1134Characteristics of Hospital-Acquired Influenza in Adults in Southern Ontario, 2005-2012
Notice bibliographique
Résumé
Background. Influenza poses a particular threat to vulnerable hospitalized patients. We reviewed the characteristics of hospital acquired influenza identified by surveillance in Toronto from 2005 to 2012. Methods. The Toronto Invasive Bacterial Diseases Network has performed population based surveillance for laboratory confirmed influenza associated with hospitalization in south central Ontario since the 2004/5 influenza season. Eligible patients were those with influenza identified by EIA, DFA, culture, and/or RT-PCR who either required hospitalization for the illness associated with the positive test, or were admitted to an acute care hospital when the specimen was obtained. Acute care hospital acquired influenza (HAI) was defined as influenza with symptom onset >72 hours after hospital admission. Results. Between January 2005 and May 2012, 3130 adult influenza cases were identified, of which 318 (10%) were HAI. Of these, 268 were Influenza A (54 H1N1, 112 H3N2, and 103 not subtyped) and 50 were Influenza B. The median rate of HAI was 1.15 per 100,000 patient days (range 0.47-1.93) with no discernible trend. 22% of cases were associated with declared hospital outbreaks. Compared to community acquired cases, patients with HAI were older (70 vs 66 years old, p < 0.01), more likely to have prior chronic illness (95.3% vs 90.6%, p < 0.01), and more likely to be infected by influenza A (84% vs 77%, p < 0.05). At diagnosis, only 40% of hospital acquired cases met the CDC definition for Influenza-like illness. Patients with hospital acquired influenza were more likely to require ICU admission (26% vs 20%, p < 0.001) and more likely to die within 15 days of diagnosis (18% vs 9%, p < 0.001). Median time from admission to onset of symptoms was 12 days (range 3-209 days). 192/318 (60%) patients were treated with antibiotics, and 217/318 (68%) with antivirals (compared to 84% and 59% in community acquired cases, respectively). Median time from symptom onset to antiviral therapy was 48 hours. Conclusion. Hospital acquired influenza has atypical presentations and results in a significant number of ICU admissions and deaths. Our surveillance identified only a fraction of cases. Active surveillance studies are needed to further define clinical criteria for influenza testing, and to identify cases occurring after hospital discharge. Disclosures. A. Mcgeer, Hoffman LaRoche: Grant Investigator, Investigator and Scientific Advisor, Research grant and Research support; GSK: Grant Investigator, Investigator and Scientific Advisor, Research grant and Research support; Novartis: Grant Investigator, Investigator and Scientific Advisor, Research grant and Research support; Sanofi Pasteur: Grant Investigator and Scientific Advisor, Research grant and Research support
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».