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Nosocomial influenza in a pediatric general ward: Effects of isolation and cohort placement of children with influenza

Published online by Cambridge University Press:  16 March 2023

Woosuck Suh Open the ORCID record for Woosuck Suh [Opens in a new window]  and
Seung Beom Han Open the ORCID record for Seung Beom Han [Opens in a new window]
Woosuck Suh
Affiliation:
Department of Pediatrics, Daejeon St. Mary’s Hospital, The Catholic University of Korea, Daejeon, Republic of Korea
Seung Beom Han*
Affiliation:
Department of Pediatrics, Hallym University Hangang Sacred Heart Hospital, Seoul, Republic of Korea
*
Author for correspondence: Seung Beom Han, E-mail: beomsid@catholic.ac.kr
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Abstract

Objective:

Many studies have described nosocomial outbreaks of influenza in specialized wards. We evaluated nosocomial transmission of influenza in a pediatric general ward.

Design:

Retrospective observational study.

Setting:

Single secondary hospital.

Patients:

The study included 814 hospitalized children with influenza between September 2015 and August 2020.

Methods:

The medical records of the included children were retrospectively reviewed, and clinical characteristics of children with community-acquired (CA) influenza and hospital-acquired (HA) influenza were determined. The room of each included child during hospitalization was traced to identify the children exposed to them.

Results:

CA influenza and HA influenza were diagnosed in 789 (96.9%) and 25 (3.1%) children, respectively. Among children with CA influenza, 691 (87.6%) were isolated or place in a cohort on admission. In total, 98 children (12.4%) admitted to multibed rooms exposed 307 children with noninfluenza diseases to influenza during 772 patient days; 3 exposed children (1.0%) were diagnosed with HA influenza. Including these 3 children, 25 children (19 without definite in-hospital exposure to influenza and 3 exposed to other children with HA influenza) were diagnosed with HA influenza, and 11 (44.0%) exposed 31 children with noninfluenza diseases to influenza for 85 patient days. Also, 3 exposed children (9.7%) were diagnosed with HA influenza, a significantly higher rate than that for CA influenza (P = .005). The clinical characteristics were comparable between children with HA influenza and those with CA influenza.

Conclusions:

Cohort placement of children with influenza in a pediatric general ward can be effective in controlling nosocomial transmission of influenza. However, control measures for children with HA influenza should be emphasized.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 44 , Issue 10 , October 2023 , pp. 1637 - 1642
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Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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References

