Fabiana Cazzorla1, Othmane Azzam1, Emeline Buet1, Meghann Gallouche2, Sylvie Larrat3, Céline Giner1, Marie Reine Mallaret1, Patrice Morand4, Caroline Landelle5. 1. Grenoble Alpes University Hospital, Infection Control Unit, Grenoble, France. 2. University Grenoble Alpes, CNRS, MESP TIM-C, UMR 5525, Grenoble Alpes University Hospital, Infection Control Unit, Grenoble, France. 3. Grenoble Alpes University Hospital, Virology Laboratory, Grenoble, France. 4. University Grenoble Alpes, CNRS, CEA, UMR 5075, Structural Biology Institut, Grenoble Alpes University Hospital, Virology Laboratory, Grenoble, France. 5. University Grenoble Alpes, CNRS, MESP TIM-C, UMR 5525, Grenoble Alpes University Hospital, Infection Control Unit, Grenoble, France. Electronic address: caroline.landelle@gmail.com.
Abstract
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.
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.