Rapid diagnosis of seasonal influenza virus and cohorting of hospitalized patients on an influenza ward: a prospective analysis of outcomes

• Published in: The Journal of hospital infection 2020-07, Vol.105 (3), p.509-517
• Main Authors: O'Kelly, B., Conway, A., McNally, C., McConkey, S., Kelly, A., de Barra, E.
• Format: Article
• Language: English
• Subjects: Influenza; Influenza ward; Prospective cohort study; Seasonal influenza
• ISSN: 0195-6701; 1532-2939
• DOI: 10.1016/j.jhin.2020.03.023

The influenza season of 2017/2018 was burdensome in comparison with previous years. Management of patients with seasonal influenza is poorly described. To assess the impact of managing patients with influenza on a dedicated influenza ward on antimicrobial use and duration, and length of stay (LOS). A prospective cohort study was performed from 1st January to 28th February 2018. Patients diagnosed with influenza in the emergency department (ED) were cohorted under infectious disease (ID) or general internal medicine (GIM) services on a 35-bed influenza ward. At times of maximum capacity, some patients were managed on other wards by other services. Ninety-one patients were admitted to the influenza ward from the ED (64 ID, 27 GIM); of these, 38 patients had influenza A. Patients managed by the ID service were generally switched to oral antibiotics sooner than patients managed by the GIM service (median 3 vs 5 days; P=0.049). Antibiotic duration was shorter for patients managed by the ID service compared with patients managed by the GIM service (median 7 vs 9 days; P=0.016). LOS was shorter for patients managed by the ID service on the influenza ward compared with patients with influenza on non-influenza wards (median 5 vs 9 days; P=0.007). No significant difference in LOS was seen between patients on the influenza ward managed by the ID and GIM services (median 5 vs 7 days; P=0.30). Patients with influenza managed by the ID service on the influenza ward had a shorter duration of intravenous and total antimicrobial use compared with patients managed by the GIM service, and had reduced LOS compared with patients with influenza on non-influenza wards.