Impact of the COVID-19 Pandemic on Influenza Vaccination Coverage of Healthcare Personnel in Alicante, Spain.

Influenza is a health problem and vaccination is the most effective measure to prevent it. The objective of this study was to evaluate the impact of the COVID-19 pandemic on vaccination coverage (VC) against influenza in healthcare workers (HCWs). A cross-sectional study was conducted at the Dr. Balmis University General Hospital in the province of Alicante (Spain), in which vaccination data were collected retrospectively. Adverse effects (AEs) were detected via telephone call between 15 and 30 days after vaccination. The existence of significant changes in VC between the different seasons studied was evaluated using Chi square with a statistical significance level of p < 0.05. A total of 8403 HCWs vaccinated throughout the different seasons were studied. The vaccination coverage of HCWs for influenza pre-COVID-19 pandemic (2019/20 season) was 51.9%; increased during the pandemic to 67.9% (2020/21 season) and 65.5% (2021/22 season); and, after the pandemic, it decreased to 42.7% (2022/23 season) (p < 0.05). The most frequent reason for vaccination during the periods evaluated was "self-protection", followed by "protection of patients" and "protection of family members". Of all HCWs evaluated, 26.6% (1460/5493) reported at least one AE. During the COVID-19 pandemic, HCWs' influenza vaccination coverage fluctuated considerably. There has been an increase in VC during the most critical moments of the pandemic, both in the 2020/21 and 2021/22 seasons, which has, subsequently, decreased in the 2022/2023 season, to levels below pre-pandemic (2019/2020 season), which justifies implementing specific measures to recover VC in Spain.

Impact of COVID-19 on the degree of compliance with hand hygiene: a repeated cross-sectional study.

Hand hygiene (HH) is the paramount measure used to prevent healthcare-associated infections. A repeated cross-sectional study was undertaken with direct observation of the degree of compliance on HH of healthcare personnel during the SARS-CoV-2 pandemic. Between, 2018-2019, 9,083 HH opportunities were considered, and 5,821 in 2020-2022. Chi squared tests were used to identify associations. The crude and adjusted odds ratios were used along with a logistic regression model for statistical analyses. Compliance on HH increased significantly (p < 0.001) from 54.5% (95% CI: 53.5, 55.5) to 70.1% (95% CI: 68.9, 71.2) during the COVID-19 pandemic. This increase was observed in four of the five key moments of HH established by the World Health Organization (WHO) (p < 0.05), except at moment 4. The factors that were significantly and independently associated with compliance were the time period considered, type of healthcare-personnel, attendance at training sessions, knowledge of HH and WHO guidelines, and availability of hand disinfectant alcoholic solution in pocket format. Highest HH compliance occurred during the COVID-19 pandemic, reflecting a positive change in healthcare-personnel's behaviour regarding HH recommendations.

Efectividad de la vacuna antigripal para prevenir casos graves de gripe. Temporada 2022/2023 / Effectiveness of influenza vaccine in preventing severe cases of influenza: Season 2022/2023

Introducción: La gripe supone una importante carga en términos de morbimortalidad, siendo la vacunación una de las medidas más efectivas para su prevención. Por lo que el objetivo de este estudio es conocer la efectividad de la vacuna antigripal para prevenir casos de gripe grave en los pacientes ingresados en un hospital de tercer nivel durante la temporada 2022/23. Metodología: Estudio de casos y controles. Se incluyeron todos los pacientes hospitalizados con resultado positivo en una RT-PCR de gripe. Se consideró caso a aquellos que cumplieron criterio de caso grave (neumonía, sepsis, fallo multiorgánico, ingreso en la UCI o exitus). Quienes no los cumplían se consideraron controles. Se calculó la efectividad vacunal (EV) para prevenir los casos graves y su intervalo de confianza al 95%. Resultados: Un total de 403 pacientes ingresaron con gripe confirmada. Noventa y ocho (24,3%) de ellos desarrollaron gripe grave. Del total, el 50,6% fueron varones y el 47,1% fueron mayores de 65 años. La EV ajustada por tipo de gripe, edad y ciertas comorbilidades fue del 40,6% (−21,9-71,1). En un análisis segmentado, la vacuna de la gripe resultó efectiva para la prevención de los casos graves en todas las categorías. Resultó especialmente relevante en el grupo de 65 años o más (EVa=60,9%; −2,0-85,0) y en los pacientes con gripe A (EVa=56,7%; 1,5-80,9). Conclusiones: La vacunación antigripal redujo notablemente la aparición de casos graves de gripe en los pacientes hospitalizados, por tanto, sigue siendo la principal estrategia para reducir la morbimortalidad y los costes asociados.(AU)

