Influenza vaccination of healthcare workers in acute-care hospitals: a case-control study of its effect on hospital-acquired influenza among patients

<p>Abstract</p> <p>Background</p> <p>In acute-care hospitals, no evidence of a protective effect of healthcare worker (HCW) vaccination on hospital-acquired influenza (HAI) in patients has been documented. Our study objective was to ascertain the effectiveness of influenza vaccination of HCW on HAI among patients.</p> <p>Methods</p> <p>A nested case-control investigation was implemented in a prospective surveillance study of influenza-like illness (ILI) in a tertiary acute-care university hospital. Cases were patients with virologically-confirmed influenza occurring ≥ 72 h after admission, and controls were patients with ILI presenting during hospitalisation with negative influenza results after nasal swab testing. Four controls per case, matched per influenza season (2004-05, 2005-06 and 2006-07), were randomly selected. Univariate and multivariate conditional logistic regression models were fitted to assess factors associated with HAI among patients.</p> <p>Results</p> <p>In total, among 55 patients analysed, 11 (20%) had laboratory-confirmed HAI. The median HCW vaccination rate in the units was 36%. The median proportion of vaccinated HCW in these units was 11.5% for cases vs. 36.1% for the controls (<it>P </it>= 0.11); 2 (20%) cases and 21 (48%) controls were vaccinated against influenza in the current season (<it>P </it>= 0.16). The proportion of ≥ 35% vaccinated HCW in short-stay units appeared to protect against HAI among patients (odds ratio = 0.07; 95% confidence interval 0.005-0.98), independently of patient age, influenza season and potential influenza source in the units.</p> <p>Conclusions</p> <p>Our observational study indicates a shielding effect of more than 35% of vaccinated HCW on HAI among patients in acute-care units. Investigations, such as controlled clinical trials, are needed to validate the benefits of HCW vaccination on HAI incidence in patients.</p

Early-onset ventilator-associated pneumonia incidence in intensive care units: a surveillance-based study

ABSTRACT: BACKGROUND: The incidence of ventilator-associated pneumonia (VAP) within the first 48 hours of intensive care unit (ICU) stay has been poorly investigated. The objective was to estimate early-onset VAP occurrence in ICUs within 48 hours after admission. METHODS: We analyzed data from prospective surveillance between 01/01/2001 and 31/12/2009 in 11 ICUs of Lyon hospitals (France). The inclusion criteria were: first ICU admission, not hospitalized before admission, invasive mechanical ventilation during first ICU day, free of antibiotics at admission, and ICU stay &gt;=48 hours. VAP was defined according to a national protocol. Its incidence was the number of events per 1,000 invasive mechanical ventilation-days. The Poisson regression model was fitted from day 2 (D2) to D8 to incident VAP to estimate the expected VAP incidence from D0 to D1 of ICU stay. RESULTS: Totally, 367 (10.8%) of 3,387 patients in 45,760 patient-days developed VAP within the first 9 days. The predicted cumulative VAP incidence at D0 and D1 was 5.3 (2.6-9.8) and 8.3 (6.1-11.1), respectively. The predicted cumulative VAP incidence was 23.0 (20.8-25.3) at D8. The proportion of missed VAP within 48 hours from admission was 11% (9%-17%). CONCLUSIONS: Our study indicates underestimation of early-onset VAP incidence in ICUs, if only VAP occurring [greater than or equal to]48 hours is considered to be hospital-acquired. Clinicians should be encouraged to develop a strategy for early detection after ICU admission

A New Experimental Method to Determine the Henry’s Law Constant of a Volatile Organic Compound Adsorbed in Soil

This paper presents a new mechanical method to determine Henry’s law constant (HLC) of a volatile organic compound (VOC). This method is an extension of the one proposed by Ouoba et al. (2010) to determine the water activity in porous media. This work focuses on TCE and aims at characterizing its liquid-vapor equilibrium in various cases in the form of a pure liquid phase or dissolved in an aqueous solution, adsorbed or not in a natural soil. A liquid phase is disposed in a closed chamber whose volume can be incrementally increased. The recording of the total gas pressure leads to evaluating the vapor partial pressure of a volatile compound even in the case of an aqueous solution. This method has been validated using various aqueous solutions of TCE and the HLC obtained is in agreement with the literature. Then, the validity of Henry’s law has been asserted in the case of an aqueous solution of TCE adsorbed in a hygroscopic soil. Indeed, a linear relation between the vapor partial pressure of TCE and its concentration has been obtained while the HLC is about 16% lower. This result highlights the influence of adsorption phenomena on vapor/liquid equilibrium

Hospitalization in double-occupancy rooms and the risk of hospital-acquired influenza: a prospective cohort study

International audienceHospitalization in double-occupancy rooms and the risk of hospital-acquired influenza were assessed prospectively. The incidence was 2.0 for 100 patient-days in double- vs. 0.7 in single-occupancy rooms (p 0.028). The adjusted hazard ratio of hospital-acquired influenza was 2.67 (95% confidence interval 1.05-6.76) in patients hospitalized in double- compared to single-occupancy rooms

Community-acquired Legionnaires' disease in a renal transplant recipient with unclear incubation period: the importance of molecular typing

International audienceTransplant recipients are at risk of developing Legionnaires' disease (LD) because of impaired cellular immunity. Here, we describe a renal transplant recipient who developed LD at least 10 days after hospital admission and transplantation. The hospital water network was initially suspected, but further testing determined that the probable source was the patient's domestic water supply. Our report also suggests that the patient's immunosuppressed state may have switched potential colonization to pneumonia