Nosocomial acquisition of influenza is associated with significant morbidity and mortality: results of a prospective observational study

Luke Blagdon Snell, Jasper P. Vink, Neville Verlander, Shahjahan Miah, Angie Lackenby, David Williams, Hannah Mitchell, Csaba Beviz, Morloh Kabia, Emma Cunningham, Rahul Batra, Jonathan Edgeworth, Maria Zambon, Gaia Nebbia

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

Background: Nosocomial acquisition of influenza is known to occur but the risk after exposure to a known case and the outcomes after acquisition are poorly defined. Methods: Prospective observational study of patients exposed to influenza from another patient in a multi-site healthcare organisation, with follow-up of 7 days or until discharge, and PCR-confirmation of symptomatic disease. Multivariable analysis was used to investigate association of influenza acquisition with high dependency unit/intensive care unit (HDU/ITU) admission and in-hospital mortality. Results: 23/298 (7.7%) contacts of 11 cases were subsequently symptomatic and tested influenza-positive during follow-up. HDU/ITU admission was significantly higher in these secondary cases (6/23, 26%) compared to flu-negative contacts (20/275, 7.2%; p = 0.002). In-hospital mortality was significantly higher in secondary cases (5/23, 21.7%) compared to flu-negative contacts (11/275, 4%; p < 0.001). In multivariable analysis, age (OR 1.25 95% CI: 1.01–1.54, p = 0.02) and being a secondary case (OR 4.77, 95% CI: 1.63–13.9, p = 0.008) were significantly associated with HDU/ITU admission in contacts. Age (OR 1.00, 95% CI: 0.93–1.00, p = 0.02), being a secondary case after exposure to influenza (OR 3.81, 95% CI 1.09–13.3, p = 0.049) and co-morbidity (OR 1.29 per unit increment in the Charlson score, 95% CI 1.02–1.61, p = 0.03) were significantly associated with in-hospital mortality in contacts. Conclusions: Nosocomial acquisition of influenza was significantly associated with increased risk of HDU/ITU admission and in-hospital mortality.

Original languageEnglish
Pages (from-to)1118-1123
Number of pages6
JournalJournal of Infection and Public Health
Volume15
Issue number10
DOIs
Publication statusPublished - 7 Sept 2022

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