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Teoli J, Amour S, Dananché C, Dauwalder O, Gerbier-Colomban S, Mauranne CC, Zorio V, Monard C, Arnal S, Friggeri A, Lepape A, Guerin C, Rimmelé T, Argaud L, Munier-Marion E, Gustin MP, Vanhems P. Trends in the proportion of resistant bacteria involved in ventilator-associated pneumonia as the first hospital-acquired infection in intensive care units between 2003 and 2016 in Lyon, France. Am J Infect Control 2021; 49:1454-1456. [PMID: 33930517 DOI: 10.1016/j.ajic.2021.04.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 04/19/2021] [Accepted: 04/19/2021] [Indexed: 10/21/2022]
Abstract
The aim of this study was to describe the proportion of multidrug-resistant microorganisms (MDROs) involved in ventilator-associated pneumonia (VAP) as the first hospital-acquired infection in 536 adults with restricted risk factors for MDRO-related infection. We found a significant decrease in the percentage of MDROs involved in VAP between 2003 and 2016 and this percentage increased when VAP occurred after day 10.
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Descamps A, Lenzi N, Galtier F, Lainé F, Lesieur Z, Vanhems P, Amour S, L'Honneur AS, Fidouh N, Foulongne V, Lagathu G, Duval X, Merle C, Lina B, Carrat F, Launay O, Loubet P. In-hospital and midterm out-hospital complications of adults hospitalised with respiratory syncytial virus infection in France, 2017-2019: an observational study. Eur Respir J 2021; 59:13993003.00651-2021. [PMID: 34446468 DOI: 10.1183/13993003.00651-2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 07/06/2021] [Indexed: 11/05/2022]
Abstract
OBJECTIVES To describe the clinical characteristics and in/out-hospital outcomes of respiratory syncytial virus (RSV) infection among adults hospitalised with influenza-like illness (ILI) and compared against patients admitted for influenza. METHODS Adults hospitalised with ILI were prospectively included from five French university hospitals over two consecutive winter seasons (2017/2018 and 2018/2019). RSV and influenza virus were detected by multiplex RT-PCR on nasopharyngeal swabs. RSV-positive patients were compared to RSV-negative and influenza-positive hospitalised patients. Poisson regression models were used to estimate the adjusted prevalence ratio (aPR) associated with in-hospital and post-discharge outcomes between RSV and influenza infections. The in-hospital outcome was a composite of the occurrence of at least one complication, length of stay ≥7 days, intensive care unit (ICU) admission, use of mechanical ventilation and in-hospital death. Post-discharge outcome included 30/90-day all-cause mortality and 90-day readmission rates. RESULTS Overall, 1,428 hospitalised adults with ILI were included. RSV was detected in 8% (114/1428) and influenza virus in 31% (437/1428). Patients hospitalised with RSV were older than those with influenza (mean age, 73.0 versus 68.8 years; p=0.015) with a higher frequency of respiratory (52% versus 39%, p=0.012) or cardiac chronic diseases (52% versus 41%, p=0.039) and longer hospitalisation duration (median stay 8 versus 6 days, p<0.001). Anti-influenza therapies were less prescribed among RSV than influenza patients (20% versus 66%, p<0.001). In-hospital composite outcome was poorer in RSV patients (adjusted prevalence ratio (aPR)=1.5; 95% Confidence Interval (95% CI) 1.1-2.1) than in those hospitalised with influenza. No difference was observed for the post-discharge composite outcome (aPR=1.1; 95% CI 0.8-1.6). CONCLUSION RSV infection results in serious respiratory illness with in-hospital outcomes worse than influenza and with similar midterm post-discharge outcomes.
