老年人严重急性呼吸道感染（SARI）监测：一家大学医院的经验（2017-2018 年和 2018-2019 年季节）。

Severe Acute Respiratory Infections (SARI) surveillance in over-65-years-old patients: the experience of a University hospital (seasons 2017-2018 and 2018-2019).

机构信息

Sapienza University of Rome, Rome, Italy

Sant’Andrea Hospital, Rome, Italy

出版信息

Ann Ig. 2021 May-Jun;33(3):278-288. doi: 10.7416/ai.2021.2440.

DOI:10.7416/ai.2021.2440

PMID:33739359

Abstract

BACKGROUND

Influenza is a relevant public health problem, also due to the risk of complications. The most effective measure to prevent influenza is vaccination; therefore, at present, there is consensus among European countries, regarding the need for routine seasonal influenza vaccination of elderly and individuals at increased risk of severe influenza. At the same time, influenza surveillance is necessary to understand the viruses circulating and effectiveness of vaccination strategies. The present study reports the results of two seasons influenza surveillance (2017/2018 and 2018/2019) conduced in an University Hospital in Rome among hospitalized patients aged ≥65 years.

STUDY DESIGN

A prospective cohort study.

METHODS

The study consisted of systematic daily screening of all admissions among patients aged ≥65 years meeting a syndromic SARI case definition during two consecutive influenza seasons: 2017/2018 and 2018/2019. Characteristics of patients and their risk factors were collected by a standardized questionnaire and nose-pharyngeal swabs were performed to each patient. Influenza vaccine effectiveness (IVE), rates of vaccinated subjects and case fatality rate were also evaluated.

RESULTS

Influenza was laboratory confirmed in 11 (9.9%) of the 111 and 11 (9.6%) of the 115 enrolled patients in seasons 2017/18 and 2018/19, respectively. Adjusted IVE against all influenza type, calculated for each season, was 88.5% (95% CI: 38.9 to 97.8) and 61.7% (95% CI: -59.9 to 90.9) for 2017/2018 and 2018/2019 seasons, respectively. Our analysis shows a Case Fatality Rate of 2.7% and 4.3% for the 2017/18 and 2018/19 seasons, respectively.

CONCLUSIONS

The surveillance of SARI conduced in one hospital in Rome confirmed that influenza is an important cause of hospital admissions. Routine monitoring of infectious diseases and related aetiology associated with SARI, also at the local-level, is useful for targeting the right preventive measures.

摘要

背景

流感是一个相关的公共卫生问题，也存在并发症的风险。预防流感最有效的措施是接种疫苗；因此，目前欧洲各国一致认为，老年人和有患严重流感风险的人需要常规接种季节性流感疫苗。同时，进行流感监测对于了解流行病毒和疫苗接种策略的效果是必要的。本研究报告了在罗马一家大学医院进行的两个季节流感监测（2017/2018 年和 2018/2019 年）的结果，监测对象为≥65 岁的住院患者。

研究设计

前瞻性队列研究。

方法

本研究对 2017/2018 年和 2018/2019 年两个连续流感季节中符合综合征性严重急性呼吸道感染（SARI）病例定义的所有≥65 岁住院患者进行了系统的每日筛查。通过标准化问卷收集患者的特征和危险因素，并对每位患者进行鼻咽喉拭子检测。还评估了流感疫苗有效性（IVE）、接种疫苗者的比例和病死率。

结果

在 2017/18 年和 2018/19 年分别纳入的 111 例和 115 例患者中，有 11 例（9.9%）和 11 例（9.6%）患者的流感得到实验室确认。计算每个季节的所有流感类型的调整后 IVE 分别为 88.5%（95%CI：38.9 至 97.8）和 61.7%（95%CI：-59.9 至 90.9）。我们的分析显示，2017/18 年和 2018/19 年的病死率分别为 2.7%和 4.3%。