Severe influenza/respiratory syncytial virus infections and hospital antimicrobial stewardship opportunities: Impact of a 4-year surveillance including molecular diagnosis

Marc Bourgeois, Nathalie Ausselet, Veronique Gerard, Louis De Canniere, Nathan Scius, Isabelle Michaux, Te Din Huang, Pierre Bogaerts, Charlotte Vandamme, Benoît Bihin, Benedicte Delaere

Research output: Contribution to journalArticlepeer-review

Abstract

Objective:To assess the prevalence of influenza and respiratory syncytial virus (RSV) in adults hospitalized for a respiratory infection in the winter months and to evaluate the impact of a viral diagnosis on empirical antimicrobial management (antibiotics and antivirals).Design:Observational cohort study.Setting:Acute-care university hospital.Patients:The study included 963 adult patients hospitalized over a 4-year surveillance period.Methods:Annual surveillance timelines were defined according to epidemiological criteria related to the circulation of RSV and influenza viruses in the general population. Patients were screened following a severe acute respiratory infection (SARI) case definition at the emergency department and were enrolled for molecular assay targeting influenza/RSV viruses after oral informed consent. Epidemiological and clinical data were recorded prospectively, microbiological investigations, antimicrobial management, and outcome data were reviewed retrospectively.Results:An influenza or RSV virus was documented in 316 of 963 patients (33%). Optimization of antimicrobial management (AM) was achieved in 162 of 265 patients (61%) with a positive viral diagnosis and no bacterial infection at admission (AM treatment not initiated, n = 111; discontinued, n = 51). In contrast, only 128 of 462 patients (28%) with negative microbiological investigations did not have AM treatment initiated (n = 116) or had such treatment discontinued (n = 12). Early, targeted antiviral treatment was prescribed in 235 of 253 patients (93%) confirmed with influenza. Epidemiological, clinical, and outcome data were similar in both groups.Conclusion:Epidemiological surveillance associated with influenza/RSV molecular diagnosis in adults hospitalized for severe winter respiratory infections dramatically enhanced antimicrobial management.

Original languageEnglish
Pages (from-to)1184-1189
Number of pages6
JournalInfection Control and Hospital Epidemiology
Volume41
Issue number10
DOIs
Publication statusPublished - 1 Oct 2020
Externally publishedYes

Fingerprint

Dive into the research topics of 'Severe influenza/respiratory syncytial virus infections and hospital antimicrobial stewardship opportunities: Impact of a 4-year surveillance including molecular diagnosis'. Together they form a unique fingerprint.

Cite this