Auvinen Raija, Huotari Kaisa, Nohynek Hanna, Syrjänen Ritva K, Skogberg Kirsi
Inflammation Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Department of Health Security, Finnish Institute for Health and Welfare, Helsinki, Finland.
Infect Prev Pract. 2024 Dec 26;7(1):100431. doi: 10.1016/j.infpip.2024.100431. eCollection 2025 Mar.
While nosocomial influenza is common, the risk of transmission in acute care remains unclear in the absence of systematic surveillance. Even less is known about the risk of nosocomial respiratory syncytial virus (RSV) among immunocompetent adults.
To compare the proportions and incidences of nosocomial cases caused by these two similar respiratory infections among hospitalized adults.
A retrospective study was conducted at two tertiary care hospitals in Southern Finland. Data on all hospitalized adult patients with a positive RSV or influenza test during 2016-22 were used to detect all nosocomial and community-acquired RSV and influenza cases. The proportion of nosocomial cases of all hospitalized cases was calculated. The incidences of nosocomial cases per 1000 bed-days were calculated by season and ward type for the five seasons before the COVID-19 pandemic.
Nosocomial RSV and influenza occurred in 2.8% and 8.1% of all hospitalized adult patients with a laboratory-confirmed infection. Over five seasons, 2016-20, the total incidences of nosocomial RSV and influenza cases per 1000 bed-days were 0.027 (95% confidence interval: 0.013, 0.050) and 0.32 (0.27, 0.39). Nosocomial RSV infections were especially poorly recorded with a virus-specific ICD-10 diagnosis code listed for only 16.7% of RSV and 59.8% of nosocomial influenza patients.
Despite preventive measures, the incidence of nosocomial influenza was more than tenfold, and the proportion of nosocomial cases was almost threefold compared with RSV among hospitalized adults in acute care. Prevention and surveillance of both nosocomial influenza and RSV should be improved also among immunocompetent adult patients.
虽然医院获得性流感很常见，但在缺乏系统监测的情况下，急性护理中的传播风险仍不明确。对于免疫功能正常的成年人中医院获得性呼吸道合胞病毒（RSV）的风险，了解得更少。
比较这两种相似的呼吸道感染在住院成人中引起的医院获得性病例的比例和发病率。
在芬兰南部的两家三级护理医院进行了一项回顾性研究。利用2016年至2022年期间所有RSV或流感检测呈阳性的住院成年患者的数据，以检测所有医院获得性和社区获得性RSV和流感病例。计算所有住院病例中医院获得性病例的比例。在2019冠状病毒病大流行前的五个季节中，按季节和病房类型计算每1000个床日的医院获得性病例发病率。
在所有实验室确诊感染的住院成年患者中，医院获得性RSV和流感分别占2.8%和8.1%。在2016年至2020年的五个季节中，每1000个床日的医院获得性RSV和流感病例的总发病率分别为0.027（95%置信区间：0.013，0.050）和0.32（0.27，0.39）。医院获得性RSV感染的记录尤其不佳，只有16.7%的RSV患者和59.8%的医院获得性流感患者有病毒特异性的国际疾病分类第十版（ICD-10）诊断代码。
尽管采取了预防措施，但在急性护理的住院成人中，医院获得性流感的发病率是RSV的十多倍，医院获得性病例的比例几乎是RSV的三倍。在免疫功能正常的成年患者中，也应加强对医院获得性流感和RSV的预防和监测。