Introduction: Influenza poses a significant burden in terms of morbidity and mortality, with vaccination being one of the most effective measures for its prevention. Therefore, the aim of this study is to determine the effectiveness of the influenza vaccine in preventing cases of severe influenza in patients admitted to a tertiary hospital during the 2022/23 season. Methods: Case-control study. All hospitalised patients with a positive result in an RT-PCR for influenza were included. Those who met the criteria for a severe case (pneumonia, sepsis, multi-organ failure, admission to ICU or exitus) were considered cases. Those who did not meet these criteria were considered controls. Vaccine effectiveness (VE) to prevent severe cases and its 95% confidence interval were calculated. Results: A total of 403 patients were admitted with confirmed influenza. Of these, 98 (24.3%) developed severe influenza. Of the total, 50.6% were men and 47.1% were over 65 years of age. VE adjusted for influenza type, age and certain comorbidities was 40.6% (−21.9 to 71.1). In a segmented analysis, influenza vaccine was effective in preventing severe cases in all categories. It was particularly relevant in the 65+ age group (VEa=60.9%; −2.0 to 85.0) and in patients with influenza A (VEa=56.7%; 1.580.9). Conclusion: Influenza vaccination markedly reduced the occurrence of severe cases of influenza in hospitalised patients, therefore, it remains the main strategy to reduce morbidity and mortality and associated costs.(AU)

Effectiveness of influenza vaccine in preventing severe cases of influenza: Season 2022/2023.

INTRODUCTION: Influenza poses a significant burden in terms of morbidity and mortality, with vaccination being one of the most effective measures for its prevention. Therefore, the aim of this study is to determine the effectiveness of the influenza vaccine in preventing cases of severe influenza in patients admitted to a tertiary hospital during the 2022/23 season. METHODS: Case-control study. All hospitalised patients with a positive result in an RT-PCR for influenza were included. Those who met the criteria for a severe case (pneumonia, sepsis, multi-organ failure, admission to ICU or exitus) were considered cases. Those who did not meet these criteria were considered controls. Vaccine effectiveness (VE) to prevent severe cases and its 95% confidence interval were calculated. RESULTS: A total of 403 patients were admitted with confirmed influenza. Of these, 98 (24.3%) developed severe influenza. Of the total, 50.6% were men and 47.1% were over 65 years of age. VE adjusted for influenza type, age and certain comorbidities was 40.6% (-21.9 to 71.1). In a segmented analysis, influenza vaccine was effective in preventing severe cases in all categories. It was particularly relevant in the 65+ age group (VEa = 60.9%; -2.0 to 85.0) and in patients with influenza A (VEa = 56.7%; 1.5-80.9). CONCLUSION: Influenza vaccination markedly reduced the occurrence of severe cases of influenza in hospitalised patients, therefore, it remains the main strategy to reduce morbidity and mortality and associated costs.

[Degree of compliance with hand hygiene recommendations by health care personnel in an emergency department before and after the COVID-19 pandemic.] / Grado de cumplimiento de las recomendaciones de higiene de manos del personal sanitario de un servicio de urgencias antes y después de la pandemia de COVID-19.

