Routes of transmission during a nosocomial influenza A(H3N2) outbreak among geriatric patients and healthcare workers
Routes of transmission during a nosocomial influenza A(H3N2) outbreak among geriatric patients and healthcare workers
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DOI：
10.1016/j.jhin.2013.11.009
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发表时间：
2014-03-01
影响因子：
6.9
通讯作者：
Lina, B.
中科院分区：
文献类型：
--
作者：
Eibach, D.;Casalegno, J. -S.;Lina, B.
背景资料：流感对住院的老年患者来说是一种危及生命的感染，他们可能通过医护人员（HCW）、其他患者或访客感染。2011/2012年流感季节，里昂Edouard Herriot医院老年科发生甲型H3 N2流感疫情。目的：通过序列分析阐明此次甲型H3 N2流感疫情的传播链，并确定预防措施。方法：流感患者的实验室检测-2012年2月19日至3月15日期间，急性护理老年科的类似疾病显示了22例流感病例。计算患者和医务工作者的发病率，并使用问卷调查分析可能的流行病学联系。神经氨酸酶和血凝素基因的培养阳性样本和社区流感样本进行测序和聚类检测患者相同的病毒strain.Findings：16例患者和6个HCWs受到影响，导致的攻击率分别为24%和11%。记录了6例医院感染。序列分析证实了三个独立的流感集群在三个不同的部分老年病房。对于至少两个集群，HCW源determined.Conclusion：流行病学和微生物学结果证实流感从HCW传播给患者。建议提高疫苗接种率、采取隔离措施和加强手部卫生，以防止在未来流感季节爆发。(C)2014年，卫生保健感染协会。由爱思唯尔有限公司出版。保留所有权利。
Background: Influenza presents a life-threatening infection for hospitalized geriatric patients, who might be nosocomially infected via healthcare workers (HCWs), other patients or visitors. In the 2011/2012 influenza season an influenza A(H3N2) outbreak occurred in the geriatric department at the Hopital Edouard Herriot, Lyon.Aim: To clarify the transmission chain for this influenza A(H3N2) outbreak by sequence analysis and to identify preventive measures.Methods: Laboratory testing of patients with influenza-like illness in the acute care geriatric department revealed 22 cases of influenza between 19th February and 15th March 2012. Incidences for patients and HCWs were calculated and possible epidemiological links were analysed using a questionnaire. Neuraminidase and haemagglutinin genes of culture-positive samples and community influenza samples were sequenced and clustered to detect patients with identical viral strains.Findings: Sixteen patients and six HCWs were affected, resulting in an attack rate of 24% and 11% respectively. Six nosocomial infections were recorded. The sequence analysis confirmed three independent influenza clusters on three different sections of the geriatric ward. For at least two clusters, an HCW source was determined.Conclusion: Epidemiological and microbiological results confirm influenza transmission from HCWs to patients. A higher vaccination rate, isolation measures and better hand hygiene are recommended in order to prevent outbreaks in future influenza seasons. (C) 2014 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.