Institute of Biomedicine, Department of Infectious Diseases, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Public Health Agency of Sweden, Solna, Sweden.
J Hosp Infect. 2019 Jan;101(1):30-37. doi: 10.1016/j.jhin.2018.06.004. Epub 2018 Aug 23.
To describe a hospital outbreak of influenza B virus (InfB) infection during season 2015/2016 by combining clinical and epidemiological data with molecular methods.
Twenty patients diagnosed with InfB from a hospital outbreak over a four-week-period were included. Nasopharyngeal samples (NPS) positive for InfB by multiplex real-time polymerase chain reaction were sent for lineage typing and whole genome sequencing (WGS). Medical records were reviewed retrospectively for data regarding patient characteristics, localization, exposure and outcome, and assembled into a timeline. In order to find possible connections to the hospital outbreak, all patients with a positive NPS for influenza from the region over an extended time period were also reviewed.
All 20 cases of InfB were of subtype B/Yamagata, and 17 of 20 patients could be linked to each other by either shared room or shared ward. WGS was successful or partially successful for 15 of the 17 viral isolates, and corroborated the epidemiological link supporting a close relationship. In the main affected ward, 19 of 75 inpatients were infected with InfB during the outbreak period, resulting in an attack rate of 25%. One probable case of influenza-related death was identified.
InfB may spread within an acute care hospital, and advanced molecular methods may facilitate assessment of the source and extent of the outbreak. A multi-faceted approach, including rapid diagnosis, early recognition of outbreak situations, simple rules for patient management and the use of regular infection control measures, may prevent nosocomial transmission of influenza virus.
通过结合临床和流行病学数据与分子方法，描述 2015/2016 年度期间医院内乙型流感病毒（InfB）感染爆发情况。
在为期四周的时间内，共纳入了 20 例因 InfB 感染而确诊的患者。通过多重实时聚合酶链反应检测到鼻咽样本（NPS）呈 InfB 阳性的患者，将其样本用于谱系分型和全基因组测序（WGS）。回顾性分析病历资料，以获取患者特征、定位、暴露和结果等方面的数据，并将其整理成时间表。为了寻找可能与医院爆发有关的线索，还回顾了该地区在较长时间内所有因流感而 NPS 呈阳性的患者。
20 例 InfB 均为 B/Yamagata 亚型，其中 20 例患者中的 17 例可通过共享房间或病房彼此相关联。对 17 例病毒分离株中的 15 例进行了 WGS 测序，测序成功或部分成功，这与支持密切关联的流行病学联系结果一致。在主要受影响的病房中，75 名住院患者中有 19 人在爆发期间感染了 InfB，感染率为 25%。发现了一例可能与流感相关的死亡病例。
InfB 可能在急性护理医院内传播，先进的分子方法可能有助于评估疫情的来源和范围。多方面的方法，包括快速诊断、早期识别疫情情况、简单的患者管理规则以及常规感染控制措施的使用，可能有助于预防流感病毒在医院内的传播。