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Affiliation(s)
- Alexandre Descamps
- Université de Paris, Inserm CIC 1417, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, CIC Cochin Pasteur, Paris, France
| | - Nezha Lenzi
- Inserm, F-CRIN, Innovative Clinical Research Network in Vaccinology (I-REIVAC), Paris, France
| | - Florence Galtier
- Inserm, F-CRIN, Innovative Clinical Research Network in Vaccinology (I-REIVAC), Paris, France.,Inserm CIC 1411, Montpellier University Hospital, Montpellier, France
| | - Fabrice Lainé
- Inserm, F-CRIN, Innovative Clinical Research Network in Vaccinology (I-REIVAC), Paris, France.,Inserm CIC 1414, CHU Rennes, Rennes, France
| | - Zineb Lesieur
- Inserm, F-CRIN, Innovative Clinical Research Network in Vaccinology (I-REIVAC), Paris, France
| | - Philippe Vanhems
- Inserm, F-CRIN, Innovative Clinical Research Network in Vaccinology (I-REIVAC), Paris, France.,Service Hygiène, Épidémiologie, Infection, Vigilance et Prévention (SHEIP), Hôpital Édouard Herriot, Hospices Civils de Lyon, Lyon, France.,Centre International de Recherche en Infectiologie (CIRI), Equipe Public Health Epidemiology and Evolutionary Ecology of Infectious Diseases (PHE3ID), Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, Lyon, France
| | - Sélilah Amour
- Service Hygiène, Épidémiologie, Infection, Vigilance et Prévention (SHEIP), Hôpital Édouard Herriot, Hospices Civils de Lyon, Lyon, France.,Centre International de Recherche en Infectiologie (CIRI), Equipe Public Health Epidemiology and Evolutionary Ecology of Infectious Diseases (PHE3ID), Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, Lyon, France
| | | | | | - Vincent Foulongne
- Service de Virologie, CHU Montpellier, Hôpital Saint Eloi, Montpellier, France
| | - Gisèle Lagathu
- Laboratoire de virologie, Pôle micro-organismes, CHU Rennes, Rennes, France
| | - Xavier Duval
- Inserm, F-CRIN, Innovative Clinical Research Network in Vaccinology (I-REIVAC), Paris, France.,Assistance Publique Hôpitaux de Paris, Hôpital Bichat, Centre d'Investigation Clinique, Inserm CIC 1425, Paris, France.,Université de Paris, IAME, INSERM, Paris, France
| | - Corinne Merle
- Infectious Diseases Department, Montpellier University Hospital, Montpellier, France
| | - Bruno Lina
- Hospices Civils de Lyon, Laboratoire de Virologie, Institut des Agents Infectieux (IAI), Centre National de Référence des virus Respiratoires France Sud, Hôpital de la Croix-Rousse, Lyon, France
| | - Fabrice Carrat
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), Assistance Publique Hôpitaux de Paris, Hôpital Saint Antoine, Paris, France
| | - Odile Launay
- Université de Paris, Inserm CIC 1417, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, CIC Cochin Pasteur, Paris, France.,Inserm, F-CRIN, Innovative Clinical Research Network in Vaccinology (I-REIVAC), Paris, France.,Last authors contributed equally to this article
| | - Paul Loubet
- Inserm, F-CRIN, Innovative Clinical Research Network in Vaccinology (I-REIVAC), Paris, France .,Department of Infectious and Tropical Disease, VBMI, INSERM U1047, CHU Nîmes, Univ Montpellier, Nîmes, France.,Last authors contributed equally to this article
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Saadatian-Elahi M, Amour S, Elias C, Henaff L, Dananché C, Vanhems P. Tobacco smoking and severity of COVID-19: Experience from a hospital-based prospective cohort study in Lyon, France. J Med Virol 2021; 93:6822-6827. [PMID: 34314045 PMCID: PMC8426692 DOI: 10.1002/jmv.27233] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 07/24/2021] [Indexed: 12/14/2022]
Abstract
Information gathered so far from published studies attest the existence of a complex relationship between tobacco smoking and the severity of COVID-19. We investigated the association between smoking habits and the severity of COVID-19 in patients hospitalized in university-affiliated hospitals in Lyon, France. Baseline sociodemographic, clinical and biological characteristics of adult COVID-19 hospitalized patients presenting from the community were prospectively collected and analyzed. Tobacco exposure was documented at admission. Characteristics of patients hospitalized in medical wards to those admitted or transferred to intensive care units (ICUs) were compared using Mann-Whitney and Χ2 or Fisher's exact test. A composite endpoint including admission or transfer to ICU or death was created as a proxy for severe outcome. Adjusted odds ratio (aOR) and 95% confidence interval (95% CI) were calculated to identify variables independently associated with a severe outcome. Of the 645 patients with documented information on smoking habits, 62.6% were never-smokers, 32.1% ex-smokers, and 5.3% active smokers. Past tobacco use was independently associated with an increased risk of severe outcome (aOR: 1.71; 95% CI: 1.12-2.63), whereas a nonsignificant protective trend was found for active smoking. The results suggest that past smoking is associated with enhanced risk of progressing toward severe COVID-19 disease in hospitalized patients.
