Caracterización clínica y epidemiológica de infección asociada a atención en salud por virus influenza en pacientes críticos / Clinical and epidemiological characterization of healthcare acquired influenza in critical ill patients

RESUMEN

Resumen Introduccion: Las infecciones asociadas a atencion de salud (IAAS) aumentan la morbilidad y mortalidad. Durante 2014, en Hospital Clinico Red de Salud UC Christus (RS-UCCH) se estimo que 15% de las infecciones virales respiratorias fueron adquiridas durante la atencion de salud, siendo mas frecuente el virus influenza. Objetivos: Caracterizacion clinico-epidemiologica de IAAS por influenza en pacientes hospitalizados en unidades de pacientes criticos (UPC) y cuidados especiales. Material y Metodos: Estudio descriptivo. Se incluyeron pacientes en UPC y cuidados especiales con IAAS influenza entre 2014 y 2017 en RS-UCCH. IAAS por influenza se definio como inicio de sintomas y/o RPC-TR positiva para virus influenza ≥ 48 h de ingreso hospitalario, sin sintomatologia respiratoria o estudio negativo previo. Resultados: Se identificaron 22 pacientes, edad mediana 74 anos. La influenza fue adquirida en promedio al dia 13; el 77% fue por influenza A y el 27% presento coinfeccion respiratoria. Trece (59%) estaban hospitalizados en UPC, dos (15%) por problemas pulmonares. El 86% tenia co-morbilidad y el 50% descompensacion de ella. No estaba vacunado 59%; la letalidad observada fue 18%. Conclusiones: IAAS por influenza ocurrio en pacientes cronicos, de mayor edad y no vacunados. Es primordial educar en prevencion de IAAS y mantener altas coberturas de vacunacion.

ABSTRACT

Background: Healthcare-associated infections (HAIs) increase morbidity and mortality. During 2014, at the Hospital Clinico Red de Salud UC Christus (RS-UCCH) it was estimated that 15% of respiratory viral infections were acquired during hospitalization and influenza A was more frequent. Aims: Clinical and epidemiological characterization of HAIs due to influenza virus in patients hospitalized in critical care units (CCU) and special care. Methods: Descriptive study. We included patients hospitalized in CCU and special care with hospital acquired influenza during 2014-2017. HAI due to influenza was defined as symptom onset and/or positive influenza PCR after ≥ 48 hours of hospital admission, without previous respiratory symptoms or previous negative influenza test study. Results: 22 patients were identified, median age was 74 years. Influenza was acquired average on day 13. Influenza A was detected in 77% and 27% had respiratory co-infection. Thirteen (59%) were hospitalized in CCU, only 2 (15%) due to lung problems. Comorbidity was present in 86% and decompensation in 50%. Only 41% received influenza vaccine. The associated lethality was 18%. Conclusions: HAI due to influenza occurred in chronic, older and unvaccinated patients. Education about HAIs and continuous high vaccination coverage must be reinforced.