Hospital-acquired influenza infections detected by a surveillance system over six seasons, from 2010/2011 to 2015/2016

Abstract

Background: In addition to outbreaks of nosocomial influenza, sporadic nosocomial influenza infections also occur but are generally not reported in the literature. This study aimed to determine the epidemiologic characteristics of cases of nosocomial influenza compared with the remaining severe cases of severe influenza in acute hospitals in Catalonia (Spain) which were identified by surveillance.Methods: An observational case-case epidemiological study was carried out in patients aged ≥18 years from Catalan 12 hospitals between 2010 and 2016. For each laboratory-confirmed influenza case (nosocomial or not) we collected demographic, virological and clinical characteristics. We defined patients with nosocomial influenza as those admitted to a hospital for a reason other than acute respiratory infection in whom ILI symptoms developed ≥48 h after admission and influenza virus infection was confirmed using RT-PCR. Mixed-effects regression was used to estimate the crude and adjusted OR. Results: One thousand seven hundred twenty-two hospitalized patients with severe laboratory-confirmed influenza virus infection were included: 96 (5.6%) were classified as nosocomial influenza and more frequently had > 14 days of hospital stay (42.7% vs. 27.7%, P < .001) and higher mortality (18.8% vs. 12.6%, P < .02). The variables associated with nosocomial influenza cases in acute-care hospital settings were chronic renal disease (aOR 2.44 95% CI 1.44-4.15) and immunodeficiency (aOR 1.79 95% CI 1.04-3.06). Conclusions: Nosocomial infections are a recurring problem associated with high rates of chronic diseases and death. These findings underline the need for adherence to infection control guidelines.

Risk factors for hospital-acquired influenza A and patient characteristics: a matched case-control study

“…In the UK, during the 2009 H1N1 pandemic, 2% of hospitalized cases with influenza A were considered hospital-acquired [19]. In an epidemiological study based on the data of six influenza seasons from 2010 to 2011 to 2015-2016 in Spain, of the hospitalized patients with confirmed severe influenza, 5.6% were classified as hospital-acquired [20]. Data are expressed as frequencies and percentages in parenthesis unless otherwise stated; IQR Interquartile range (25th to 75th percentile); SD Standard deviation COPD Chronic obstructive pulmonary disease; ALT Alanine aminotransferase; AST Aspartate aminotransferase; ALB Albumin; TBIL Total bilirubin; DBIL Direct Bilirubin; BUN Blood urea nitrogen; CRE Creatinine; K + Plasma potassium; Na + Plasma sodium; Ca + Serum calcium; a Malignancy: cancer or hematological malignancies; b Immunosuppression: chemotherapy or radiotherapy within 1 month before illness onset, using immunosuppressive therapy with a daily dose of ≥20 mg prednisolone (or its equivalent) for more than 15 continuous days before onset of the illness, and hematopoietic stem cells or solid organ transplant < 10 years c Leukocytopenia: leukocyte count < 3500/mm 3 d Neutrophilopenia: neutrophilic granulocyte count < 1800/mm 3 e Lymphocytopenia: lymphocyte count < 1100/mm 3 f Anemia: hemoglobin < 120 g/L for men and < 110 g/L for women g Thrombocytopenia: platelet count < 125 /mm 3 h Hypoalbuminemia: ALB < 40 g/L i Pleural effusion: on single or both sides found by radiographic j Corticosteroid: intravenous drip or atomizing inhalation k Influenza vaccine: vaccination coverage was 1 in 76 and 2 in 85, respectively, due to death and loss of follow-up This variability in the prevalence of hospital-acquired influenza A can be attributed to variations in study design and differences between regions and strains of virus.…”

Risk factors for hospital-acquired influenza A and patient characteristics: A matched case-control study

“…were classi ed as hospital-acquired in uenza [20] . The variability is understandable given the variation in study designs and differences between regions and virus strains.…”

Predictors of Growth of Escherichia Coli on Lab Coats as Part of Hospital-Acquired Infection Transmission Through Healthcare Personnel Attire

“…Such contamination of E. coli predisposes patients to E. coli bacteremia, which in turn leads to adverse health outcomes, such as increased length of stay and cost of those patients 37 as well as advanced colorectal neoplasia 38 . As a result, infection control starting with combating contamination with E. coli and its strains should be structured and adhered to by HCP as part of their efforts in eradicating nosocomial infections [39][40][41] . Subsequently, further steps should be antimicrobial susceptibility testing to contribute signi cantly in the treatment of nosocomial infections for patients in the healthcare departments 42 .…”