Molecular Characteristics of Outbreaks of Nosocomial Infection with Influenza A/H3N2 Virus Variants

Oguma, Taeko; Saito, Reiko; Masaki, Hironori; Hoshino, Kazuhiko; Zaraket, Hassan; Suzuki, Yasushi; Caperig-Dapat, Isolde; Dapat, Clyde; Baranovich, Tatiana; Kuroki, Reiki; Makimoto, Yasushi; Shirahige, Yutaka; Asoh, Norichika; Degawa, Satoshi; Ishikawa, Hidefumi; Kageura, Hironobu; Hosoi, M; Sano, Hiroshi

doi:10.1086/658671

Cited by 24 publications

(13 citation statements)

References 25 publications

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“…Detection of respiratory viruses in symptomatic staff, including high-risk pathogens such as RSV, influenza, parainfluenza, and metapneumovirus, indicates multiple opportunities for staff to introduce community respiratory viruses into an outpatient clinic. All these respiratory viruses have been associated with inpatient nosocomial outbreaks and have the potential to cause severe disease in immunocompromised patients [31][32][33]. Strict policies restricting symptomatic staff from working may mitigate the potential impact of provider transmission as the source of nosocomial outbreaks.…”

Section: Discussionmentioning

confidence: 99%

Nosocomial Transmission of Respiratory Syncytial Virus in an Outpatient Cancer Center

Chu

Englund

Podczervinski

et al. 2014

Biology of Blood and Marrow Transplantation

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Background Respiratory syncytial virus (RSV) outbreaks in inpatient settings are associated with poor outcomes in cancer patients. The use of molecular epidemiology to document RSV transmission in the outpatient setting has not been well described. Methods We performed a retrospective cohort study of two nosocomial outbreaks of RSV at the Seattle Cancer Care Alliance (SCCA). Subjects included patients seen at the SCCA with RSV detected in two outbreaks in 2007-2008 and 2012, and all employees with respiratory viruses detected in the 2007-2008 outbreak. A subset of samples was sequenced using semi-nested polymerase chain reaction targeting the RSV attachment glycoprotein coding region. Results Fifty-one cases of RSV were identified in 2007-2008. Clustering of identical viral strains was detected in 10 (67%) of 15 patients with RSV sequenced from 2007-2008. As part of a multimodal infection control strategy implemented as a response to the outbreak, symptomatic employees had nasal washes collected. Of 254 employee samples, 91 (34%) tested positive for a respiratory virus, including 14 with RSV. In another RSV outbreak in 2012, 24 cases of RSV were identified; nine (90%) of 10 patients had the same viral strain, and 1 (10%) had another viral strain. Conclusions We document spread of clonal strains within an outpatient cancer care setting. Infection control interventions should be implemented in outpatient, as well as inpatient, settings to reduce person-to-person transmission and limit progression of RSV outbreaks.

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Section: Discussionmentioning

confidence: 99%

Nosocomial Transmission of Respiratory Syncytial Virus in an Outpatient Cancer Center

Chu

Englund

Podczervinski

et al. 2014

Biology of Blood and Marrow Transplantation

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“…These data were used to identify lapses in, and reaffirm the importance of stricter infection control measures. 29 Full length analyses of neuraminidase and haemagglutinin genes of influenza A(H1N1)pdm09 viruses during the 2011 influenza season showed that they were distinct compared to viruses that were circulating during the influenza pandemic of 2009, but associated with viruses collected from Newcastle, Australia, at the time of transmission of oseltamivir resistant A(H1N1)pdm09 viruses in the community. 26 Similar techniques have also identified the circulation patterns of influenza B viruses, an observation that assists with understanding influenza vaccine composition and effectiveness.…”

Section: Detection Of Antiviral Resistancementioning

confidence: 99%

Molecular diagnosis of respiratory viruses

Somerville¹,

Ratnamohan²,

Dwyer³

et al. 2015

Pathology

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The increasing availability of nucleic acid amplification tests since the 1980s has revolutionised our understanding of the pathogenesis, epidemiology, clinical and laboratory aspects of known and novel viral respiratory pathogens. High-throughput, multiplex polymerase chain reaction is the most commonly used qualitative detection method, but utilisation of newer techniques such as next-generation sequencing will become more common following significant cost reductions. Rapid and readily accessible isothermal amplification platforms have also allowed molecular diagnostics to be used in a 'point-of-care' format. This review focuses on the current applications and limitations of molecular diagnosis for respiratory viruses.

