Nosocomial Influenza Infection among Post-influenza-vaccinated Patients with Severe Pulmonary Diseases

Berg, Hans F.; Gendt, J. Van; Rimmelzwaan, Guus F.; Peeters, Marcel; Keulen, P. van

doi:10.1053/jinf.2002.1104

Cited by 25 publications

(9 citation statements)

References 14 publications

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“…2 " 6 The Centers for Disease Control and Prevention w e l 1 studied. Moreover, the degree of acceptance of LAIV, as (CDC) recommends that all HCWs receive the influenza vac-compared with TIV, and the rate of related influenza-like cine annually 2 illness among HCWs has not been investigated. We therefore Two types of influenza vaccines are currently licensed for undertook a cross-sectional survey at 2 hospitals in the Uniuse in the United States: live attenuated influenza vaccine v e r s i t y o f Pittsburgh Medical Center (UPMC) system to as-(LAIV), which is a cold-adapted virus delivered via drops c e r t a i n v a c c i n a t i o n r a t e s a n f beliefs about the influenza vac- r ' which is an inactivated or killed vaccine delivered via intramuscular injection.…”

Section: Infect Control Hosp Epidemiol 2007; 28:171-177mentioning

confidence: 99%

Influenza Vaccination Rates and Motivators Among Healthcare Worker Groups

Christini

Shutt

Byers

2007

Infect. Control Hosp. Epidemiol.

125

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Section: Infect Control Hosp Epidemiol 2007; 28:171-177mentioning

confidence: 99%

Influenza Vaccination Rates and Motivators Among Healthcare Worker Groups

Christini

Shutt

Byers

2007

Infect. Control Hosp. Epidemiol.

125

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“…Nosocomial influenza and other outbreaks result in significant morbidity and costs 2,3 and can occur in the absence of community epidemics 4 . During outbreaks of infectious diseases, hospitals may amplify virus transmission, as demonstrated during severe acute respiratory syndrome (SARS) 5 .…”

Section: Introductionmentioning

confidence: 99%

A cluster randomized clinical trial comparing fit-tested and non-fit-tested N95 respirators to medical masks to prevent respiratory virus infection in health care workers

MacIntyre

Wang

Cauchemez

et al. 2011

Influenza and Other Respiratory Viruses

235

378

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Please cite this paper as: MacIntyre et al. (2011) A cluster randomized clinical trial comparing fit‐tested and non‐fit‐tested N95 respirators to medical masks to prevent respiratory virus infection in health care workers. Influenza and Other Respiratory Viruses DOI: 10.1111/j.1750‐2659.2010.00198.x. Background We compared the efficacy of medical masks, N95 respirators (fit tested and non fit tested), in health care workers (HCWs). Methods A cluster randomized clinical trial (RCT) of 1441 HCWs in 15 Beijing hospitals was performed during the 2008/2009 winter. Participants wore masks or respirators during the entire work shift for 4 weeks. Outcomes included clinical respiratory illness (CRI), influenza‐like illness (ILI), laboratory‐confirmed respiratory virus infection and influenza. A convenience no‐mask/respirator group of 481 health workers from nine hospitals was compared. Findings The rates of CRI (3·9% versus 6·7%), ILI (0·3% versus 0·6%), laboratory‐confirmed respiratory virus (1·4% versus 2·6%) and influenza (0·3% versus 1%) infection were consistently lower for the N95 group compared to medical masks. By intention‐to‐treat analysis, when P values were adjusted for clustering, non‐fit‐tested N95 respirators were significantly more protective than medical masks against CRI, but no other outcomes were significant. The rates of all outcomes were higher in the convenience no‐mask group compared to the intervention arms. There was no significant difference in outcomes between the N95 arms with and without fit testing. Rates of fit test failure were low. In a post hoc analysis adjusted for potential confounders, N95 masks and hospital level were significant, but medical masks, vaccination, handwashing and high‐risk procedures were not. Interpretation Rates of infection in the medical mask group were double that in the N95 group. A benefit of respirators is suggested but would need to be confirmed by a larger trial, as this study may have been underpowered. The finding on fit testing is specific to the type of respirator used in the study and cannot be generalized to other respirators. Trial registration Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN: ACTRN12609000257268 (http://www.anzctr.org.au).

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“…HCWs may also be a source of infection in nosocomial outbreaks [ 11 ]. Transmission of influenza from patient-to-HCW and HCW-to-patient have been identified in many cases highlighting the importance HCWs play in hospital transmission [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Viral and bacterial upper respiratory tract infection in hospital health care workers over time and association with symptoms

et al. 2017

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BackgroundBacterial colonisation of the respiratory tract is commonly described and usually thought to be of no clinical significance. The aim of this study was to examine the presence and significance of bacteria and viruses in the upper respiratory tract of healthcare workers (HCWs), and association with respiratory symptoms.MethodsA prospective cohort study was conducted in China and 223 HCWs were recruited from fever clinics and respiratory, paediatric, emergency/Intensive medication wards. Participants were followed over 4 weeks (7th May 2015 to 4th June 2015) for development of clinical respiratory illness (CRI). Nasopharyngeal swabs were obtained at baseline and at the end of the study. The primary endpoints were laboratory-confirmed bacterial colonisation and viral respiratory infection. Rates of the following infections in symptomatic and asymptomatic participants were compared at the start or end of the study; 1) all bacterial/viral infections, 2) bacterial infection and bacterial-viral co-infections, excluding virus only infections, and 3) only bacterial infections.ResultsBacterial colonisation was identified in 88% (196/223) of participants at the start or end of the study. Among these participants, 66% (148/223) had only bacterial colonisation while 22% (48/223) had co-infection with a virus. Bacteria were isolated from 170 (76.2%) participants at baseline and 127 (57%) participants at the end of the study. Laboratory confirmed viral infections were identified in 53 (23.8%) participants - 35 (15.7%) at the baseline and 20 (9.0%) at the end of the study.CRI symptoms were recorded in 12 participants (4.5%) and all had a positive bacterium isolation at baseline (n = 11) or end of the study (n = 1). Among asymptomatic participants, 187 (87%) had bacterial colonisation or bacterial/viral co-infection at baseline or end of the study. Viruses were also isolated from 5 (2.4%) asymptomatic cases. Rates of all infection outcomes were higher in symptomatic participants, however differences were not statistically significant.ConclusionWe isolated high rates of bacteria and viruses in the upper respiratory tract of hospital HCWs, which may reflect greater exposure to respiratory infections in the hospital. Although respiratory infections are mostly symptomatic, the association between bacterial colonization and symptomatic illness is not clear. In the healthcare setting, HCWs may acquire and transmit infection to patients and other HCWs around them. Larger studies are required to explore ongoing occupational risk of respiratory infection in hospitals HCWs.

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Nosocomial Influenza Infection among Post-influenza-vaccinated Patients with Severe Pulmonary Diseases

Cited by 25 publications

References 14 publications

Influenza Vaccination Rates and Motivators Among Healthcare Worker Groups

Influenza Vaccination Rates and Motivators Among Healthcare Worker Groups

A cluster randomized clinical trial comparing fit-tested and non-fit-tested N95 respirators to medical masks to prevent respiratory virus infection in health care workers

Viral and bacterial upper respiratory tract infection in hospital health care workers over time and association with symptoms

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