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Observational Study
. 2015 Dec:73:47-51.
doi: 10.1016/j.jcv.2015.10.016. Epub 2015 Oct 24.

Characterisation of nosocomial and community-acquired influenza in a large university hospital during two consecutive influenza seasons

Daniela Huzly  1 , Sven Kurz  2 , Winfried Ebner  2 , Markus Dettenkofer  2 , Marcus Panning  3
Affiliations
Observational Study

Characterisation of nosocomial and community-acquired influenza in a large university hospital during two consecutive influenza seasons

Daniela Huzly et al. J Clin Virol. 2015 Dec.

Abstract

Background: Nosocomial influenza is increasingly recognized as an important public health threat causing considerable morbidity and mortality each year. However, data on nosocomial influenza is usually collected during outbreaks only and clinical information of nosocomial influenza is sparsely available.

Objectives: To systematically analyse the distribution of nosocomial and community-acquired influenza and epidemiological characteristics in a tertiary care unit in two consecutive seasons.

Study design: A retrospective observational study was conducted to identify and characterise cases of nosocomial and community-acquired influenza at Freiburg University hospital from 1 January 2013 to 30 April 2014. A validated multiplex RT-PCR to detect influenza virus and other respiratory pathogens was used throughout. Clinical information was retrieved from the hospital-based information system.

Results: Overall, 218 patients with laboratory-confirmed influenza were included (179 in the first, 39 patients in the second season). A rate of 20% of nosocomial influenza was observed throughout. A fatal outcome was recorded for 9% of nosocomial cases, which were mainly associated with influenza virus A(H1N1)pdm09. Nosocomial influenza occurred in all age groups, but fatalities were only observed in patients ≥18 years. Patients with nosocomial influenza were significantly older, underwent therapy for blood malignancies and immunosuppressive regimens more frequently, and received solid organ transplantation more often compared to community-acquired patients.

Conclusions: Despite the different distribution of virus subtypes and epidemiological properties between both influenza seasons, the rate of nosocomial cases remained similar. Systematic detection and targeted prevention measures seem mandatory to minimize nosocomial influenza.

Keywords: Hospital; Hygiene; Influenza virus; Multiplex PCR; Nosocomial influenza.

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Figures

Fig. 1
Fig. 1
Distribution of influenza cases (A) and nosocomial influenza cases (B) from January 2013 until April 2014.
Fig. 2
Fig. 2
Distribution of influenza subtypes across all age groups included in this study. Numbers above each column indicate number of patients.
Fig. 3
Fig. 3
Rate of fatal and nosocomial cases across all age groups included in this study. Numbers above each column indicate number of patients.
See this image and copyright information in PMC

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