775Nosocomial Influenza (NI) in cancer patients during a high activity season in Mexico City

Background. NI constitutes a serious risk among patients with immunodeficiency. Vaccination of health-care workers (HCW) and infection control measures compliance is the cornerstone for the prevention of NI. We present a cluster of patients with cancer and NI during a high activity season in Mexico (winter 2013-14). Methods. Patients and HCW with influenza-like illness (ILI) from Instituto Nacional de Cancerologia in Mexico City (126-bed, teaching, referral cancer hospital for adult patients) are regularly evaluated by the Infectious Diseases Department. Those with high suspicion of ILI are tested for influenza by rtPCR. Patients who developed ILI between January 1, 2014 and March 31, 2014 and tested positive to influenza were included, and those who had been in-hospital >= 48 hr were considered as nosocomial. We studied patients characteristics, hospital length of stay, neoplasia related variables and respiratory tract infection (RTI) symptoms, clinical course and outcomes. Results. Between January and March, 2014, 100 patients (tested: 97) and 53 (tested: 48) HCW were evaluated with ILI. 62 patients were admitted because of ILI, and 6 (8.8%) developed ILI while in-hospital. Of the 68 admitted patients, 34 (50%) were positive to influenza (AH1N1: 28, H3N2: 6). Four and 2 patients with NI were positive to AH1N1 and H3N2, respectively. Two had leukemia, 2 lymphoma, 1 aplastic anemia and 1 breast cancer; 5 (83.3%) were male. Four (66%) received chemotherapy within 30 days of the onset of symptoms; 5 (83%) had lymphopenia and 1 (16%) had < 500 neutrophils. All were treated with oseltamivir, 3 patients for 10 days and 1 for 15 days, because of shedding and/or persistence of symptoms. Two (33.3%) patients were on mechanical ventilation, both died, 1 of influenza and 1 with septic shock, both positive to H1N1. Conclusion. NI accounted for 17.6% of the confirmed influenza patients admitted to the hospital, mostly, with hematological neoplasia. Attributable mortality rate was 33.3%, similar to that observed for community-acquired influenza. Most cases were related to AH1N1, as was reported for North America during this last influenza season. Disclosures. All authors: No reported disclosures.