Investigating Epidemiologic and Molecular Links Between Patients With Community- and Hospital-Acquired Influenza A: 2017-2018 and 2019-2020, Michigan.

Autor: Wan T; Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA., Lauring AS; Department of Microbiology and Immunology, University of Michigan, Ann Arbor, Michigan, USA.; Division of Infectious Diseases, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA., Valesano AL; Department of Microbiology and Immunology, University of Michigan, Ann Arbor, Michigan, USA., Fitzsimmons WJ; Division of Infectious Diseases, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA., Bendall EE; Department of Microbiology and Immunology, University of Michigan, Ann Arbor, Michigan, USA., Kaye KS; Division of Allergy, Immunology and Infectious Diseases, Department of Medicine, Rutgers-Robert Wood Johnson School of Medicine, New Brunswick, New Jersey, USA., Petrie JG; Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Institute, Marshfield, Wisconsin, USA.
Jazyk: angličtina
Zdroj: Open forum infectious diseases [Open Forum Infect Dis] 2023 Feb 08; Vol. 10 (2), pp. ofad061. Date of Electronic Publication: 2023 Feb 08 (Print Publication: 2023).
DOI: 10.1093/ofid/ofad061
Abstrakt: Background: Hospital-acquired influenza virus infection (HAII) can cause severe morbidity and mortality. Identifying potential transmission routes can inform prevention strategies.
Methods: We identified all hospitalized patients testing positive for influenza A virus at a large, tertiary care hospital during the 2017-2018 and 2019-2020 influenza seasons. Hospital admission dates, locations of inpatient service, and clinical influenza testing information were retrieved from the electronic medical record. Time-location groups of epidemiologically linked influenza patients were defined and contained ≥1 presumed HAII case (first positive ≥48 hours after admission). Genetic relatedness within time-location groups was assessed by whole genome sequencing.
Results: During the 2017-2018 season, 230 patients tested positive for influenza A(H3N2) or unsubtyped influenza A including 26 HAIIs. There were 159 influenza A(H1N1)pdm09 or unsubtyped influenza A-positive patients identified during the 2019-2020 season including 33 HAIIs. Consensus sequences were obtained for 177 (77%) and 57 (36%) of influenza A cases in 2017-2018 and 2019-2020, respectively. Among all influenza A cases, there were 10 time-location groups identified in 2017-2018 and 13 in 2019-2020; 19 of 23 groups included ≤4 patients. In 2017-2018, 6 of 10 groups had ≥2 patients with sequence data, including ≥1 HAII case. Two of 13 groups met this criteria in 2019-2020. Two time-location groups from 2017-2018 each contained 3 genetically linked cases.
Conclusions: Our results suggest that HAIIs arise from outbreak transmission from nosocomial sources as well as single infections from unique community introductions.
Competing Interests: Potential conflicts of interest. A. S. L. reports consulting fees from Sanofi and Roche, outside the submitted work. All other authors report no potential conflicts.
(© The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)
Databáze: MEDLINE
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