Transmission and Effect of Multiple Clusters of Seasonal Influenza in a Swiss Geriatric Hospital

Pagani, Léonardo; Thomas, Yves; Huttner, Benedikt; Sauvan, Valérie; Notaridis, Grigorios; Kaiser, Laurent; Iten, Anne; Pittet, Didier; Harbarth, Stéphan Juergen

doi:10.1111/jgs.13339

Cited by 43 publications

(38 citation statements)

References 30 publications

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“…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%

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: Measures For Hap Preventionmentioning

confidence: 99%

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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“…Previous applications of next generation sequencing of influenza have included elucidating zoonosis and describing transmission of seasonal and pandemic strains . In the context of nosocomial transmission, several studies have used next generation sequencing to assess differences between sequences of specific influenza genome segments (HA, NA and/or PB2) or to investigate small outbreaks . These results have highlighted the importance of multiple introductions of community strains.…”

Section: Introductionmentioning

confidence: 99%

Nosocomial transmission of influenza: A retrospective cross‐sectional study using next generation sequencing at a hospital in England (2012‐2014)

Blackburn¹,

Frampton²,

Smith³

et al. 2019

Influenza Resp Viruses

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BackgroundThe extent of transmission of influenza in hospital settings is poorly understood. Next generation sequencing may improve this by providing information on the genetic relatedness of viral strains.ObjectivesWe aimed to apply next generation sequencing to describe transmission in hospital and compare with methods based on routinely‐collected data.MethodsAll influenza samples taken through routine care from patients at University College London Hospitals NHS Foundation Trust (September 2012 to March 2014) were included. We conducted Illumina sequencing and identified genetic clusters. We compared nosocomial transmission estimates defined using classical methods (based on time from admission to sample) and genetic clustering. We identified pairs of cases with space‐time links and assessed genetic relatedness.ResultsWe sequenced influenza sampled from 214 patients. There were 180 unique genetic strains, 16 (8.8%) of which seeded a new transmission chain. Nosocomial transmission was indicated for 32 (15.0%) cases using the classical definition and 34 (15.8%) based on genetic clustering. Of the 50 patients in a genetic cluster, 11 (22.0%) had known space‐time links with other cases in the same cluster. Genetic distances between pairs of cases with space‐time links were lower than for pairs without spatial links (P < .001).ConclusionsGenetic data confirmed that nosocomial transmission contributes significantly to the hospital burden of influenza and elucidated transmission chains. Prospective next generation sequencing could support outbreak investigations and monitor the impact of infection and control measures.

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“…Influenza is responsible for 3‐5 million cases of severe illness and 250 000‐500 000 deaths each year worldwide . In healthcare settings, outbreaks of influenza can result in significant morbidity and mortality especially in those with compromised or immature immune systems including the elderly, children younger than 5 years of age and those with chronic underlying conditions …”

Section: Introductionmentioning

confidence: 99%

Factors associated with influenza vaccination among healthcare workers in acute care hospitals in Canada

Hussain

McGeer

McNeil

et al. 2018

Influenza Resp Viruses

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BackgroundInfluenza vaccine coverage rates among healthcare workers (HCWs) in acute care facilities in Canada remain below national targets.ObjectiveTo determine factors associated with influenza vaccine uptake among HCWs.MethodsThis secondary analysis of a prospective cohort study included HCWs aged 18‐69 years, working ≥20 h/wk in a Canadian acute care hospital. Questionnaires were administered to participants in the fall of the season of participation (2011/12‐2013/14) which captured demographic/household characteristics, medical histories, occupational, behavioural and risk factors for influenza. Generalized estimating equation logistic regression was used to determine factors associated with vaccine uptake in the season of participation.ResultsThe adjusted odds ratio for influenza vaccination in the current season was highest for those vaccinated in 3 of 3 previous seasons (OR 156; 95% CI 98, 248) followed by those vaccinated in 2 of 3 and 1 of 3 previous seasons when compared with those not vaccinated. Compared with nurses, physicians (OR 4.2; 95% CI 1.4, 13.2) and support services staff (OR 1.8; 95% CI 1.3, 2.4) had higher odds ratios for vaccine uptake. Conversely, HCWs identifying as Black had lower odds of uptake compared with those with European ancestry (OR 0.44, 95% CI 0.26‐0.75) when adjusted for other factors in the model.ConclusionHealthcare workers differ in their annual uptake of influenza vaccine based on their past vaccination history, occupation and ethnicity. These findings indicate a need to determine whether there are other vaccine‐hesitant groups within healthcare settings and learn which approaches are successful in increasing their uptake of influenza vaccines.

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Transmission and Effect of Multiple Clusters of Seasonal Influenza in a Swiss Geriatric Hospital

Cited by 43 publications

References 30 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

Nosocomial transmission of influenza: A retrospective cross‐sectional study using next generation sequencing at a hospital in England (2012‐2014)

Factors associated with influenza vaccination among healthcare workers in acute care hospitals in Canada

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