Huzly Daniela, Kurz Sven, Ebner Winfried, Dettenkofer Markus, Panning Marcus
Institute for Virology, Medical Center-University of Freiburg, Freiburg, Germany.
Department for Environmental Health Sciences and Hospital Infection Control, Medical Center-University of Freiburg, Freiburg, Germany.
J Clin Virol. 2015 Dec;73:47-51. doi: 10.1016/j.jcv.2015.10.016. Epub 2015 Oct 24.
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.
To systematically analyse the distribution of nosocomial and community-acquired influenza and epidemiological characteristics in a tertiary care unit in two consecutive seasons.
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.
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.
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.
医院获得性流感日益被视为一种重要的公共卫生威胁，每年都会导致相当高的发病率和死亡率。然而，医院获得性流感的数据通常仅在疫情暴发期间收集，且关于医院获得性流感的临床信息非常稀少。
系统分析一家三级医疗机构连续两个季节中医院获得性流感和社区获得性流感的分布情况及流行病学特征。
进行了一项回顾性观察研究，以确定并描述2013年1月1日至2014年4月30日期间弗赖堡大学医院医院获得性流感和社区获得性流感的病例。全程使用经过验证的多重逆转录聚合酶链反应（RT-PCR）来检测流感病毒和其他呼吸道病原体。临床信息从医院信息系统中获取。
总体而言，纳入了218例实验室确诊的流感患者（第一季179例，第二季39例）。整个期间医院获得性流感的发生率为20%。医院获得性流感病例中有9%出现了致命结局，主要与甲型H1N1流感病毒（pdm09）有关。医院获得性流感在所有年龄组中均有发生，但仅在18岁及以上患者中观察到死亡病例。与社区获得性流感患者相比，医院获得性流感患者年龄显著更大，更频繁地接受血液系统恶性肿瘤治疗和免疫抑制方案，且更常接受实体器官移植。
尽管两个流感季节之间病毒亚型分布和流行病学特性有所不同，但医院获得性流感病例的发生率保持相似。系统检测和针对性预防措施似乎对于将医院获得性流感降至最低至关重要。
