Hospital-acquired influenza infections detected by a surveillance system over six seasons, from 2010/2011 to 2015/2016
Hospital-acquired influenza infections detected by a surveillance system over six seasons, from 2010/2011 to 2015/2016
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DOI：
10.1186/s12879-020-4792-7
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发表时间：
2020-01-28
影响因子：
3.7
通讯作者：
Force, L. L.
中科院分区：
文献类型：
--
作者：
Godoy, P.;Torner, N.;Force, L. L.
背景除了医院内流感爆发外，也会发生散发性医院内流感感染，但文献中一般没有报道。本研究旨在确定医院内流感病例的流行病学特征，并与加泰罗尼亚（西班牙）急性医院中通过监测确定的其余重症流感病例进行比较。方法在2010年至2016年期间对加泰罗尼亚12家医院的≥ 18岁患者进行了观察性病例-病例流行病学研究。对于每个实验室确诊的流感病例（医院或非医院），我们收集人口统计学，病毒学和临床特征。我们将医院内流感患者定义为因急性呼吸道感染以外的原因而入院的患者，这些患者在入院后≥ 48 h出现ILI症状，并使用RT-PCR证实流感病毒感染。混合效应回归用于估计粗OR和校正OR。结果纳入1722例实验室确诊的重症流感病毒感染住院患者：96例（5.6%）被归类为院内流感，住院时间> 14天（42.7% vs. 27.7%，P <0.001）和死亡率较高（18.8% vs. 12.6%，P <0.02）。与急性护理医院环境中医院内流感病例相关的变量为慢性肾脏疾病（aOR 2.44 95% CI 1.44-4.15）和免疫缺陷（aOR 1.79 95% CI 1.04-3.06）。结论医院感染是一个反复出现的问题，与慢性病和死亡率高有关。这些发现强调了遵守感染控制指南的必要性。
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.