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Background <p>Protecting patients from hospital-acquired viral respiratory infections is a major challenge, but the hierarchy of measures to achieve this is not yet completely clear.</p> Aim <p>To describe the epidemiology of hospital-acquired viral respiratory infections and associations with structural hospital factors and adherence to infection control protocols.</p> Methods <p>Retrospective cohort study conducted over 10 consecutive years (2014–2023) within 27 hospital wards in a 900-bed university hospital in Paris, France. All hospitalized adult patients who were tested for at least one virus on a respiratory sample during their stay were included. Structural factors (percentage of double occupancy rooms) and adherence to infection control protocols by healthcare workers (measured by consumption of alcohol-based hand sanitizer and of facemasks) were included as predictors in the model.</p> Main outcome and measure <p>Incidence of hospital-acquired viral respiratory infections, defined by a positive PCR test for at least one respiratory virus, performed at least 5&#xa0;days after hospital admission. Data were analyzed on ward-year aggregated data, with a linear mixed-effects model.</p> Findings <p>Overall, 183 994 viral PCR tests were performed over the study period. Incidence of hospital-acquired viral respiratory infections was 0.57/1000 hospital-days. After adjustment on other factors (mean length of stay, use of PCR testing), incidence of hospital-acquired viral respiratory infections in a given ward was significantly associated with: the incidence of community-acquired viral respiratory infections among patients admitted to the ward (+ 0.10/1000 hospital-days per each additional point of incidence; <i>P</i> &lt; 0.001), the number of double-occupancy rooms (+ 0.04/1000 hospital-days per each 10%-increase of double-occupancy rooms; <i>P</i> = 0.03) and masks consumption (+ 0.33/1000 hospital-days per 10 additional masks used per day; <i>P</i> = 0.04). Similar results were found for double-occupancy rooms (+ 0.01/1000 hospital-days per each 10%-increase of double-occupancy rooms; <i>P</i> = 0.012) in the sub-group analysis of influenza cases.</p> Conclusion <p>In a given hospital ward, the incidence of community-acquired cases and the proportion of double-occupancy rooms are independently associated with the incidence hospital-acquired viral respiratory infections.</p>

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Associations between hospital structure, infection control and incidence of hospital-acquired viral respiratory infections: a 10-year surveillance study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年4月11日

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  • Costa Salachas,
  • Quentin Le Hingrat,
  • Skerdi Haviari,
  • Audrey Valdes,
  • Vincent Mackiewicz,
  • Isabelle Lolom,
  • Nadhira Fidouh,
  • Benoît Visseaux,
  • Donia Bouzid,
  • Diane Descamps,
  • Jean-Christophe Lucet,
  • Charlotte Charpentier,
  • Solen Kernéis

摘要

Background

Protecting patients from hospital-acquired viral respiratory infections is a major challenge, but the hierarchy of measures to achieve this is not yet completely clear.

Aim

To describe the epidemiology of hospital-acquired viral respiratory infections and associations with structural hospital factors and adherence to infection control protocols.

Methods

Retrospective cohort study conducted over 10 consecutive years (2014–2023) within 27 hospital wards in a 900-bed university hospital in Paris, France. All hospitalized adult patients who were tested for at least one virus on a respiratory sample during their stay were included. Structural factors (percentage of double occupancy rooms) and adherence to infection control protocols by healthcare workers (measured by consumption of alcohol-based hand sanitizer and of facemasks) were included as predictors in the model.

Main outcome and measure

Incidence of hospital-acquired viral respiratory infections, defined by a positive PCR test for at least one respiratory virus, performed at least 5 days after hospital admission. Data were analyzed on ward-year aggregated data, with a linear mixed-effects model.

Findings

Overall, 183 994 viral PCR tests were performed over the study period. Incidence of hospital-acquired viral respiratory infections was 0.57/1000 hospital-days. After adjustment on other factors (mean length of stay, use of PCR testing), incidence of hospital-acquired viral respiratory infections in a given ward was significantly associated with: the incidence of community-acquired viral respiratory infections among patients admitted to the ward (+ 0.10/1000 hospital-days per each additional point of incidence; P < 0.001), the number of double-occupancy rooms (+ 0.04/1000 hospital-days per each 10%-increase of double-occupancy rooms; P = 0.03) and masks consumption (+ 0.33/1000 hospital-days per 10 additional masks used per day; P = 0.04). Similar results were found for double-occupancy rooms (+ 0.01/1000 hospital-days per each 10%-increase of double-occupancy rooms; P = 0.012) in the sub-group analysis of influenza cases.

Conclusion

In a given hospital ward, the incidence of community-acquired cases and the proportion of double-occupancy rooms are independently associated with the incidence hospital-acquired viral respiratory infections.