Is it possible to hospitalize patients in multiple-bed room without increasing the risk of hospital-acquired influenza? Description of a pragmatic preventive strategy in a French university hospital.


Journal

American journal of infection control
ISSN: 1527-3296
Titre abrégé: Am J Infect Control
Pays: United States
ID NLM: 8004854

Informations de publication

Date de publication:
02 2022
Historique:
received: 22 06 2021
revised: 17 09 2021
accepted: 18 09 2021
pubmed: 26 9 2021
medline: 3 3 2022
entrez: 25 9 2021
Statut: ppublish

Résumé

Large inrush of patients through Emergency Department during influenza season can be dramatic. The purpose of this study was to evaluate the impact of an emergency preventive strategy, namely admission of patients with influenza in multiple-bed room with patients free from influenza, on the occurrence of hospital-acquired influenza (HAI). When a patient with an influenza RT-PCR diagnosis was hospitalized in a multiple-bed room, the emergency preventive strategy was applied: selection of non-immunocompromised neighbor, implementation of physical barriers (rigid screen pulled between beds, surgical mask for healthcare workers and visitors), preemptive Oseltamivir therapy for the neighbor. From 29/11/2017 to 10/05/2018 a total of 464 hospitalized influenza patients were included; 318 were placed in multiple-bed room and 141 in single room. Emergency preventive strategy was correctly applied for 75.1% of patients in multiple-bed room. A total of 8 exposed neighbors matched HAI definition despite strategy. 7 were already exposed to the case before the set-up of the strategy. Only one case of documented transmission of influenza occurred after application of an incorrect emergency preventive strategy: preventive posology of Oseltamivir was not correct. These preliminary results suggest that the occurrence of HAI in multiple-bed rooms can be limited by the implementation of maximum precautions and urge us to promote further evaluation of the strategy. A detection bias should be considered without a systematic neighbors monitoring.

Sections du résumé

BACKGROUND
Large inrush of patients through Emergency Department during influenza season can be dramatic. The purpose of this study was to evaluate the impact of an emergency preventive strategy, namely admission of patients with influenza in multiple-bed room with patients free from influenza, on the occurrence of hospital-acquired influenza (HAI).
METHODS
When a patient with an influenza RT-PCR diagnosis was hospitalized in a multiple-bed room, the emergency preventive strategy was applied: selection of non-immunocompromised neighbor, implementation of physical barriers (rigid screen pulled between beds, surgical mask for healthcare workers and visitors), preemptive Oseltamivir therapy for the neighbor.
RESULTS
From 29/11/2017 to 10/05/2018 a total of 464 hospitalized influenza patients were included; 318 were placed in multiple-bed room and 141 in single room. Emergency preventive strategy was correctly applied for 75.1% of patients in multiple-bed room. A total of 8 exposed neighbors matched HAI definition despite strategy. 7 were already exposed to the case before the set-up of the strategy. Only one case of documented transmission of influenza occurred after application of an incorrect emergency preventive strategy: preventive posology of Oseltamivir was not correct.
CONCLUSIONS
These preliminary results suggest that the occurrence of HAI in multiple-bed rooms can be limited by the implementation of maximum precautions and urge us to promote further evaluation of the strategy. A detection bias should be considered without a systematic neighbors monitoring.

Identifiants

pubmed: 34562527
pii: S0196-6553(21)00617-9
doi: 10.1016/j.ajic.2021.09.016
pii:
doi:

Substances chimiques

Antiviral Agents 0
Oseltamivir 20O93L6F9H

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

155-158

Informations de copyright

Copyright © 2021 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Auteurs

Fabiana Cazzorla (F)

Grenoble Alpes University Hospital, Infection Control Unit, Grenoble, France.

Othmane Azzam (O)

Grenoble Alpes University Hospital, Infection Control Unit, Grenoble, France.

Emeline Buet (E)

Grenoble Alpes University Hospital, Infection Control Unit, Grenoble, France.

Meghann Gallouche (M)

University Grenoble Alpes, CNRS, MESP TIM-C, UMR 5525, Grenoble Alpes University Hospital, Infection Control Unit, Grenoble, France.

Sylvie Larrat (S)

Grenoble Alpes University Hospital, Virology Laboratory, Grenoble, France.

Céline Giner (C)

Grenoble Alpes University Hospital, Infection Control Unit, Grenoble, France.

Marie Reine Mallaret (MR)

Grenoble Alpes University Hospital, Infection Control Unit, Grenoble, France.

Patrice Morand (P)

University Grenoble Alpes, CNRS, CEA, UMR 5075, Structural Biology Institut, Grenoble Alpes University Hospital, Virology Laboratory, Grenoble, France.

Caroline Landelle (C)

University Grenoble Alpes, CNRS, MESP TIM-C, UMR 5525, Grenoble Alpes University Hospital, Infection Control Unit, Grenoble, France. Electronic address: caroline.landelle@gmail.com.

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