Abstract
BackgroundIn 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.MethodsAn 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.ResultsOne 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).ConclusionsNosocomial 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.
Highlights
In addition to outbreaks of nosocomial influenza, sporadic nosocomial influenza infections occur but are generally not reported in the literature
This study aimed to determine the epidemiologic characteristics of nosocomial influenza cases in acute-care hospital settings in Catalonia (Spain) identified by surveillance rather than through outbreak control activity during six consecutive influenza seasons (2010–2011 to 2015–2016)
Nosocomial influenza cases had a higher frequency of age 65–74 years (22.9% vs. 18.8%, P < .13), and ≥ 75 years (40.6% vs. 33.9%, P < .15), diabetes (35.4% vs. 24.4%, P = .02), chronic renal disease (29.2% vs. 12.8% P < .001), immunodeficiency (28.1% vs. 18.9% P < .001), chronic cardiovascular disease (39.6% vs. 28.8% P < .02) and chronic liver disease (8.3% vs. 6.4% P = .25)
Summary
In addition to outbreaks of nosocomial influenza, sporadic nosocomial influenza infections 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. Among adults aged ≥65 years and patients with underlying chronic diseases influenza is a leading cause of severe illness and death. Sentinel surveillance of patients hospitalized due to severe laboratory-confirmed influenza is critical to control the. The Department of Health of Catalonia (Spain) introduced the surveillance of patients hospitalized with laboratory-confirmed influenza to supplement the information provided by the influenza sentinel surveillance system, based on primary healthcare physicians, in October 2010 [4]. Nosocomial influenza is a recognized public health problem in acute-care hospital settings [5] and has been associated with significant morbidity, mortality and high economic costs due to longer hospital stays. It is likely to be under-recognized due to rapid patient turnover and delays in diagnosis
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