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Affiliation(s)
- Mitra Saadatian-Elahi
- Service Hygiène, Epidémiologie, Infectiovigilance et Prévention, Centre Hospitalier Edouard Herriot, Hospices Civils de Lyon, Lyon, France.,Public Health, Epidemiology and Evolutionary Ecology of Infectious Diseases (PHE3ID), Inserm - U1111, Lyon, France
| | - Sélilah Amour
- Service Hygiène, Epidémiologie, Infectiovigilance et Prévention, Centre Hospitalier Edouard Herriot, Hospices Civils de Lyon, Lyon, France.,Public Health, Epidemiology and Evolutionary Ecology of Infectious Diseases (PHE3ID), Inserm - U1111, Lyon, France
| | - Christelle Elias
- Service Hygiène, Epidémiologie, Infectiovigilance et Prévention, Centre Hospitalier Edouard Herriot, Hospices Civils de Lyon, Lyon, France.,Public Health, Epidemiology and Evolutionary Ecology of Infectious Diseases (PHE3ID), Inserm - U1111, Lyon, France
| | - Laetitia Henaff
- Service Hygiène, Epidémiologie, Infectiovigilance et Prévention, Centre Hospitalier Edouard Herriot, Hospices Civils de Lyon, Lyon, France.,Public Health, Epidemiology and Evolutionary Ecology of Infectious Diseases (PHE3ID), Inserm - U1111, Lyon, France
| | - Cédric Dananché
- Service Hygiène, Epidémiologie, Infectiovigilance et Prévention, Centre Hospitalier Edouard Herriot, Hospices Civils de Lyon, Lyon, France.,Public Health, Epidemiology and Evolutionary Ecology of Infectious Diseases (PHE3ID), Inserm - U1111, Lyon, France
| | - Philippe Vanhems
- Service Hygiène, Epidémiologie, Infectiovigilance et Prévention, Centre Hospitalier Edouard Herriot, Hospices Civils de Lyon, Lyon, France.,Public Health, Epidemiology and Evolutionary Ecology of Infectious Diseases (PHE3ID), Inserm - U1111, Lyon, France
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4
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Bénet T, Amour S, Valette M, Saadatian-Elahi M, Aho-Glélé LS, Berthelot P, Denis MA, Grando J, Landelle C, Astruc K, Paris A, Pillet S, Lina B, Vanhems P. Incidence of Asymptomatic and Symptomatic Influenza Among Healthcare Workers: A Multicenter Prospective Cohort Study. Clin Infect Dis 2021; 72:e311-e318. [PMID: 32750120 DOI: 10.1093/cid/ciaa1109] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 08/03/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Influenza is an important cause of viral hospital-acquired infection involving patients, healthcare workers (HCW), and visitors. The frequency of asymptomatic influenza among HCW with possible subsequent transmission is poorly described. The objective is to determine the cumulative incidence of asymptomatic, paucisymptomatic, and symptomatic influenza among HCW. METHOD A multicenter prospective cohort study was done in 5 French university hospitals, including 289 HCW during the 2016-2017 influenza season. HCW had 3 physical examinations (time [T] 0, before epidemic onset; T.1, before epidemic peak; T.2, T.3, after epidemic peak). A blood sample was taken each time for influenza serology and a nasal swab was collected at T1 and T2 for influenza detection by polymerase chain reaction (PCR). Positive influenza was defined as either a positive influenza PCR, and/or virus-specific seroconversion against influenza A, the only circulating virus, with no vaccination record during follow-up. Symptoms were self-reported daily between T1 and T2. Cumulative incidence of influenza was stratified by clinical presentation per 100 HCW. RESULTS Of the 289 HCW included, 278 (96%) completed the entire follow-up. Overall, 62 HCW had evidence of influenza of whom 46.8% were asymptomatic, 41.9% were paucisymptomatic, and 11.3% were symptomatic. Cumulative influenza incidence was 22.3% (95% confidence interval [CI]: 17.4%-27.2%). Cumulative incidence of asymptomatic influenza was 5.8% (95% CI: 3.3%-9.2%), 13.7% (95% CI: 9.9%-18.2%) for paucisymptomatic influenza, and 2.9% (95% CI: 1.3%-5.5%) for symptomatic influenza. CONCLUSIONS Asymptomatic and paucisymptomatic influenza were frequent among HCW, representing 47% and 42% of the influenza burden, respectively. These findings highlight the importance of systematic implementation of infection control measures among HCW regardless of respiratory symptoms from preventing nosocomial transmission of influenza. CLINICAL TRIALS REGISTRATION NCT02868658.
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Affiliation(s)
- Thomas Bénet
- Service d'Hygiène, Epidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, Lyon, France.,Équipe Épidémiologie et Santé Internationale, Laboratoire des Pathogènes Émergents, Fondation Mérieux, Centre International de Recherche en Infectiologie, Institut National de la Santé et de la Recherche Médicale U1111, Centre National de la Recherche Scientifique Unité Mixte de Recherche 5308, École Nationale Supérieure de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Sélilah Amour
- Service d'Hygiène, Epidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, Lyon, France
| | - Martine Valette
- Centre National de Référence des Infections Respiratoires, Région Sud.,Laboratoire de Virologie, Hôpital de la Croix-Rousse, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France
| | - Mitra Saadatian-Elahi
- Service d'Hygiène, Epidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, Lyon, France
| | | | - Philippe Berthelot
- Unité de Gestion du Risque Infectieux, Service d'Infectiologie, CHU de Saint-Etienne, Saint-Etienne, France.,Laboratoire des Agents Infectieux et Hygiène, CHU de Saint-Etienne, Saint-Etienne, France
| | - Marie-Agnès Denis
- Service de médecine et santé au travail, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France.,Ifsttar, UMRESTTE, UMR T_9405 Univ Lyon, Université Claude Bernard Lyon1, Lyon, France
| | - Jacqueline Grando
- Service d'Hygiène, Epidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, Lyon, France
| | - Caroline Landelle
- Service d'hygiène hospitalière, CHU Grenoble Alpes, Grenoble, France.,Université Grenoble Alpes, CNRS, Grenoble INP, TIMC-IMAG, Grenoble, France
| | - Karine Astruc
- Service d'Epidémiologie et d'Hygiène Hospitalière, CHU de Dijon, Dijon, France
| | - Adeline Paris
- Centre d'Investigation Clinique, Inserm CIC1406, CHU de Grenoble Alpes, Grenoble, France