OBJECTIVE: Hand Hygiene (HH) is the most important measure to prevent healthcare-associated infections. The aim of this study was to determine the impact of the COVID-19 pandemic on the degree of compliance (DC) of HH in an Emergency Department (ED). METHODS: Cross-sectional study. DC of HH in the ED was calculated from 2005 to 2021. We studied the association between DC of HH and different variables (age, sex, status, ED area, time of WHO, etc.) by calculating the Odds Ratio (OR) and its 95% confidence interval (95%CI). To study the impact of the pandemic, we compared the C of HH before and after the onset of the COVID-19 pandemic, calculated the OR and its 95%CI. RESULTS: DC of HH increased to 75.9% (95%CI: 68.6%-83.2%) in the period after pandemic onset from the previous baseline period of 48.9% (95%CI: 43.4%-54.5%) (p<0.001). Factors significantly and independently associated with DC of HH were time period (before or after pandemic), attending training sessions, having alcohol solution in pocket format and WHO moments 3,4 and 5. CONCLUSIONS: DC of HH in the ED has reached the highest value in 17 years of monitoring following the COVID-19 pandemic. This increase reflects a very positive change in the behavior of healthcare personnel with respect to HH.

OBJETIVO: La Higiene de Manos (HM) es la medida más importante para prevenir las infecciones asociadas a la asistencia sanitaria. El objetivo de este trabajo fue conocer el impacto de la pandemia de COVID-19 en el grado de cumplimiento (GC) de la HM en un Servicio de Urgencias (SU). METODOS: Estudio transversal. Se calculó el GC de la HM en el SU desde 2005 hasta 2021. Se estudió la asociación entre el GC de la HM y distintas variables (edad, sexo, estamento, área de urgencias, momento de la OMS, etc) calculando la Odds Ratio (OR) y su intervalo de confianza al 95% (IC95%). Para estudiar el impacto de la pandemia, se comparó el GC de la HM antes y después del inicio de la pandemia de COVID-19, se calculó la OR y su IC95%. RESULTADOS: El GC de la HM aumentó al 75,9% (IC95%: 68,6%-83,2%) en el periodo posterior al inicio de la pandemia con respecto al periodo de referencia anterior que fue del 48,9% (IC95%: 43,4%-54,5%) (p<0,001). Los factores asociados de forma significativa e independiente al GC de la HM fueron el periodo de tiempo (antes o después de la pandemia), asistir a sesiones formativas, disponer de solución alcohólica en formato bolsillo y los momentos 3,4 y 5 de la OMS. CONCLUSIONES: El GC de la HM en el SU ha alcanzado el máximo valor en 17 años de monitorización tras la pandemia de COVID-19. Este incremento refleja un cambio muy positivo en el comportamiento del personal sanitario con respecto a la HM.

[Incidence of streptococcal pharyngitis]. / Incidencia de faringitis estreptocócica.

OBJECTIVE: To determine the incidence of streptococcal pharyngitis in patients younger than 2 years of age, and to evaluate the role of group C streptococci as a pathogenic agent in acute pharyngitis through throat culture in symptomatic patients. MATERIAL AND METHODS: We performed a retrospective descriptive study of patients with clinical symptoms of acute pharyngitis and fast detection of streptococcal antigen and/or exudate culture who attended the emergency department between February 2004 and February 2005. RESULTS: Group A beta-hemolytic streptococcus (GAS) was isolated by pharyngeal culture in 85 patients aged less than 2 years (12.6%). In these patients the fast test displayed lower sensitivity and positive predictive value (PPV) (sensitivity: 78%; PPV: 69%, p < 0.01). Patients aged less than 2 years had a greater frequency fever, exanthema and catarrhal symptoms than older children (p < 0.01). In the younger age group, erythromycin resistance rates increased to 24.7% (p = 0.08). Group C streptococcus was isolated in 5.2% (43 patients). The most frequent reason for consultation was fever (74.4%) and the most common findings on examination were abnormal pharynx in 90.7%, odynophagia and adenopathies in 55.8%. Two incidence peaks (in May and September) were observed, with sporadic cases throughout the year. CONCLUSIONS: In our sample, the percentage of GAS in patients aged less than 2 years was higher than that reported in other series. In this age group, the sensitivity of the fast test is lower than in other age groups and there is a higher rate of erythromycin resistance. The percentage of tonsillitis due to serotype C was also slightly higher than expected. Two peaks of incidence were observed, similar to those occurring with SGA, with sporadic cases throughout the year.