541. The Effect of Systematic Screening for Influenza Infection in a Coronary Care Unit (CCU)
Session: Poster Abstract Session: Respiratory Viruses
Thursday, October 8, 2015
Room: Poster Hall

Background: Our aim was to evaluate the effects of systematic influenza screening in patients admitted to a CCU during two epidemic seasons.

Methods: During the 2014 influenza season a systematic screening of all non-scheduled admitted patient was initiated during the last weeks of the flu period (February 2014: Period A). In the season 2015 (January-March 2015: Period B) systematic screening was continued. Characteristics of both periods were compared.

Results: Incidence was much higher during period A, 5/26 (19.2%) vs 7/104 (6.7%). The comparison of both periods is shown in Table 1. Influenza A predominated in period A (100% versus 29%; p=0.01). In the recent period unsuspected influenza diagnosis was reduced (80% versus 14%, p=0.02); less antibiotics were prescribed at admission (100% versus 29%, p= 0.01) and related mortality disappeared (60% versus 0%, P= 0.01).

Conclusion: Increased awareness and systematic screening of influenza among cardiologist of coronary units may significantly reduce the unsuspected cases, the use of unnecessary antimicrobials and improve the patient's outcome. The role of influenza in the admission of patients with cardiac arrest or myocardial infarction needs to be further clarified.

Table 1. Comparison between patients diagnosed with influenza during period A (2014) versus period B (2015)

Variables

Period A

(n=5) (%)

Period B

(n=7) (%)

p

Gender. Male

4 (80)

4 (57)

0.40

Age (mean-SD)

65.40 (±9.07)

71.71 (±16.87)

0.16

Cause of CCU1 admission

   NSTEMI2

   Decompensated heart failure

   Cardiorespiratory arrest

   Others3

0 (0)

2 (40)

2 (40)

1 (20)

3 (43)

0 (0)

0 (0)

4 (57)

0.06

Pre-existing CV4 disease

3 (60)

5 (71)

0.67

Unsuspected influenza diagnosis

4 (80)

1 (14)

0.02

Influenza vaccination

1 (20)

4 (57)

0.19

Influenza symptoms in the previous 7 days

1 (20)

3 (43)

0.40

Influenza type

  Type A

   Type B

5 (100)

0 (0)

2 (29)

5 (71)

0.01

Antibiotics prescribed at admission

5 (100)

2 (29)

0.01

Prescribed oseltamivir

5 (100)

5 (71)

0.19

ARDS5

2 (40)

1 (14)

0.31

Death

3 (60)

0 (0)

0.01

1CCU: Coronary care unit; 2NSTEMI: Non-elevated ST myocardial infarction; 3Others: syncope (2014), atrial flutter, arrhythmic storm, transcatheter aortic valve implantation and pericardial effusion (2015); 4CV: cardiovascular; 5ARDS: Acute respiratory distress syndrome.

Patricia Munoz, MD, PhD1, Iago Sousa, MD2, Alia Eworo, MD1, Manuel Martínez-Sellés, MD2, Marcela González-Del Vecchio, MD1, Hector Bueno, MD2, Paula López Roa, MD, PhD1, Miriam Juárez, MD2, Pilar Catalan, MD3, Francisco Noriega, MD2 and Emilio Bouza, MD, PhD4, (1)Clinical Microbiology and Infectious Diseases, Hospital general Universitario Gregorio Marañón, Madrid, Spain, (2)Cardiology, Hospital general Universitario Gregorio Marañón, Madrid, Spain, (3)Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañon, Madrid, Spain, (4)Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain

Disclosures:

P. Munoz, None

I. Sousa, None

A. Eworo, None

M. Martínez-Sellés, None

M. González-Del Vecchio, None

H. Bueno, None

P. López Roa, None

M. Juárez, None

P. Catalan, None

F. Noriega, None

E. Bouza, None

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