| | - Sylvie Pillet
- Laboratoire des Agents Infectieux et Hygiène, CHU de Saint-Etienne, Saint-Etienne, France
| | - Bruno Lina
- Centre National de Référence des Infections Respiratoires, Région Sud.,Laboratoire de Virologie, Hôpital de la Croix-Rousse, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France.,Inserm, F-CRIN, Réseau Innovative Clinical Research in Vaccinology (I-REIVAC), Lyon center, France
| | - Philippe Vanhems
- Service d'Hygiène, Epidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, Lyon, France.,Équipe Épidémiologie et Santé Internationale, Laboratoire des Pathogènes Émergents, Fondation Mérieux, Centre International de Recherche en Infectiologie, Institut National de la Santé et de la Recherche Médicale U1111, Centre National de la Recherche Scientifique Unité Mixte de Recherche 5308, École Nationale Supérieure de Lyon, Université Claude Bernard Lyon 1, Lyon, France.,Inserm, F-CRIN, Réseau Innovative Clinical Research in Vaccinology (I-REIVAC), Lyon center, France
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5
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Kuczewski E, Munier-Marion E, Amour S, Bénet T, Rongieras F, Monneuse O, Vanhems P. How to save time in surveillance without losing quality: comparison of two methods of surgical site infection surveillance in orthopaedic prosthetics in a French university hospital. J Infect Prev 2020; 21:202-205. [PMID: 33193823 DOI: 10.1177/1757177420939240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 05/31/2020] [Indexed: 11/16/2022] Open
Abstract
Surgical site infection (SSI) surveillance methods are not standardised and are often time-consuming. We compared an active method, based on orthopaedic department staff reporting suspected SSI, with a semi-automated method, based on computerised extraction of surgical revisions, after total hip and knee arthroplasty. Both methods allowed finding the same SSI cases. We found the same sensitivity but higher specificity with a straightforward time gain using the passive method. This represents an added value for the organisation of an effective SSI surveillance, based on existing hospital databases.
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Affiliation(s)
- Elisabetta Kuczewski
- Infection Control and Epidemiology Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Elodie Munier-Marion
- Infection Control and Epidemiology Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Sélilah Amour
- Infection Control and Epidemiology Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Thomas Bénet
- Infection Control and Epidemiology Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France.,Emerging Pathogens Laboratory - Fondation Mérieux, Centre International de Recherche en Infectiologie, ENS de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Frédéric Rongieras
- Orthopedic and Traumatological Surgery Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Olivier Monneuse
- Emergency Surgery - General Surgery Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Philippe Vanhems
- Infection Control and Epidemiology Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France.,Emerging Pathogens Laboratory - Fondation Mérieux, Centre International de Recherche en Infectiologie, ENS de Lyon, Université Claude Bernard Lyon 1, Lyon, France
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6
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Loubet P, Mathieu P, Lenzi N, Galtier F, Lainé F, Lesieur Z, Vanhems P, Duval X, Postil D, Amour S, Rogez S, Lagathu G, L'Honneur AS, Foulongne V, Houhou N, Lina B, Carrat F, Launay O. Characteristics of human metapneumovirus infection in adults hospitalized for community-acquired influenza-like illness in France, 2012-2018: a retrospective observational study. Clin Microbiol Infect 2020; 27:127.e1-127.e6. [PMID: 32283266 PMCID: PMC7195031 DOI: 10.1016/j.cmi.2020.04.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 03/27/2020] [Accepted: 04/04/2020] [Indexed: 11/26/2022]
Abstract
Objectives To describe the prevalence, clinical features and complications of human metapneumovirus (hMPV) infections in a population of adults hospitalized with influenza-like illness (ILI). Methods This was a retrospective, observational, multicenter cohort study using prospectively collected data from adult patients hospitalized during influenza virus circulation, for at least 24 h, for community-acquired ILI (with symptom onset <7 days). Data were collected from five French teaching hospitals over six consecutive winters (2012–2018). Respiratory viruses were identified by multiplex reverse transcription polymerase chain reaction (RT-PCR) on nasopharyngeal specimens. hMPV + patients were compared with hMPV– patients, influenza+ and respiratory syncytial virus (RSV)+ patients using multivariate logistic regressions. Primary outcome was the prevalence of hMPV in patients hospitalized for ILI. Results Among the 3148 patients included (1449 (46%) women, 1988 (63%) aged 65 and over; 2508 (80%) with chronic disease), at least one respiratory virus was detected in 1604 (51%, 95% confidence interval (CI) 49–53), including 100 cases of hMPV (100/3148, 3% 95% CI 3–4), of which 10 (10%) were viral co-infection. In the hMPV + patients, mean length of stay was 7 days, 62% (56/90) developed a complication, 21% (14/68) were admitted to intensive care unit and 4% (4/90) died during hospitalization. In comparison with influenza + patients, hMPV + patients were more frequently >65 years old (adjusted odds ratio (aOR) = 3.3, 95% CI 1.9–6.3) and presented more acute heart failure during hospitalization (aOR = 1.8, 95% CI 1.0–2.9). Compared with RSV + patients, hMPV + patients had less cancer (aOR = 0.4, 95% CI 0.2–0.9) and were less likely to smoke (aOR = 0.5, 95% CI 0.2–0.9) but had similar outcomes, especially high rates of respiratory and cardiovascular complications. Conclusions Adult hMPV infections mainly affect the elderly and patients with chronic conditions and are responsible for frequent cardiac and pulmonary complications similar to those of RSV infections. At-risk populations would benefit from the development of antivirals and vaccines targeting hMPV.
