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首页> 外文期刊>BMC Pulmonary Medicine >Hospital-acquired influenza in an Australian tertiary Centre 2017: a surveillance based study
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Hospital-acquired influenza in an Australian tertiary Centre 2017: a surveillance based study

机译：2017年澳大利亚三级中心医院获得性流感：一项基于监测的研究

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In 2017, Australia experienced its highest levels of influenza virus activity since the 2009 pandemic. This allowed detailed comparison of the characteristics of patients with community and hospital-acquired influenza, and infection control factors that contributed to influenza spread. A surveillance based study was conducted on hospitalised patients with laboratory-confirmed influenza at the Canberra Hospital during April–October 2017. Differences between the hospital-acquired and community-acquired patient characteristics and outcomes were assessed by univariate analysis. Epidemiologic curves were developed and cluster distribution within the hospital was determined. Two hundred and ninety-two patients were included in the study. Twenty-eight (9.6%) acquired influenza in hospital, representing a higher proportion than any of the previous 5?years (range 0.9–5.8%). These patients were more likely to have influenza A (p?=?0.021), had higher rates of diabetes (p?=?0.015), malignancy (p?=?0.046) and chronic liver disease (p?=?0.043). Patients acquiring influenza in hospital met clinical criteria for influenza like illness in 25% of cases, compared with 64.4% for community-acquired cases (p??0.001). Hospital-acquired influenza cases occurred in two distinct clusters. Patients were moved an average of 5 times after diagnosis. Mean length of stay following diagnosis was 13?days compared to 5?days for community-acquired cases (p??0.001). Of the patients with hospital-acquired influenza, 22 were in shared rooms during their incubation period and 9 were not isolated in single rooms following diagnosis. Treatment was initiated within the recommended 48?h period following symptom onset for 62.5% of hospital-acquired cases compared with 39.8% of community-acquired cases (p?=?0.033). Our results show that clinical presentation differed between patients with hospital-acquired influenza compared with those who acquired influenza in the community. Cases occurred in two clusters suggesting intra-hospital transmission rather than random importation from the community, highlighting the importance of infection control measures to limit influenza spread. Patients with hospital-acquired influenza may present without classical features of an influenza-like illness and this should promote earlier diagnostic testing and isolation to limit spread. Movement of patients after diagnosis is likely to facilitate spread within the hospital.
机译：自2009年大流行以来，澳大利亚在2017年经历了最高水平的流感病毒活动。这样就可以详细比较社区和医院获得性流感患者的特征，以及导致流感传播的感染控制因素。 2017年4月至2017年10月，在堪培拉医院对住院的实验室确诊流感患者进行了基于监测的研究。通过单因素分析评估了医院获得性和社区获得性患者特征和结局之间的差异。制定了流行病学曲线并确定了医院内的群集分布。研究共纳入292例患者。医院中有28名（9.6％）得了流感，占过去5年任何时间的比例更高（范围为0.9-5.8％）。这些患者更有可能患上甲型流感（p = 0.021），糖尿病（p = 0.015），恶性肿瘤（p = 0.046）和慢性肝病（p = 0.043）更高。在医院中获得流感的患者中有25％的人符合类似流感的临床标准，而在社区获得性病例中则为64.4％（p <0.001）。医院获得的流感病例分布在两个不同的群体中。诊断后平均将患者移动5次。诊断后的平均住院时间为13天，而社区获得者的平均住院时间为5天（p <0.001）。在医院获得性流感的患者中，有22位在潜伏期期间位于共用房间，而9位在诊断后并未隔离在单个房间中。在症状发作后的推荐的48小时内开始治疗，占医院获得病例的62.5％，而社区获得病例为39.8％（p？=？0.033）。我们的结果表明，与社区感染流感的患者相比，医院获得性流感患者的临床表现有所不同。在两个集群中发生的病例表明医院内传播而不是从社区随机输入，突出表明了采取感染控制措施以限制流感传播的重要性。患有医院获得性流感的患者可能没有典型的流感样疾病特征，因此应促进早期诊断测试和隔离以限制传播。诊断后患者的活动可能会促进医院内的传播。

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