Health Care–Acquired Viral Respiratory Diseases

Goins, William P.; Talbot, H. Keipp; Talbot, Thomas R.

doi:10.1016/j.idc.2010.11.010

Cited by 45 publications

(20 citation statements)

References 83 publications

(92 reference statements)

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“…Universal use of mask irrespective of vaccination status is effective in reducing nosocomial transmission of influenza, but may be difficult to implement [57, 58]. HCW vaccination, cohort nursing and antiviral prophylaxis for high risk patients during an outbreak reduce transmission and the deleterious consequences of influenza infection, including lower respiratory tract infections [46, 48]. …”

Section: Resultsmentioning

confidence: 99%

“…Viral infections - among patients with HAP, approximately 20% are due to viral pathogens and are associated with increased morbidity and mortality [46, 47]. Respiratory viral infections, especially influenza and respiratory syncytial virus, affect mainly immunocompromised patients and nosocomial transmission is common [48].…”

Section: Measures For Hap Preventionmentioning

confidence: 99%

“…Respiratory viral infections, especially influenza and respiratory syncytial virus, affect mainly immunocompromised patients and nosocomial transmission is common [48]. Multimodal interventions including 1) contact and droplet precautions, 2) cohort nursing, 3) influenza vaccination of HCW and high risk populations, 4) chemoprophylaxis to residents in long term care facilities during an influenza outbreak and 5) generalized use of masks irrespective of vaccination status have shown to be effective in prevention of nosocomial spread of influenza and other respiratory viruses [46, 48–50]. …”

Section: Measures For Hap Preventionmentioning

confidence: 99%

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Prevention of hospital-acquired pneumonia in non-ventilated adult patients: a narrative review

Pássaro

Harbarth

Landelle

2016

Antimicrob Resist Infect Control

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BackgroundPneumonia is one of the leading hospital-acquired infections worldwide and has an important impact. Although preventive measures for ventilator-associated pneumonia (VAP) are well known, less is known about appropriate measures for prevention of hospital-acquired pneumonia (HAP).AimThe purpose of this narrative review is to provide an overview of the current standards for preventing HAP in non-ventilated adult patients.MethodsA search of the literature up to May 2015 was conducted using Medline for guidelines published by national professional societies or professional medical associations. In addition, a comprehensive search for the following preventive measures was performed: hand hygiene, oral care, bed position, mobilization, diagnosis and treatment of dysphagia, aspiration prevention, viral infections and stress bleeding prophylaxis.FindingsRegarding international guidelines, several measures were recommended for VAP, whilst no specific recommendations for HAP prevention in non-ventilated patients are available. There is reasonable evidence available that oral care is associated with a reduction in HAP. Early mobilization interventions, swift diagnosis and treatment of dysphagia, and multimodal programmes for the prevention of nosocomial influenza cross-infection, have a positive impact on HAP reduction. The impact of bed position and stress bleeding prophylaxis remains uncertain. Systematic antibiotic prophylaxis for HAP prevention should be avoided.ConclusionScant literature and little guidance is available for the prevention of HAP among non-ventilated adult patients. In addition, the criteria used for the diagnosis of HAP and the populations targeted in the studies selected are heterogeneous. Oral care was the most studied measure and was commonly associated with a decrease in HAP rate, although a broad range of interventions are proposed. No robust evidence is available for other measures. Further high-quality studies are required to evaluate the impact of specific measures on HAP prevention in non-ventilated adult patients.

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Section: Resultsmentioning

confidence: 99%

Section: Measures For Hap Preventionmentioning

confidence: 99%

Section: Measures For Hap Preventionmentioning

confidence: 99%

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Prevention of hospital-acquired pneumonia in non-ventilated adult patients: a narrative review

Pássaro

Harbarth

Landelle

2016

Antimicrob Resist Infect Control

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“…Doch nosokomiale Influenzainfektionen können auch für medizinische Beschäftigte eine relevante Gesundheitsgefährdung darstellen (beispielsweise für pulmonal oder kardial vorerkrankte Mitarbeiter, schwangere Beschäftigte; [12]). In einer Seroprävalenzstudie fand sich in einer Influenzasaison bei nahezu jedem vierten ungeimpften Mitarbeiter eine Influenzainfektion [13,14]. Eine Übersichts-arbeit über 12 nosokomiale Influenzaausbrüche belegte, dass sich auf den betroffenen Stationen bis zu 50% der Patienten infizierten.…”