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Affiliation(s)
- P Loubet
- VBMI, INSERM U1047, Department of Infectious and Tropical Disease, CHU Nîmes, Univ Montpellier, Nîmes, France; Inserm, F-CRIN, Réseau Innovative Clinical Research in Vaccinology (I-REIVAC), Paris, France.
| | - P Mathieu
- Université Paris Descartes, Sorbonne Paris Cité, Inserm, CIC Cochin Pasteur, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France
| | - N Lenzi
- Inserm, F-CRIN, Réseau Innovative Clinical Research in Vaccinology (I-REIVAC), Paris, France
| | - F Galtier
- Inserm, F-CRIN, Réseau Innovative Clinical Research in Vaccinology (I-REIVAC), Paris, France; CIC1411, CHU Montpellier, Hôpital Saint Eloi, Montpellier, F-34295, France
| | - F Lainé
- Inserm, F-CRIN, Réseau Innovative Clinical Research in Vaccinology (I-REIVAC), Paris, France; Centre d'Investigations Cliniques, INSERM UMR CIC 1414, Hôpital Pontchaillou, Rennes, France
| | - Z Lesieur
- Inserm, F-CRIN, Réseau Innovative Clinical Research in Vaccinology (I-REIVAC), Paris, France
| | - P Vanhems
- Inserm, F-CRIN, Réseau Innovative Clinical Research in Vaccinology (I-REIVAC), Paris, France; Service d'Hygiène, Epidémiologie et Prévention, Hospices Civils de Lyon, F-69437 Lyon, France
| | - X Duval
- Inserm, F-CRIN, Réseau Innovative Clinical Research in Vaccinology (I-REIVAC), Paris, France; CIC1125, Hôpital Bichat Claude Bernard, Paris, France
| | - D Postil
- CHU Dupuytren, CIC 1435, Limoge Cedex, France
| | - S Amour
- Service d'Hygiène, Epidémiologie et Prévention, Hospices Civils de Lyon, F-69437 Lyon, France
| | - S Rogez
- CHU Dupuytren, Service Bactériologie, Virologie, Hygiène, Limoges Cedex, France
| | - G Lagathu
- Université Rennes-I, Virologie, Hôpital Pontchaillou, Rennes, France
| | - A-S L'Honneur
- AHU, Service de Virologie, Hôpital Cochin, Paris, France
| | - V Foulongne
- Service de Virologie, CHU Montpellier, Hôpital Saint Eloi, Montpellier, F-34295, France
| | - N Houhou
- Laboratoire de Virologie, Hôpital Bichat Claude Bernard, Paris, France
| | - B Lina
- Hospices Civils de Lyon, Laboratoire de Virologie, Institut des Agents Infectieux (IAI), Centre National de Référence des virus Respiratoires France Sud, Hôpital de la Croix-Rousse, 69317 Lyon Cedex 04, France
| | - F Carrat
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP, AP-HP, Hôpital Saint Antoine, F75013 Paris, France
| | - O Launay
- Inserm, F-CRIN, Réseau Innovative Clinical Research in Vaccinology (I-REIVAC), Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Inserm, CIC Cochin Pasteur, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France
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7
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Bénézit F, Loubet P, Galtier F, Pronier C, Lenzi N, Lesieur Z, Jouneau S, Lagathu G, L'Honneur AS, Foulongne V, Vallejo C, Alain S, Duval X, Houhou N, Costa Y, Vanhems P, Amour S, Carrat F, Lina B, Launay O, Tattevin P. Non-influenza respiratory viruses in adult patients admitted with influenza-like illness: a 3-year prospective multicenter study. Infection 2020; 48:489-495. [PMID: 32056143 PMCID: PMC7095392 DOI: 10.1007/s15010-019-01388-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 12/24/2019] [Indexed: 12/19/2022]
Abstract
PURPOSE To describe the burden, and characteristics, of influenza-like illness (ILI) associated with non-influenza respiratory viruses (NIRV). METHODS We performed a prospective, multicenter, observational study of adults admitted with ILI during three influenza seasons (2012-2015). Patients were screened for picornavirus, respiratory syncytial virus (RSV), coronavirus, human metapneumovirus, adenovirus, bocavirus, parainfluenza virus, and influenza, by PCR on nasopharyngeal samples. We excluded patients coinfected with NIRV and influenza. RESULTS Among 1421 patients enrolled, influenza virus was detected in 535 (38%), and NIRV in 215 (15%), mostly picornavirus (n = 61), RSV (n = 53), coronavirus 229E (n = 48), and human metapneumovirus (n = 40). In-hospital mortality was 5% (NIRV), 4% (influenza), and 5% (no respiratory virus). As compared to influenza, NIRV were associated with age (median, 73 years vs. 68, P = 0.026), chronic respiratory diseases (53% vs. 45%, P = 0.034), cancer (14% vs. 9%, P = 0.029), and immunosuppressive drugs (21% vs. 14%, P = 0.028), and inversely associated with diabetes (18% vs. 25%, P = 0.038). On multivariable analysis, only chronic respiratory diseases (OR 1.5 [1.1-2.0], P = 0.008), and diabetes (OR 0.5 [0.4-0.8], P = 0.01) were associated with NIRV detection. CONCLUSIONS NIRV are common in adults admitted with ILI during influenza seasons. Outcomes are similar in patients with NIRV, influenza, or no respiratory virus.
