Hospices Civils de Lyon, Hôpital Edouard Herriot, Service d'Hygiène, Epidémiologie et Prévention, Lyon, France.
BMC Infect Dis. 2012 Feb 1;12:30. doi: 10.1186/1471-2334-12-30.
In acute-care hospitals, no evidence of a protective effect of healthcare worker (HCW) vaccination on hospital-acquired influenza (HAI) in patients has been documented. Our study objective was to ascertain the effectiveness of influenza vaccination of HCW on HAI among patients.
A nested case-control investigation was implemented in a prospective surveillance study of influenza-like illness (ILI) in a tertiary acute-care university hospital. Cases were patients with virologically-confirmed influenza occurring ≥ 72 h after admission, and controls were patients with ILI presenting during hospitalisation with negative influenza results after nasal swab testing. Four controls per case, matched per influenza season (2004-05, 2005-06 and 2006-07), were randomly selected. Univariate and multivariate conditional logistic regression models were fitted to assess factors associated with HAI among patients.
In total, among 55 patients analysed, 11 (20%) had laboratory-confirmed HAI. The median HCW vaccination rate in the units was 36%. The median proportion of vaccinated HCW in these units was 11.5% for cases vs. 36.1% for the controls (P = 0.11); 2 (20%) cases and 21 (48%) controls were vaccinated against influenza in the current season (P = 0.16). The proportion of ≥ 35% vaccinated HCW in short-stay units appeared to protect against HAI among patients (odds ratio = 0.07; 95% confidence interval 0.005-0.98), independently of patient age, influenza season and potential influenza source in the units.
Our observational study indicates a shielding effect of more than 35% of vaccinated HCW on HAI among patients in acute-care units. Investigations, such as controlled clinical trials, are needed to validate the benefits of HCW vaccination on HAI incidence in patients.
在急症医院中，没有证据表明医护人员（HCW）接种疫苗对患者的医院获得性流感（HAI）有保护作用。我们的研究目的是确定 HCW 接种流感疫苗对患者 HAI 的效果。
在一家三级急症大学医院对流感样疾病（ILI）进行前瞻性监测研究中，进行了嵌套病例对照调查。病例为病毒学确诊的流感患者，且在入院后至少 72 小时发生，对照组为入院期间出现 ILI 且鼻拭子检测流感结果为阴性的患者。每个病例匹配 4 个对照，按流感季节（2004-05、2005-06 和 2006-07）进行匹配。采用单变量和多变量条件逻辑回归模型评估与患者 HAI 相关的因素。
共分析了 55 例患者，其中 11 例（20%）发生实验室确诊的 HAI。单位 HCW 疫苗接种率中位数为 36%。这些单位中，病例组中接种疫苗的 HCW 中位数比例为 11.5%，对照组为 36.1%（P = 0.11）；2 例（20%）病例和 21 例（48%）对照组在本季节接种了流感疫苗（P = 0.16）。短期住院单位中≥35%的接种 HCW 比例似乎可预防患者发生 HAI（比值比=0.07；95%置信区间 0.005-0.98），独立于患者年龄、流感季节和单位中潜在的流感来源。
我们的观察性研究表明，急性护理单位中接种疫苗的 HCW 比例超过 35%，可对患者的 HAI 起到保护作用。需要进行对照临床试验等研究，以验证 HCW 接种对患者 HAI 发生率的益处。