Biggerstaff, M, Cauchemez, S, Reed, C, Gambhir, M, Finelli, L. Estimates of the reproduction number for seasonal, pandemic, and zoonotic influenza: a systematic review of the literature. BMC Infect Dis 2014;14:480.CrossRefGoogle ScholarPubMed
Carrat, F, Vergu, E, Ferguson, NM, et al. Time lines of infection and disease in human influenza: a review of volunteer challenge studies. Am J Epidemiol 2008;167:775–785.CrossRefGoogle ScholarPubMed
Maltezou, HC, Drancourt, M. Nosocomial influenza in children. J Hosp Infect 2003;55:83–91.CrossRefGoogle ScholarPubMed
Baek, JH, Seo, YB, Choi, WS, et al. Guideline on the prevention and control of seasonal influenza in healthcare setting. Korean J Intern Med 2014;29:265–280.CrossRefGoogle ScholarPubMed
Uyeki, TM, Bernstein, HH, Bradley, JS, et al. Clinical practice guidelines by the Infectious Diseases Society of America: 2018 update on diagnosis, treatment, chemoprophylaxis, and institutional outbreak management of seasonal influenzaa. Clin Infect Dis 2019;68:e1–e47.CrossRefGoogle Scholar
Voirin, N, Barret, B, Metzger, MH, Vanhems, P. Hospital-acquired influenza: a synthesis using the Outbreak Reports and Intervention Studies of Nosocomial Infection (ORION) statement. J Hosp Infect 2009;71:1–14.CrossRefGoogle ScholarPubMed
Coleman, BL, Ng, W, Mahesh, V, et al. Active surveillance for influenza reduces but does not eliminate hospital exposure to patients with influenza. Infect Control Hosp Epidemiol 2017;38:387–392.CrossRefGoogle Scholar
Fullana Barcelo, MI, Asensio Rodriguez, J, Artigues Serra, F, et al. Epidemiological and clinical characteristics of community-acquired and nosocomial influenza cases and risk factors associated with complications: a four-season analysis of all adult patients admitted in a tertiary hospital. Influenza Other Respir Viruses 2021;15:352–360.CrossRefGoogle ScholarPubMed
Gallouche, M, Terrisse, H, Larrat, S, et al. Effect of a multimodal strategy for prevention of nosocomial influenza: a retrospective study at Grenoble Alpes University Hospital from 2014 to 2019. Antimicrob Resist Infect Control 2022;11:31.CrossRefGoogle ScholarPubMed
Youngs, J, Marshall, B, Farragher, M, et al. Implementation of influenza point-of-care testing and patient cohorting during a high-incidence season: a retrospective analysis of impact on infection prevention and control and clinical outcomes. J Hosp Infect 2019;101:276–284.CrossRefGoogle ScholarPubMed
Bocquet, A, Wintenberger, C, Lupo, J, et al. Description of an influenza outbreak in a French university hospital and risk factors of nosocomial influenza. Eur J Clin Microbiol Infect Dis 2021;40:879–884.CrossRefGoogle Scholar
Luque-Paz, D, Pronier, C, Bayeh, B, et al. Incidence and characteristics of nosocomial influenza in a country with low vaccine coverage. J Hosp Infect 2020;105:619–624.CrossRefGoogle Scholar
Naudion, P, Lepiller, Q, Bouiller, K. Risk factors and clinical characteristics of patients with nosocomial influenza A infection. J Med Virol 2020;92:1047–1052.CrossRefGoogle ScholarPubMed
Parkash, N, Beckingham, W, Andersson, P, Kelly, P, Senanayake, S, Coatsworth, N. Hospital-acquired influenza in an Australian tertiary centre 2017: a surveillance based study. BMC Pulm Med 2019;19:79.CrossRefGoogle Scholar
Macesic, N, Kotsimbos, TC, Kelly, P, Cheng, AC. Hospital-acquired influenza in an Australian sentinel surveillance system. Med J Aust 2013;198:370–372.CrossRefGoogle Scholar
Huzly, D, Kurz, S, Ebner, W, Dettenkofer, M, Panning, M. Characterisation of nosocomial and community-acquired influenza in a large university hospital during two consecutive influenza seasons. J Clin Virol 2015;73:47–51.CrossRefGoogle Scholar
Khandaker, G, Rashid, H, Zurynski, Y, et al. Nosocomial vs community-acquired pandemic influenza A (H1N1) 2009: a nested case–control study. J Hosp Infect 2012;82:94–100.CrossRefGoogle ScholarPubMed
Martin, D, Honemann, M, Liebert, UG. Dynamics of nosocomial parainfluenza virus type 3 and influenza virus infections at a large German university hospital between 2012 and 2019. Diagn Microbiol Infect Dis 2021;99:115244.CrossRefGoogle Scholar
Bischoff, W, Petraglia, M, McLouth, C, Viviano, J, Bischoff, T, Palavecino, E. Intermittent occurrence of healthcare-onset influenza cases in a tertiary-care facility during the 2017–2018 flu season. Am J Infect Control 2020;48:112–115.CrossRefGoogle Scholar
Han, SB, Rhim, JW, Kang, JH, Lee, KY. Clinical features and outcomes of influenza by virus type/subtype/lineage in pediatric patients. Transl Pediatr 2021;10:54–63.CrossRefGoogle ScholarPubMed
Roosenhoff, R, Reed, V, Kenwright, A, et al. Viral kinetics and resistance development in children treated with neuraminidase inhibitors: the Influenza Resistance Information Study (IRIS). Clin Infect Dis 2020;71:1186–1194.CrossRefGoogle ScholarPubMed
Shinjoh, M, Takano, Y, Takahashi, T, Hasegawa, N, Iwata, S, Sugaya, N. Postexposure prophylaxis for influenza in pediatric wards oseltamivir or zanamivir after rapid antigen detection. Pediatr Infect Dis J 2012;31:1119–1123.CrossRefGoogle ScholarPubMed
Peaper, DR, Branson, B, Parwani, V, et al. Clinical impact of rapid influenza PCR in the adult emergency department on patient management, ED length of stay, and nosocomial infection rate. Influenza Other Respir Viruses 2021;15:254–261.CrossRefGoogle ScholarPubMed
Hayden, FG, Asher, J, Cowling, BJ, et al. Reducing influenza virus transmission: the potential value of antiviral treatment. Clin Infect Dis 2022;74:532–540.CrossRefGoogle ScholarPubMed
Blackburn, RM, Frampton, D, Smith, CM, et al. Nosocomial transmission of influenza: a retrospective cross-sectional study using next generation sequencing at a hospital in England (2012–2014). Influenza Other Respir Viruses 2019;13:556–563.CrossRefGoogle Scholar
Tamo, R, Turk, T, Boni, J, et al. Secondary attack rates from asymptomatic and symptomatic influenza virus shedders in hospitals: results from the TransFLUas influenza transmission study. Infect Control Hosp Epidemiol 2022;43:312–318.CrossRefGoogle ScholarPubMed