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Affiliation(s)
- François Bénézit
- Université Rennes-I, Service Des Maladies Infectieuses et de Réanimation Médicale, Hôpital Pontchaillou, CHU Pontchaillou, 2 rue Henri Le Guilloux, 35033, Rennes Cedex, France
| | - Paul Loubet
- Université Paris Descartes, Sorbonne Paris Cité; Inserm, CIC Cochin Pasteur, Innovative Clinical Research Network in VACcinology (I-REIVAC), Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France
| | - Florence Galtier
- Inserm, F-CRIN, Innovative Clinical Research Network in Vaccinology (I-REIVAC), Paris, France.,CIC1411, CHU Montpellier, Hôpital Saint Eloi, 34295, Montpellier, France
| | - Charlotte Pronier
- Université Rennes-I, Virologie, Hôpital Pontchaillou, Rennes, France
| | - Nezha Lenzi
- Université Paris Descartes, Sorbonne Paris Cité; Inserm, CIC Cochin Pasteur, Innovative Clinical Research Network in VACcinology (I-REIVAC), Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France
| | - Zineb Lesieur
- Université Paris Descartes, Sorbonne Paris Cité; Inserm, CIC Cochin Pasteur, Innovative Clinical Research Network in VACcinology (I-REIVAC), Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France
| | - Stéphane Jouneau
- Université Rennes-I, Pneumologie, Hôpital Pontchaillou, Rennes, France.,Inserm, CIC 1414, Université Rennes-I, Hôpital Pontchaillou, Rennes, France
| | - Gisèle Lagathu
- Université Rennes-I, Virologie, Hôpital Pontchaillou, Rennes, France
| | | | - Vincent Foulongne
- Service de Virologie, CHU Montpellier, Hôpital Saint Eloi, 34295, Montpellier, France
| | | | - Sophie Alain
- Univ. Limoges, INSERM, CHU Limoges, RESINFIT, U1092, 87000, Limoges, France
| | - Xavier Duval
- CIC1125, Hôpital Bichat Claude Bernard, APHP, Inserm, F-CRIN, Innovative Clinical Research Network in Vaccinology (I-REIVAC), Paris, France
| | - Nawal Houhou
- Laboratoire de Virologie, Hôpital Bichat Claude Bernard, Paris, France
| | - Yolande Costa
- CIC1125, Hôpital Bichat Claude Bernard, APHP, Inserm, F-CRIN, Innovative Clinical Research Network in Vaccinology (I-REIVAC), Paris, France
| | - Philippe Vanhems
- Service D'Hygiène, Epidémiologie et Prévention, Hospices Civils de Lyon, 69437, Lyon, France.,Laboratoire des Pathogènes Emergents-Fondation Mérieux, Centre International de Recherche en Infectiologie, Institut National de la Santé et de la Recherche Médicale U1111, Centre National de La Recherche Scientifique, UMR5308, Ecole Normale Supérieure de Lyon, Université Claude Bernard Lyon, Lyon, France
| | - Sélilah Amour
- Service D'Hygiène, Epidémiologie et Prévention, Hospices Civils de Lyon, 69437, Lyon, France
| | - Fabrice Carrat
- Sorbonne Université, INSERM, Institut Pierre Louis D'Epidémiologie et de Santé Publique IPLESP, AP-HP, Hôpital Saint Antoine, 75013, Paris, France
| | - Bruno Lina
- Hospices Civils de Lyon, Laboratoire de Virologie, Institut Des Agents Infectieux (IAI), Centre National de Référence Des Virus Respiratoires France Sud, Hôpital de La Croix-Rousse, 69317, Lyon Cedex 04, France
| | - Odile Launay
- Université Paris Descartes, Sorbonne Paris Cité; Inserm, CIC Cochin Pasteur, Innovative Clinical Research Network in VACcinology (I-REIVAC), Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France
| | - Pierre Tattevin
- Université Rennes-I, Service Des Maladies Infectieuses et de Réanimation Médicale, Hôpital Pontchaillou, CHU Pontchaillou, 2 rue Henri Le Guilloux, 35033, Rennes Cedex, France. .,Inserm, CIC 1414, Université Rennes-I, Hôpital Pontchaillou, Rennes, France.
