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Effect of influenza vaccination among healthcare workers on hospital-acquired influenza in short-stay hospitalized patients: A multicenter pilot study in France

Published online by Cambridge University Press:  06 April 2022

Sélilah Amour
Affiliation:
Service d’Hygiène, Epidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, Lyon, France Centre International de Recherche en Infectiologie, Institut National de la Santé et de la Recherche Médicale, Centre National de la Recherche Scientifique Unité Mixte de Recherche, École Nationale Supérieure de Lyon, Université Claude Bernard Lyon, Lyon, France
Thomas Bénet
Affiliation:
Service d’Hygiène, Epidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, Lyon, France
Corinne Regis
Affiliation:
Université de Lyon, Université Claude Bernard Lyon, Lyon, France
Olivier Robert
Affiliation:
Service de Médecine du travail, Hôpital Edouard Herriot, Groupement Hospitalier Centre, Hospices Civils de Lyon, Lyon, France
Luc Fontana
Affiliation:
Service de Médecine du travail, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
Bruno Lina
Affiliation:
Laboratoire de Virologie, Institut des Agents Infectieux, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France Centre National de Référence des Virus des Infections Respiratoires (dont la grippe), Hospices Civils de Lyon, Lyon, France Faculté de Médecine Lyon Est, CIRI, Inserm U1111 CNRS UMR5308, Université Lyon, Virpath, Lyon, France
Bruno Pozzetto
Affiliation:
Laboratoire Agents infectieux et Hygiène, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
Philippe Berthelot
Affiliation:
Unité de Gestion du Risque Infectieux, Service d’Infectiologie et Service des Agents Infectieux et Hygiène, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
Philippe Vanhems*
Affiliation:
Service d’Hygiène, Epidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, Lyon, France Centre International de Recherche en Infectiologie, Institut National de la Santé et de la Recherche Médicale, Centre National de la Recherche Scientifique Unité Mixte de Recherche, École Nationale Supérieure de Lyon, Université Claude Bernard Lyon, Lyon, France
*
Author for correspondence: Prof. Philippe Vanhems, E-mail: philippe.vanhems@chulyon.fr

Abstract

Background:

Exposure to infected healthcare workers (HCWs) is a source of hospital-acquired (HA) influenza. We estimated the risk of HA influenza for hospitalized patients by rate of influenza vaccine coverage (IVC) of HCWs.

Methods:

A case–case negative control study nested in a prospective cohort was conducted in 2 French university hospitals during 2 influenza seasons. Each inpatient with influenza-like illness (ILI) provided a nasal swab sample that was systematically analyzed for influenza virus by polymerase chain reaction (PCR) testing. An HA influenza case was a patient with a virological confirmation of influenza with onset of symptoms ≥72 hours after admission to the ward. The IVC rate of HCWs in each participating ward was calculated from the data provided by the occupational health departments. A mixed-effect logistic regression was performed with adjustments on patient sex, age, the presence of a potential source of influenza on the ward in the 5 days prior to the start of the ILI, type of ward and influenza season.

Results:

The overall HA influenza attack rate was 1.9 per 1,000 hospitalized patients. In total, 24 confirmed HA influenza cases and 141 controls were included. The crude odds ratio (OR) of HA influenza decreased from 0.52 (95% confidence interval [CI], 0.21–1.29) to 0.14 (95% CI, 0.03–0.63) when the IVC of HCWs increased from 20% to 40%. After adjustment, IVC ≥40% was associated with a risk reduction of HA influenza (aOR, 0.07; 95% CI, 0.01–0.78).

Conclusions:

Considering a limited sample size, influenza vaccination of HCWs is highly suggestive of HA flu prevention among hospitalized patients.

Trial Registration: clinicaltrials.gov identifier: NCT02198638.

Type
Original Article
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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Footnotes

PREVIOUS PRESENTATION. This study was presented in part as abstract P092 at the Sixth International Conference on Prevention and Infection Control (ICPIC) in Geneva, Switzerland, on September 14–17, 2021.

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