12 janvier 2023

Prévention des grippes nosocomiales : ajouter le port du masque et le diagnostic rapide aux mesures habituelles

Effect of a multimodal strategy for prevention of nosocomial influenza: a retrospective study at Grenoble Alpes university hospital from 2014 to 2019

Background. A multimodal strategy to prevent nosocomial influenza was implemented in 2015-2016 in Grenoble Alpes University Hospital. Three modalities were implemented in all units: promotion of vaccination among healthcare workers, epidemiologic surveillance and communication campaigns. Units receiving a high number of patients with influenza implemented 2 additional modalities: improvement of diagnosis capacities and systematic surgical mask use. The main objective was to assess the effectiveness of the strategy for reducing the risk of nosocomial influenza. Methods. A study was conducted retrospectively investigating 5 epidemic seasons (2014-2015 to 2018-2019) including all patients hospitalized with a positive influenza test at Grenoble Alpes university hospital. The weekly number of nosocomial influenza cases was analyzed by Poisson regression and incidence rate ratios (IRR) were estimated. Results. A total of 1540 patients, resulting in 1559 stays, were included. There was no significant difference between the 5 influenza epidemic seasons in the units implementing only 3 measures. In the units implementing the 5 measures, there was a reduction of nosocomial influenza over the seasons when the strategy was implemented compared to the 2014-2015 epidemic season (IRR=0.56, 95% CI=0.23-1.34 in 2015-2016; IRR=0.39, 95% CI=0.19-0.81 in 2016-2017; IRR=0.50, 95% CI=0.24-1.03 in 2017-2018; IRR=0.48, 95% CI=0.23-0.97 in 2018-2019). Conclusions. Our data mainly suggested that the application of the strategy with 5 modalities, including systematic surgical mask use and rapid diagnosis, seemed to reduce by half the risk of nosocomial influenza. Further data, including medico-economic studies, are necessary to determine the opportunity of extending these measures at a larger scale.

Gallouche M, Terrisse H, Larrat S, et al. Antimicrob Resist Infect Control 2022;11(1):31. Doi : 10.1186/s13756-021-01046-y.