUP], Mar?n-Corral J[SUP]2[/SUP], Vil? C[SUP]3[/SUP], Masclans JR[SUP]4[/SUP], Loeches IM[SUP]5[/SUP], Barbadillo S[SUP]6[/SUP], Gonz?lez de Molina FJ[SUP]7[/SUP], Rodr?guez A[SUP]8[/SUP]; H1N1 GETGAG/SEMICYUC Study Group.
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] Influenza A (H1N1)pdm09 virus infection acquired in the hospital and in critically ill patients admitted to the intensive care unit (ICU) has been poorly characterized.
[h=4]AIM:[/h] To assess the clinical impact of hospital-acquired infection with influenza A (H1N1)pdm09 virus in critically ill patients.
[h=4]METHODS:[/h] Analysis of a prospective database of the Spanish registry (2009-2015) of patients with severe influenza A admitted to the ICU. Infection was defined as hospital-acquired when diagnosis and starting of treatment occurred from the seventh day of hospital stay with no suspicion on hospital admission, and community-acquired when diagnosis was established within the first 48 h of admission.
[h=4]FINDINGS:[/h] Of 2421 patients with influenza A (H1N1)pdm09 infection, 224 (9.3%) were classified as hospital-acquired and 1103 (45.6%) as community-acquired (remaining cases unclassified). Intra-ICU mortality was higher in the hospital-acquired group (32.9% vs 18.8%, P < 0.001). Independent factors associated with mortality were hospital-acquired influenza A (H1N1)pdm09 infection (odds ratio: 1.63, 95% confidence interval: 1.37-1.99), APACHE II score on ICU admission (1.09; 1.06-1.11), underlying haematological disease (3.19; 1.78-5.73), and need of extrarenal depuration techniques (4.20; 2.61-6.77) and mechanical ventilation (4.34; 2.62-7.21).
[h=4]CONCLUSION:[/h] Influenza A (H1N1)pdm09 infection acquired in the hospital is an independent factor for death in critically ill patients admitted to the ICU.
Copyright ? 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.
[h=4]KEYWORDS:[/h] Community-acquired infections; Critically ill; H1N1 subtype; Infuenza A virus; Mortality; Nosocomial infection
PMID: 28153560 DOI: 10.1016/j.jhin.2016.12.017
[PubMed - as supplied by publisher]