Zhou F, et al. - This study was undertaken to identify risk factors that could assist in the detection of patients with high risk of nosocomial infection following influenza on admission. As per findings, independent risk factors that could help in the detection of severe influenza A(H1N1)pdm09 patients at high risk of nosocomial infection were: the need for mechanical ventilation, sepsis, ICU admission on the first day, lymphocytopenia, older age, and anaemia.

Methods

• In this study, researchers used a database prospectively collected through a Chinese national network for hospitalised severe influenza A(H1N1)pdm09 patients and compared the characteristics on admission between patients with and without nosocomial infection.

Results

• In the final analysis, researchers enrolled a total of 2146 patients with a median age of 36.0 years, 50.2% were male and 232 (10.8%) patients complicated with nosocomial infection.
• Leading pathogens included Acinetobacter baumannii, Pseudomonas aeruginosa, Stenotrophomonas maltophilia and Staphylococcus aureus, and invasive fungal infection was found in 30 cases (12.9%).
• In patients with nosocomial infection vs those without, the reported in-hospital mortality was much higher (45.7% vs 11.8%, P < 0.001).
• Factors that were found to be independently associated with nosocomial infection included need for mechanical ventilation (OR: 3.336; 95% CI 2.362–4.712), sepsis (OR: 2.125; 95% CI 1.236–3.651), ICU admission on first day (OR: 2.074; 95% CI 1.425–3.019), lymphocytopenia (OR: 1.906; 95% CI 1.361–2.671), age > 65 years (OR: 1.83; 95% CI 1.04–3.21) and anaemia (OR: 1.39; 95% CI 1.39–2.79).