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“…Despite the existence of infection control policies and protocols, nosocomial transmission of respiratory viruses is a common problem that can occur in virtually any health-care setting [1][2][3][4][5][6][7]. The close proximity of patients, visitors and healthcare workers (HCWs) to one another, virus shedding during asymptomatic periods, low vaccination compliance (by both HCWs and the general public) as well as virus persistence in respiratory secretions and fomites can all contribute to the spread of the virus and lead to nosocomial outbreaks [2,[8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

“…Recently, influenza nosocomial transmission investigations have employed molecular techniques to corroborate comprehensive epidemiological data sets [4][5][6][7]34]. These studies through the sequencing of the Influenza hemagglutinin (HA) /neuraminidase (NA) and/or PB2 genomic regions, enabled researchers to determine virus isolate phylogenies and the potential epidemiological linkages between cases and HCWs.…”

Section: Introductionmentioning

confidence: 99%

Phylogenetic Exploration of Nosocomial Transmission Chains of 2009 Influenza A/H1N1 among Children Admitted at Red Cross War Memorial Children’s Hospital, Cape Town, South Africa in 2011

Valley‐Omar

Nindo

Mudau³

et al. 2015

PLoS ONE

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Traditional modes of investigating influenza nosocomial transmission have entailed a combination of confirmatory molecular diagnostic testing and epidemiological investigation. Common hospital-acquired infections like influenza require a discerning ability to distinguish between viral isolates to accurately identify patient transmission chains. We assessed whether influenza hemagglutinin sequence phylogenies can be used to enrich epidemiological data when investigating the extent of nosocomial transmission over a four-month period within a paediatric Hospital in Cape Town South Africa. Possible transmission chains/channels were initially determined through basic patient admission data combined with Maximum likelihood and time-scaled Bayesian phylogenetic analyses. These analyses suggested that most instances of potential hospital-acquired infections resulted from multiple introductions of Influenza A into the hospital, which included instances where virus hemagglutinin sequences were identical between different patients. Furthermore, a general inability to establish epidemiological transmission linkage of patients/viral isolates implied that identified isolates could have originated from asymptomatic hospital patients, visitors or hospital staff. In contrast, a traditional epidemiological investigation that used no viral phylogenetic analyses, based on patient co-admission into specific wards during a particular time-frame, suggested that multiple hospital acquired infection instances may have stemmed from a limited number of identifiable index viral isolates/patients. This traditional epidemiological analysis by itself could incorrectly suggest linkage between unrelated cases, underestimate the number of unique infections and may overlook the possible diffuse nature of hospital transmission, which was suggested by sequencing data to be caused by multiple unique introductions of influenza A isolates into individual hospital wards. We have demonstrated a functional role for viral sequence data in nosocomial transmission investigation through its ability to enrich traditional, non-molecular observational epidemiological investigation by teasing out possible transmission pathways and working toward more accurately enumerating the number of possible transmission events.

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Molecular Characteristics of Outbreaks of Nosocomial Infection with Influenza A/H3N2 Virus Variants

Abstract: This study showed the dissemination of highly homologous influenza virus variants among inpatients and HCWs within a short period, as a result of nosocomial transmission. These strains were also similar to influenza strains that were circulating in the community.

Cited by 24 publications

References 25 publications

Nosocomial Transmission of Respiratory Syncytial Virus in an Outpatient Cancer Center

Nosocomial Transmission of Respiratory Syncytial Virus in an Outpatient Cancer Center

Molecular diagnosis of respiratory viruses

Phylogenetic Exploration of Nosocomial Transmission Chains of 2009 Influenza A/H1N1 among Children Admitted at Red Cross War Memorial Children’s Hospital, Cape Town, South Africa in 2011

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