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Kuczewski E, Khanafer N, Amour S, Bruchon C, Debaille E, Barreto C, Grando J, Lamblin G, Doret-Dion M, Vanhems P. Réévaluation du seuil actuel d’adaptation de l’antibioprophylaxie en fonction du poids pour la prévention des infections du site opératoire en gynécologie. Med Mal Infect 2019. [DOI: 10.1016/j.medmal.2019.04.281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Kuczewski E, Khanafer N, Amour S, Bruchon C, Debaille E, Barreto C, Grando J, Lamblin G, Doret-Dion M, Vanhems P. Réévaluation du seuil actuel d’adaptation de l’antibioprophylaxie en fonction du poids pour la prévention des infections du site opératoire en gynécologie. Med Mal Infect 2019. [DOI: 10.1016/j.medmal.2019.04.280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Bénet T, Valette M, Amour S, Aho-Glélé S, Berthelot P, Grando J, Landelle C, Lina B, Vanhems P. 924. Incidence of Symptomatic and Asymptomatic Influenza Among Healthcare Workers: A Multicenter Prospective Cohort Study. Open Forum Infect Dis 2018. [PMCID: PMC6252986 DOI: 10.1093/ofid/ofy209.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Influenza is an important cause of viral nosocomial infections; however, the incidence of asymptomatic influenza among healthcare workers (HCWs) is poorly known. The objective was to estimate the cumulative incidence of asymptomatic and symptomatic influenza among HCWs. Methods The AFP (Asymptomatic Influenza Project, NCT02868658) multicenter prospective cohort study was conducted in 5 French university hospitals in Lyon (2 sites), Grenoble, Saint-Etienne, and Dijon. Each voluntary HCW was followed-up during the entire 2016–2017 influenza season with 3 visits for influenza diagnostic by PCR from nasal swabs and serology. The outcome was laboratory confirmed influenza (LCI) defined by an influenza detection by PCR, and/or influenza A seroconversion/significant increase in the anti-A antibodies titer against A/Hong-Kong/4801/2014, with the absence of seroconversion/significant increase in the level of anti-B/Brisbane/60/2008 antibodies; influenza A was indeed the only strain circulating this winter in the Lyon area. Asymptomatic cases presented no general or respiratory sign/symptom, paucisymptomatic LCI cases had those symptoms/signs but not conforming to clinical influenza, symptomatic LCI cases had temperature ≥37.8°C and cough or sore throat. Cumulative incidence was expressed per 100 HCWs. Results Overall 278 HCWs were analyzed, 84.2% were female, the mean age was 38 years, and influenza vaccination coverage in 2016–2017 was 45.3%. Globally, 62 HCWs had evidence of LCI. Among laboratory confirmed influenza cases, 67.7% (95% CI: 55.8%–79.7%, n = 42) were asymptomatic, 21.0% (95% CI: 10.5%–31.4%, n = 13) were paucisymptomatic, and 11.3% (95% CI: 3.2%–19.4%, n = 7) were symptomatic. Among HCWs, global cumulative influenza incidence was 22.3% (95% CI: 17.7%–27.5%). Cumulative incidence of asymptomatic influenza was 15.1% (95% CI: 10.9%–19.3%), it was 4.7% (95% CI: 2.2%–7.2%) for paucisymptomatic influenza, and 2.5% (95% CI: 0.1%–4.4%) for symptomatic influenza. Conclusion Asymptomatic influenza is frequent among HCWs, representing two-third of the influenza burden in this population. This highlights the importance of infection control measures among HCWs no presenting influenza symptoms. Disclosures All authors: No reported disclosures.
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Affiliation(s)
- Thomas Bénet
- Infection Control and Epidemiology Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
- International Center for Infectiology Research (CIRI), Laboratory of Emerging Pathogens, UCBL1, Lyon, France
| | | | | | | | | | | | | | - Bruno Lina
- Cnr Virus Influenza Hcl, University of Lyon, Lyon, France
| | - Philippe Vanhems
- 69, Groupement hospitalier Edouard Herriot, Hospices civils de Lyon, Lyon, France
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Barreto C, Amour S, Kuczewski E, Dupuis O, Huissoud C, Gaucherand P, Gerbier-Colomban S, Girard R, Vanhems P. Maternal infection rates: Surveillance in three obstetric units of a French University Hospital group in 2016. Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.05.407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Thierry J, Amour S, del Signore C, Vanhems P. Détection de Campylobacters spp et Salmonella spp chez l’Homme : analyse descriptive chez des patients se rendant dans des laboratoires d’analyses médicales entre 2012 et 2016. Med Mal Infect 2018. [DOI: 10.1016/j.medmal.2018.04.196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Vanhems P, Baghdadi Y, Roche S, Bénet T, Regis C, Lina B, Robert O, Voirin N, Ecochard R, Amour S. Influenza vaccine effectiveness among healthcare workers in comparison to hospitalized patients: A 2004-2009 case-test, negative-control, prospective study. Hum Vaccin Immunother 2016; 12:485-90. [PMID: 26327520 DOI: 10.1080/21645515.2015.1079677] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
The objective of this study was to calculate Vaccine Effectiveness (VE) in healthcare workers (HCW) and to compare VE between patients and HCW. A case-control investigation based on the prospective study was conducted between 2004 and 2009 in a teaching hospital. All HCW with influenza-like illness (ILI) from participating units (n = 24) were included, and vaccination status was characterized by interview. A total of 150 HCW presented ILI; 130 (87%) were female, 27 (18%) were positive for influenza, and 42 (28%) were vaccinated. Adjusted VE was 89% (95% CI 39 to 98). Among patients, adjusted VE was 42% (95% CI -39 to 76). The difference of VE (VEhcw - VEpat) was 46.15% (95% CI 2.41 to 144). The VE ratio (VEhcw / VEpat) was 2.09 (95% CI -1.60 to 134.17). Influenza VE differed between HCW and patients when the flu season was taken into account. This finding confirms the major impact of host determinants on influenza VE.
