Gorišek Miksić N, Uršič T, Simonović Z, Lusa L, Lobnik Rojko P, Petrovec M, Strle F
Department of Infectious Diseases, University Medical Centre Maribor, Ljubljanska 5, 2000, Maribor, Slovenia,
Infection. 2015 Feb;43(1):73-81. doi: 10.1007/s15010-014-0703-4. Epub 2014 Nov 18.
To assess influenza outbreaks in nursing homes (NHs) using different pharmacological preventive measures.
We compared characteristics of influenza A outbreaks that occurred during 2011/2012 influenza season in three NHs of similar size (208, 167, and 164 residents in NH1, NH2, and NH3, respectively) implementing comparable treatment approaches and non-pharmacological outbreak control measures but different prophylactic pharmacological interventions including oseltamivir 75 mg o.d. for 10 days for all residents (NH1), for directly exposed residents (NH2), and no prophylaxis (NH3).
The proportions of residents who developed acute respiratory infection (ARI) in the course of influenza outbreak were 55/208 (26.4 %) in NH1, 64/167 (38.3 %) in NH2, and 31/164 (18.9 %) in NH3; hospital admission was required in 2/55 (3.6 %), 5/64 (7.8 %), and 5/31 (16.1 %) residents of NH1, NH2, and NH3, respectively, while 1/55 (1.8 %), 1/64 (1.6 %), and 3/31 (9.7 %) residents of the corresponding NHs died during influenza outbreak. The duration of the outbreak was shorter in the NH1 where oseltamivir prophylaxis was instituted for all residents (8 days), than in NHs where selective prophylaxis with oseltamivir and no prophylaxis were used (14 and 12 days, respectively). The calculated vaccine effectiveness in residents was 48, 71, and 44 % in NH1, NH2, and NH3, respectively. Staff members had similar ARI attack rate but in comparison to residents were less often vaccinated against influenza and demonstrated higher influenza vaccine effectiveness.
Comparison of influenza outbreaks in three NHs revealed that the duration of the outbreak was the shortest in the NH where prophylaxis with oseltamivir was given to all residents.
评估采用不同药物预防措施的养老院流感暴发情况。
我们比较了2011/2012流感季节期间，三家规模相似的养老院（NH1、NH2和NH3分别有208名、167名和164名居民）甲型流感暴发的特征。这三家养老院采用了可比的治疗方法和非药物暴发控制措施，但预防性药物干预措施不同，包括NH1对所有居民给予75毫克奥司他韦每日一次，共10天；NH2对直接暴露的居民给予奥司他韦；NH3不进行预防。
在流感暴发期间发生急性呼吸道感染（ARI）的居民比例，NH1为55/208（26.4%），NH2为64/167（38.3%），NH3为31/164（18.9%）；NH1、NH2和NH3分别有2/55（3.6%）、5/64（7.8%）和5/31（16.1%）的居民需要住院治疗，而相应养老院分别有1/55（1.8%）、1/64（1.6%）和3/31（9.7%）的居民在流感暴发期间死亡。对所有居民采用奥司他韦预防的NH1暴发持续时间较短（8天），而采用选择性奥司他韦预防和不进行预防的NH2和NH3暴发持续时间分别为14天和12天。计算得出居民的疫苗效力在NH1、NH2和NH3中分别为48%、71%和44%。工作人员的ARI发病率相似，但与居民相比，接种流感疫苗的频率较低，且流感疫苗效力较高。
对三家养老院流感暴发情况的比较显示，对所有居民采用奥司他韦预防的养老院暴发持续时间最短。
