TY - JOUR
T1 - Severe influenza/respiratory syncytial virus infections and hospital antimicrobial stewardship opportunities
T2 - Impact of a 4-year surveillance including molecular diagnosis
AU - Bourgeois, Marc
AU - Ausselet, Nathalie
AU - Gerard, Veronique
AU - De Canniere, Louis
AU - Scius, Nathan
AU - Michaux, Isabelle
AU - Huang, Te Din
AU - Bogaerts, Pierre
AU - Vandamme, Charlotte
AU - Bihin, Benoît
AU - Delaere, Benedicte
N1 - Publisher Copyright:
© 2020 Cambridge University Press. All rights reserved.
PY - 2020/10/1
Y1 - 2020/10/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85087126581&partnerID=8YFLogxK
U2 - 10.1017/ice.2020.260
DO - 10.1017/ice.2020.260
M3 - Article
AN - SCOPUS:85087126581
SN - 0899-823X
VL - 41
SP - 1184
EP - 1189
JO - Infection Control and Hospital Epidemiology
JF - Infection Control and Hospital Epidemiology
IS - 10
ER -