title: Effect of two-step hygiene management on the prevention of nosocomial influenza in a season with high influenza activity.
abstract: BACKGROUND
  Rapid identification of patients infected with influenza virus, precise case definition and strict hygiene measures are important for the prevention of nosocomial transmission.
  
  
  OBJECTIVE
  To prove the usefulness of a case definition for rapid identification of patients with influenza and to investigate the effect of two-step hygiene management, including the continuous use of surgical masks by hospital staff, on the rate of nosocomial infections.
  
  
  METHODS
  All patients hospitalized between January and March 2015 with suspected influenza were enrolled. Real-time polymerase chain reaction testing for influenza was performed. Infected patients were managed according to the national hygiene guidelines, including the use of surgical masks by hospital staff during close contact with infected patients. When influenza activity increased, the continuous use of surgical masks by hospital staff was implemented as an add-on measure.
  
  
  RESULTS
  Most patients enrolled in this study were elderly (N=212, mean age 75 years). Frequency of cough was the only clinical parameter of respiratory infection that differed between influenza-negative and influenza-positive patients. Compared with the targeted use of surgical masks during close contact with infected patients, the continuous use of surgical masks for the entire working shift resulted in a reduction of nosocomial infections from 31% to 16%, respectively (P<0.01).
  
  
  CONCLUSIONS
  Discrimination between influenza A and other respiratory infections in elderly hospitalized patients was not possible based on clinical characteristics. With regard to hygiene management, the continuous use of surgical masks by hospital staff seems to be effective for the prevention of nosocomial infections.
authors: Institute of Laboratory Medicine, Microbiology and Hygiene, Barmherzige Brüder Hospital, Regensburg, Germany. Electronic address: Andreas.ambrosch@barmherzige-regensburg.de.
authors: A
authors: A
authors: Ambrosch
authors: Emergency Department, Barmherzige Brüder Hospital, Regensburg, Germany.
authors: F
authors: F
authors: Rockmann
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003428:Cross Infection / Q000517:prevention & control*; D018562:Disease Transmission, Infectious / Q000517:prevention & control*; D005260:Female; D006801:Humans; D006920:Hygiene; D017053:Infection Control / Q000379:methods*; D007251:Influenza, Human / Q000175:diagnosis* / Q000517:prevention & control*; D008297:Male; D008397:Masks / Q000706:statistics & numerical data*; D011446:Prospective Studies
keywords: Hospital setting; Hygiene management; Influenza; Nosocomial infection