Section: Influenzaimpfquoten In Hessischen Krankenhäusernunclassified

“…Demgegenüber stehen aber auf der einen Seite niedrige Impfquoten beim medizinischen Personal sowie bei den Risikogruppen, auf der anderen Seite eine nur unzureichende Erfassung der Impfquoten und der nosokomialen Influenzafälle. [14,17]. Dessen ungeachtet sind die Influenzaimpfquoten beim medizinischen Personal unzureichend [12,18].…”

Section: Influenzaimpfquoten In Hessischen Krankenhäusernunclassified

Influenzaimpfquoten in hessischen Krankenhäusern

Wicker

Gottschalk

Wolff³

et al. 2012

Bundesgesundheitsbl.

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N95 Respirators vs Medical Masks for Preventing Influenza Among Health Care Personnel

Radonovich

Simberkoff

Bessesen

et al. 2019

JAMA

456

419

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IMPORTANCE Clinical studies have been inconclusive about the effectiveness of N95 respirators and medical masks in preventing health care personnel (HCP) from acquiring workplace viral respiratory infections.OBJECTIVE To compare the effect of N95 respirators vs medical masks for prevention of influenza and other viral respiratory infections among HCP. DESIGN, SETTING, AND PARTICIPANTSA cluster randomized pragmatic effectiveness study conducted at 137 outpatient study sites at 7 US medical centers between September 2011 and May 2015, with final follow-up in June 2016. Each year for 4 years, during the 12-week period of peak viral respiratory illness, pairs of outpatient sites (clusters) within each center were matched and randomly assigned to the N95 respirator or medical mask groups.INTERVENTIONS Overall, 1993 participants in 189 clusters were randomly assigned to wear N95 respirators (2512 HCP-seasons of observation) and 2058 in 191 clusters were randomly assigned to wear medical masks (2668 HCP-seasons) when near patients with respiratory illness. MAIN OUTCOMES AND MEASURESThe primary outcome was the incidence of laboratory-confirmed influenza. Secondary outcomes included incidence of acute respiratory illness, laboratory-detected respiratory infections, laboratory-confirmed respiratory illness, and influenzalike illness. Adherence to interventions was assessed.RESULTS Among 2862 randomized participants (mean [SD] age, 43 [11.5] years; 2369 [82.8%]) women), 2371 completed the study and accounted for 5180 HCP-seasons. There were 207 laboratory-confirmed influenza infection events (8.2% of HCP-seasons) in the N95 respirator group and 193 (7.2% of HCP-seasons) in the medical mask group (difference, 1.0%, [95% CI, −0.5% to 2.5%]; P = .18) (adjusted odds ratio [OR], 1.18 [95% CI, 0.95-1.45]). There were 1556 acute respiratory illness events in the respirator group vs 1711 in the mask group (difference, −21.9 per 1000 HCP-seasons [95% CI, −48.2 to 4.4]; P = .10); 679 laboratory-detected respiratory infections in the respirator group vs 745 in the mask group (difference, −8.9 per 1000 HCP-seasons, [95% CI, −33.3 to 15.4]; P = .47); 371 laboratory-confirmed respiratory illness events in the respirator group vs 417 in the mask group (difference, −8.6 per 1000 HCP-seasons [95% CI, −28.2 to 10.9]; P = .39); and 128 influenzalike illness events in the respirator group vs 166 in the mask group (difference, −11.3 per 1000 HCP-seasons [95% CI, −23.8 to 1.3]; P = .08). In the respirator group, 89.4% of participants reported "always" or "sometimes" wearing their assigned devices vs 90.2% in the mask group.CONCLUSIONS AND RELEVANCE Among outpatient health care personnel, N95 respirators vs medical masks as worn by participants in this trial resulted in no significant difference in the incidence of laboratory-confirmed influenza.

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Health Care–Acquired Viral Respiratory Diseases

Cited by 45 publications

References 83 publications

Prevention of hospital-acquired pneumonia in non-ventilated adult patients: a narrative review

Prevention of hospital-acquired pneumonia in non-ventilated adult patients: a narrative review

Influenzaimpfquoten in hessischen Krankenhäusern

N95 Respirators vs Medical Masks for Preventing Influenza Among Health Care Personnel

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