Viral infection is not uncommon in adult patients with severe hospital-acquired pneumonia.
BACKGROUND: Viral pathogens have not generally been regarded as important causes of severe hospital-acquired pneumonia (HAP), except in patients with hematologic malignancy or transplant recipients. We investigated the role and distribution of viruses in adult with severe HAP who required intensive...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2014-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC3994115?pdf=render |
| _version_ | 1818949792249675776 |
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| author | Hyo-Lim Hong Sang-Bum Hong Gwang-Beom Ko Jin Won Huh Heungsup Sung Kyung-Hyun Do Sung-Han Kim Sang-Oh Lee Mi-Na Kim Jin-Yong Jeong Chae-Man Lim Yang Soo Kim Jun Hee Woo Younsuck Koh Sang-Ho Choi |
| author_facet | Hyo-Lim Hong Sang-Bum Hong Gwang-Beom Ko Jin Won Huh Heungsup Sung Kyung-Hyun Do Sung-Han Kim Sang-Oh Lee Mi-Na Kim Jin-Yong Jeong Chae-Man Lim Yang Soo Kim Jun Hee Woo Younsuck Koh Sang-Ho Choi |
| author_sort | Hyo-Lim Hong |
| collection | DOAJ |
| description | BACKGROUND: Viral pathogens have not generally been regarded as important causes of severe hospital-acquired pneumonia (HAP), except in patients with hematologic malignancy or transplant recipients. We investigated the role and distribution of viruses in adult with severe HAP who required intensive care. METHODS: From March 2010 to February 2012, adult patients with severe HAP required admission to the intensive care unit (ICU), 28-bed medical ICU in a tertiary care hospital, were prospectively enrolled. Respiratory viruses were detected using multiplex reverse-transcription polymerase chain reaction and/or shell vial culture. RESULTS: A total of 262 patients were enrolled and 107 patients (40.8%) underwent bronchoscopic BAL for etiologic diagnosis. One hundred and fifty-six patients (59.5%) had bacterial infections and 59 patients (22.5%) had viral infections. Viruses were detected in BAL fluid specimens of 37 patients (62.7%, 37/59). The most commonly identified viruses were respiratory syncytial virus and parainfluenza virus (both 27.1%, 16/59), followed by rhinovirus (25.4%, 15/59), and influenza virus (16.9%, 10/59). Twenty-one patients (8.0%, 21/262) had bacterial-viral coinfections and Staphylococcus aureus was the most commonly coexisting bacteria (n = 10). Viral infection in non-immunocompromised patients was not uncommon (11.1%, 16/143), although it was not as frequent as that in immunocompromised patients (36.4%, 43/119). Non-immunocompromised patients were significantly older than immunocompromised patients and had significantly higher rates of underlying chronic obstructive pulmonary disease, tuberculous destroyed lung and chronic kidney disease. The 28 day mortalities of patients with bacterial infections, viral infections and bacterial-viral coinfections were not significantly different (29.5%, 35.6% and 19.0%, respectively; p = 0.321). CONCLUSIONS: Viral pathogens are not uncommon in adult patients with severe HAP who required ICU admission. Since viral pathogens may cause severe HAP and could be a potential source of viral transmission, further investigation is required to delineate the role of viral pathogens in severe HAP. |
| first_indexed | 2024-12-20T09:08:19Z |
| format | Article |
| id | doaj.art-665d6d68c6b04556b8e36adac5d6fae6 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-20T09:08:19Z |
| publishDate | 2014-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-665d6d68c6b04556b8e36adac5d6fae62022-12-21T19:45:39ZengPublic Library of Science (PLoS)PLoS ONE1932-62032014-01-0194e9586510.1371/journal.pone.0095865Viral infection is not uncommon in adult patients with severe hospital-acquired pneumonia.Hyo-Lim HongSang-Bum HongGwang-Beom KoJin Won HuhHeungsup SungKyung-Hyun DoSung-Han KimSang-Oh LeeMi-Na KimJin-Yong JeongChae-Man LimYang Soo KimJun Hee WooYounsuck KohSang-Ho ChoiBACKGROUND: Viral pathogens have not generally been regarded as important causes of severe hospital-acquired pneumonia (HAP), except in patients with hematologic malignancy or transplant recipients. We investigated the role and distribution of viruses in adult with severe HAP who required intensive care. METHODS: From March 2010 to February 2012, adult patients with severe HAP required admission to the intensive care unit (ICU), 28-bed medical ICU in a tertiary care hospital, were prospectively enrolled. Respiratory viruses were detected using multiplex reverse-transcription polymerase chain reaction and/or shell vial culture. RESULTS: A total of 262 patients were enrolled and 107 patients (40.8%) underwent bronchoscopic BAL for etiologic diagnosis. One hundred and fifty-six patients (59.5%) had bacterial infections and 59 patients (22.5%) had viral infections. Viruses were detected in BAL fluid specimens of 37 patients (62.7%, 37/59). The most commonly identified viruses were respiratory syncytial virus and parainfluenza virus (both 27.1%, 16/59), followed by rhinovirus (25.4%, 15/59), and influenza virus (16.9%, 10/59). Twenty-one patients (8.0%, 21/262) had bacterial-viral coinfections and Staphylococcus aureus was the most commonly coexisting bacteria (n = 10). Viral infection in non-immunocompromised patients was not uncommon (11.1%, 16/143), although it was not as frequent as that in immunocompromised patients (36.4%, 43/119). Non-immunocompromised patients were significantly older than immunocompromised patients and had significantly higher rates of underlying chronic obstructive pulmonary disease, tuberculous destroyed lung and chronic kidney disease. The 28 day mortalities of patients with bacterial infections, viral infections and bacterial-viral coinfections were not significantly different (29.5%, 35.6% and 19.0%, respectively; p = 0.321). CONCLUSIONS: Viral pathogens are not uncommon in adult patients with severe HAP who required ICU admission. Since viral pathogens may cause severe HAP and could be a potential source of viral transmission, further investigation is required to delineate the role of viral pathogens in severe HAP.http://europepmc.org/articles/PMC3994115?pdf=render |
| spellingShingle | Hyo-Lim Hong Sang-Bum Hong Gwang-Beom Ko Jin Won Huh Heungsup Sung Kyung-Hyun Do Sung-Han Kim Sang-Oh Lee Mi-Na Kim Jin-Yong Jeong Chae-Man Lim Yang Soo Kim Jun Hee Woo Younsuck Koh Sang-Ho Choi Viral infection is not uncommon in adult patients with severe hospital-acquired pneumonia. PLoS ONE |
| title | Viral infection is not uncommon in adult patients with severe hospital-acquired pneumonia. |
| title_full | Viral infection is not uncommon in adult patients with severe hospital-acquired pneumonia. |
| title_fullStr | Viral infection is not uncommon in adult patients with severe hospital-acquired pneumonia. |
| title_full_unstemmed | Viral infection is not uncommon in adult patients with severe hospital-acquired pneumonia. |
| title_short | Viral infection is not uncommon in adult patients with severe hospital-acquired pneumonia. |
| title_sort | viral infection is not uncommon in adult patients with severe hospital acquired pneumonia |
| url | http://europepmc.org/articles/PMC3994115?pdf=render |
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