Salachas Costa, Le Hingrat Quentin, Haviari Skerdi, Valdes Audrey, Mackiewicz Vincent, Lolom Isabelle, Fidouh Nadhira, Visseaux Benoît, Bouzid Donia, Descamps Diane, Lucet Jean-Christophe, Charpentier Charlotte, Kernéis Solen
Université Paris Cité, INSERM, IAME, F-75018, Paris, France.
Équipe de Prévention du Risque Infectieux (EPRI), AP-HP, Hôpital Bichat, 75018, Paris, France.
Antimicrob Resist Infect Control. 2025 Apr 11;14(1):28. doi: 10.1186/s13756-025-01543-4.
Protecting patients from hospital-acquired viral respiratory infections is a major challenge, but the hierarchy of measures to achieve this is not yet completely clear.
To describe the epidemiology of hospital-acquired viral respiratory infections and associations with structural hospital factors and adherence to infection control protocols.
Retrospective cohort study conducted over 10 consecutive years (2014-2023) within 27 hospital wards in a 900-bed university hospital in Paris, France. All hospitalized adult patients who were tested for at least one virus on a respiratory sample during their stay were included. Structural factors (percentage of double occupancy rooms) and adherence to infection control protocols by healthcare workers (measured by consumption of alcohol-based hand sanitizer and of facemasks) were included as predictors in the model.
Incidence of hospital-acquired viral respiratory infections, defined by a positive PCR test for at least one respiratory virus, performed at least 5 days after hospital admission. Data were analyzed on ward-year aggregated data, with a linear mixed-effects model.
Overall, 183 994 viral PCR tests were performed over the study period. Incidence of hospital-acquired viral respiratory infections was 0.57/1000 hospital-days. After adjustment on other factors (mean length of stay, use of PCR testing), incidence of hospital-acquired viral respiratory infections in a given ward was significantly associated with: the incidence of community-acquired viral respiratory infections among patients admitted to the ward (+ 0.10/1000 hospital-days per each additional point of incidence; P < 0.001), the number of double-occupancy rooms (+ 0.04/1000 hospital-days per each 10%-increase of double-occupancy rooms; P = 0.03) and masks consumption (+ 0.33/1000 hospital-days per 10 additional masks used per day; P = 0.04). Similar results were found for double-occupancy rooms (+ 0.01/1000 hospital-days per each 10%-increase of double-occupancy rooms; P = 0.012) in the sub-group analysis of influenza cases.
In a given hospital ward, the incidence of community-acquired cases and the proportion of double-occupancy rooms are independently associated with the incidence hospital-acquired viral respiratory infections.
保护患者免受医院获得性病毒呼吸道感染是一项重大挑战，但实现这一目标的措施层级尚未完全明确。
描述医院获得性病毒呼吸道感染的流行病学情况以及与医院结构因素和感染控制方案依从性的关联。
在法国巴黎一家拥有900张床位的大学医院的27个病房内进行了一项为期10年（2014 - 2023年）的回顾性队列研究。纳入所有在住院期间至少对一份呼吸道样本进行过一种病毒检测的成年住院患者。模型中的预测因素包括结构因素（双人间的比例）和医护人员对感染控制方案的依从性（通过含酒精洗手液和口罩的消耗量来衡量）。
医院获得性病毒呼吸道感染的发病率，定义为入院至少5天后至少一种呼吸道病毒的PCR检测呈阳性。数据在病房 - 年份汇总数据上进行分析，采用线性混合效应模型。
在研究期间共进行了183994次病毒PCR检测。医院获得性病毒呼吸道感染的发病率为0.57/1000住院日。在对其他因素（平均住院时间、PCR检测的使用）进行调整后，特定病房中医院获得性病毒呼吸道感染的发病率与以下因素显著相关：该病房入院患者中社区获得性病毒呼吸道感染的发病率（每增加一个发病率点，增加0.10/1000住院日；P < 0.001）、双人间数量（双人间每增加10%，增加0.04/1000住院日；P = 0.03）以及口罩消耗量（每天每多使用10个口罩，增加0.33/1000住院日；P = 0.04）。在流感病例的亚组分析中，双人间也有类似结果（双人间每增加10%，增加0.01/1000住院日；P = 0.012）。
在特定医院病房中，社区获得性病例的发病率和双人间的比例与医院获得性病毒呼吸道感染的发病率独立相关。
