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Severe influenza/respiratory syncytial virus infections and hospital antimicrobial stewardship opportunities: impact of a 4-year surveillance including molecular diagnosis

Published online by Cambridge University Press:  22 June 2020

Marc Bourgeois Open the ORCID record for Marc Bourgeois [Opens in a new window] ,
Nathalie Ausselet ,
Veronique Gerard ,
Louis de Canniere ,
Nathan Scius ,
Isabelle Michaux ,
Te-Din Huang ,
Pierre Bogaerts ,
Charlotte Vandamme  and
Benoît Bihin
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Marc Bourgeois*
Affiliation:
Department of Infectious Diseases, CHU UCL Namur, Université catholique de Louvain, Yvoir, Belgium
Nathalie Ausselet
Affiliation:
Department of Infectious Diseases, CHU UCL Namur, Université catholique de Louvain, Yvoir, Belgium
Veronique Gerard
Affiliation:
Emergency Department, CHU UCL Namur, Université catholique de Louvain, Yvoir, Belgium
Louis de Canniere
Affiliation:
Emergency Department, CHU UCL Namur, Université catholique de Louvain, Yvoir, Belgium
Nathan Scius
Affiliation:
Emergency Department, CHU UCL Namur, Université catholique de Louvain, Yvoir, Belgium
Isabelle Michaux
Affiliation:
Department of Intensive Care, CHU UCL Namur, Université catholique de Louvain, Yvoir, Belgium
Te-Din Huang
Affiliation:
Laboratory of Microbiology, CHU UCL Namur, Université catholique de Louvain, Yvoir, Belgium
Pierre Bogaerts
Affiliation:
Laboratory of Microbiology, CHU UCL Namur, Université catholique de Louvain, Yvoir, Belgium
Charlotte Vandamme
Affiliation:
Department of Pharmacy, CHU UCL Namur, Université catholique de Louvain, Yvoir, Belgium
Benoît Bihin
Affiliation:
Biostatistics Unit, CHU UCL Namur, Université catholique de Louvain, Yvoir, Belgium (Present affiliation: Emergency Department, Clinique Saint-Luc, Bouge, Belgium [V.G.]); Department of Pharmacy, Centre Hospitalier Régional, Sambreville, Belgium [C.V.)])
Benedicte Delaere
Affiliation:
Department of Infectious Diseases, CHU UCL Namur, Université catholique de Louvain, Yvoir, Belgium
*
Author for correspondence: Marc Bourgeois, E-mail: marc.bourgeois@uclouvain.be. Or Bénédicte Delaere, mail: benedicte.delaere@uclouvain.be
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Abstract

Objective:

To assess the prevalence of influenza and respiratory syncytial virus (RSV) in adults hospitalized for a respiratory infection in the winter months and to evaluate the impact of a viral diagnosis on empirical antimicrobial management (antibiotics and antivirals).

Design:

Observational cohort study.

Setting:

Acute-care university hospital.

Patients:

The study included 963 adult patients hospitalized over a 4-year surveillance period.

Methods:

Annual surveillance timelines were defined according to epidemiological criteria related to the circulation of RSV and influenza viruses in the general population. Patients were screened following a severe acute respiratory infection (SARI) case definition at the emergency department and were enrolled for molecular assay targeting influenza/RSV viruses after oral informed consent. Epidemiological and clinical data were recorded prospectively, microbiological investigations, antimicrobial management, and outcome data were reviewed retrospectively.

Results:

An influenza or RSV virus was documented in 316 of 963 patients (33%). Optimization of antimicrobial management (AM) was achieved in 162 of 265 patients (61%) with a positive viral diagnosis and no bacterial infection at admission (AM treatment not initiated, n = 111; discontinued, n = 51). In contrast, only 128 of 462 patients (28%) with negative microbiological investigations did not have AM treatment initiated (n = 116) or had such treatment discontinued (n = 12). Early, targeted antiviral treatment was prescribed in 235 of 253 patients (93%) confirmed with influenza. Epidemiological, clinical, and outcome data were similar in both groups.

Conclusion:

Epidemiological surveillance associated with influenza/RSV molecular diagnosis in adults hospitalized for severe winter respiratory infections dramatically enhanced antimicrobial management.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 41 , Issue 10 , October 2020 , pp. 1184 - 1189
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Copyright
© 2020 by The Society for Healthcare Epidemiology of America. All rights reserved

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