tetano
Editor, Senior Moderator
J Hosp Infect
. 2020 Jun 12;S0195-6701(20)30290-5.
doi: 10.1016/j.jhin.2020.06.005. Online ahead of print.
Incidence and Characteristics of Nosocomial Influenza in a Country With Low Vaccine Coverage
D L Paz[SUP] 1 [/SUP], C Pronier[SUP] 2 [/SUP], B Bayeh[SUP] 3 [/SUP], S Jouneau[SUP] 4 [/SUP], C Grolhier[SUP] 2 [/SUP], A Le Bot[SUP] 1 [/SUP], F B?n?zit[SUP] 1 [/SUP], V Thibault[SUP] 2 [/SUP], P Tattevin[SUP] 5 [/SUP]
Affiliations
Abstract
Background: Influenza vaccination coverage is low in France, in at-risk patients and in healthcare workers.
Aim: We aimed to estimate the incidence of nosocomial influenza, its characteristics and outcome.
Methods: During one influenza season, we retrospectively evaluated all cases of documented influenza. Inpatients with symptoms onset ≥48 h after admission were enrolled. Data were collected on a standardized questionnaire.
Results: From November 2017 to April 2018, 860 patients tested positive for influenza by polymerase chain reaction analysis on a respiratory sample. Among them, 204 (23.7%) were diagnosed ≥48 h after admission, of whom 57 (6.6% of all influenza cases) fulfilled inclusion criteria for nosocomial influenza: 26 women and 31 men, median age 82 years (interquartile range, 72.2-86.9). Twenty patients (38.6%) had recently (<6 months) received the seasonal influenza vaccine. Median time between admission and symptoms onset, and between symptoms onset and diagnosis were, respectively, 11 days (7-19.5) and 29 h (15.5-48). Influenza was mostly acquired in a double-bedded room (N = 39, 68.4%), with documented exposure in 14 cases. Influenza B virus was more common in nosocomial (46/57, 80.7%), than in community-acquired cases (359/803, 44.6%), P<0.001. Mortality rate at three months was 15.8% (N = 9). Incidence of nosocomial influenza was estimated at 0.22 per 1000 hospital-days during the study period.
Conclusion: Nosocomial influenza is not rare in elderly inpatients, and may have severe consequences. Influenza B virus was over-represented, which suggests higher transmissibility and/or transmission clusters.
Keywords: Elderly; Incidence; Influenza B virus; Nosocomial influenza; Outcome; Vaccine.
. 2020 Jun 12;S0195-6701(20)30290-5.
doi: 10.1016/j.jhin.2020.06.005. Online ahead of print.
Incidence and Characteristics of Nosocomial Influenza in a Country With Low Vaccine Coverage
D L Paz[SUP] 1 [/SUP], C Pronier[SUP] 2 [/SUP], B Bayeh[SUP] 3 [/SUP], S Jouneau[SUP] 4 [/SUP], C Grolhier[SUP] 2 [/SUP], A Le Bot[SUP] 1 [/SUP], F B?n?zit[SUP] 1 [/SUP], V Thibault[SUP] 2 [/SUP], P Tattevin[SUP] 5 [/SUP]
Affiliations
- PMID: 32540461
- DOI: 10.1016/j.jhin.2020.06.005
Abstract
Background: Influenza vaccination coverage is low in France, in at-risk patients and in healthcare workers.
Aim: We aimed to estimate the incidence of nosocomial influenza, its characteristics and outcome.
Methods: During one influenza season, we retrospectively evaluated all cases of documented influenza. Inpatients with symptoms onset ≥48 h after admission were enrolled. Data were collected on a standardized questionnaire.
Results: From November 2017 to April 2018, 860 patients tested positive for influenza by polymerase chain reaction analysis on a respiratory sample. Among them, 204 (23.7%) were diagnosed ≥48 h after admission, of whom 57 (6.6% of all influenza cases) fulfilled inclusion criteria for nosocomial influenza: 26 women and 31 men, median age 82 years (interquartile range, 72.2-86.9). Twenty patients (38.6%) had recently (<6 months) received the seasonal influenza vaccine. Median time between admission and symptoms onset, and between symptoms onset and diagnosis were, respectively, 11 days (7-19.5) and 29 h (15.5-48). Influenza was mostly acquired in a double-bedded room (N = 39, 68.4%), with documented exposure in 14 cases. Influenza B virus was more common in nosocomial (46/57, 80.7%), than in community-acquired cases (359/803, 44.6%), P<0.001. Mortality rate at three months was 15.8% (N = 9). Incidence of nosocomial influenza was estimated at 0.22 per 1000 hospital-days during the study period.
Conclusion: Nosocomial influenza is not rare in elderly inpatients, and may have severe consequences. Influenza B virus was over-represented, which suggests higher transmissibility and/or transmission clusters.
Keywords: Elderly; Incidence; Influenza B virus; Nosocomial influenza; Outcome; Vaccine.