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Affiliation(s)
- P Vanhems
- a Service d'Hygiène; Epidémiologie et Prévention; Groupement hospitalier Edouard Herriot; Hospices Civils de Lyon ; Lyon , France.,b Laboratoire d'Epidémiologie et Santé Publique; Université Claude Bernard Lyon 1; Université de Lyon ; Lyon , France
| | - Y Baghdadi
- b Laboratoire d'Epidémiologie et Santé Publique; Université Claude Bernard Lyon 1; Université de Lyon ; Lyon , France
| | - S Roche
- c Service de Biostatistique; Groupement hospitalier Edouard Herriot; Hospices Civils de Lyon ; Lyon , France.,d Equipe Biostatistique-Santé; Center National de la Recherche Scientifique-Unité Mixte de Recherche 5558; Université Claude Bernard Lyon 1; Université de Lyon ; Villeurbanne , France
| | - T Bénet
- a Service d'Hygiène; Epidémiologie et Prévention; Groupement hospitalier Edouard Herriot; Hospices Civils de Lyon ; Lyon , France
| | - C Regis
- b Laboratoire d'Epidémiologie et Santé Publique; Université Claude Bernard Lyon 1; Université de Lyon ; Lyon , France
| | - B Lina
- e Centre de Biologie et Pathologie Est; Center National de référence des virus influenza région Sud; Groupement Hospitalier Est; Hospices Civils de Lyon ; Bron , France.,f Département de Virologie ; Université Lyon 1; Université de Lyon ; Bron , France
| | - O Robert
- g Service de médecine Préventive du Personnel; Groupement hospitalier Edouard Herriot; Hospices Civils de Lyon ; Lyon , France
| | - N Voirin
- a Service d'Hygiène; Epidémiologie et Prévention; Groupement hospitalier Edouard Herriot; Hospices Civils de Lyon ; Lyon , France
| | - R Ecochard
- c Service de Biostatistique; Groupement hospitalier Edouard Herriot; Hospices Civils de Lyon ; Lyon , France.,d Equipe Biostatistique-Santé; Center National de la Recherche Scientifique-Unité Mixte de Recherche 5558; Université Claude Bernard Lyon 1; Université de Lyon ; Villeurbanne , France
| | - S Amour
- a Service d'Hygiène; Epidémiologie et Prévention; Groupement hospitalier Edouard Herriot; Hospices Civils de Lyon ; Lyon , France
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Amour S, Djhehiche K, Zamora A, Bergeret A, Vanhems P. Perception of the A/H1N1 influenza pandemic and acceptance of influenza vaccination by Université Claude Bernard Lyon 1 staff: A descriptive study. Hum Vaccin Immunother 2015; 11:727-31. [PMID: 25715115 DOI: 10.1080/21645515.2015.1008887] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
We assessed the perception and attitudes of university staff, including medical school and other science specialties, toward the 2009 A/H1N1 influenza pandemic and influenza vaccination program. A cross-sectional online survey was conducted among 4,529 university personnel on October 19-20, 2009. Seven hundred (15%) employees participated in the study. Only 18% were willing to be vaccinated, men more than women (29% versus 9%, P < 0.001), and professors/researchers more than administrative/technical staff (30% vs. 6%, P < 0.001). Intention to be vaccinated was insufficient. Additional efforts are needed to improve information dissemination among university staff. Medical university personnel should receive more information to increase vaccine coverage and protect them as well as patients.
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Affiliation(s)
- Sélilah Amour
- a Observatoire de la Santé des Personnels de Lyon 1; Université de Lyon; Université Claude Bernard Lyon 1 ; Lyon , France
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Issartel B, Amour S, Serrano X, Vanhems P. L-01: Quelles conditions à la délégation aux infirmiers D.E. d’une consultation en vue d’un voyage en centre de vaccinations internationales (CVI) ? Med Mal Infect 2014. [DOI: 10.1016/s0399-077x(14)70216-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Amour S, Zamora A, Bergeret A, Vanhems P. Étude de la couverture vaccinale du personnel de l’université Claude-Bernard Lyon-1 : résultats de l’étude COVAPE. ARCH MAL PROF ENVIRO 2012. [DOI: 10.1016/j.admp.2012.09.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Amour S, Payet C, Zamora A, Bergeret A, Vanhems P. L’observatoire de la santé des personnels de l’université Lyon 1 (OSPEL) : une démarche originale. ARCH MAL PROF ENVIRO 2012. [DOI: 10.1016/j.admp.2012.03.428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Amour S, Voirin N, Regis C, Bouscambert-Duchamp M, Comte B, Coppéré B, Pires-Cronenberger S, Lina B, Vanhems P. Influenza vaccine effectiveness among adult patients in a University of Lyon hospital (2004–2009). Vaccine 2012; 30:821-4. [DOI: 10.1016/j.vaccine.2011.11.033] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2011] [Revised: 11/06/2011] [Accepted: 11/09/2011] [Indexed: 10/14/2022]
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