Febrile neutropenia: significance of elaborated screening for respiratory viruses, and the comparison of different sampling methods, in neutropenic patients with hematological malignancies
Identifieur interne : 001244 ( Main/Exploration ); précédent : 001243; suivant : 001245Febrile neutropenia: significance of elaborated screening for respiratory viruses, and the comparison of different sampling methods, in neutropenic patients with hematological malignancies
Auteurs : Rogier R. Jansen [Pays-Bas] ; Bart J. Biemond [Pays-Bas] ; Janke Schinkel [Pays-Bas] ; Sylvie M. Koekkoek [Pays-Bas] ; Richard Molenkamp [Pays-Bas] ; Menno D. De Jong [Pays-Bas] ; Caroline E. Visser [Pays-Bas]Source :
- Virology Journal [ 1743-422X ] ; 2013.
Abstract
During febrile neutropenia in only 30 to 60 percent an infectious agent is identified. This diagnostic gap could hypothetically be reduced with the broad implementation of molecular detection techniques like PCR, which has revolutionized the detection of infectious diseases during the last two decades.
We performed a longitudinal prospective study (N = 81) of neutropenic patients to assess the role of respiratory viruses in neutropenic fever and to determine the clinical relevance of blind screening for these viruses. Respiratory viruses were recovered in 14% of the patients prior to neutropenia. In 13% of neutropenic patients without fever and in 19% of those with fever, a respiratory virus was detected. Comparing different sample types; nasal swabs performed significantly better (16/117 = 43%), than throat swabs (6/106 = 6%). Throat gurgles did not show significant differences from the latter sample types.
Blind diagnostic screening for respiratory viruses before or during neutropenia is not useful. Nasal swabs are sensitive and practical option for screening on respiratory viruses.
Url:
DOI: 10.1186/1743-422X-10-212
PubMed: 23805898
PubMed Central: 3706282
Affiliations:
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Jansen</name><affiliation wicri:level="4"><nlm:aff id="I1">Department of Medical Microbiology, Academical Medical Centre, University of Amsterdam, Amsterdam, the Netherlands</nlm:aff><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Department of Medical Microbiology, Academical Medical Centre, University of Amsterdam, Amsterdam</wicri:regionArea><placeName><settlement type="city">Amsterdam</settlement><region nuts="2" type="province">Hollande-Septentrionale</region></placeName><orgName type="university">Université d'Amsterdam</orgName></affiliation><affiliation wicri:level="3"><nlm:aff id="I3">Academical Medical Centre, Room L1-245, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands</nlm:aff><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Academical Medical Centre, Room L1-245, Meibergdreef 9, 1105 AZ, Amsterdam</wicri:regionArea><placeName><settlement type="city">Amsterdam</settlement><region nuts="2" type="province">Hollande-Septentrionale</region></placeName></affiliation></author><author><name sortKey="Biemond, Bart J" sort="Biemond, Bart J" uniqKey="Biemond B" first="Bart J" last="Biemond">Bart J. 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Jansen</name><affiliation wicri:level="4"><nlm:aff id="I1">Department of Medical Microbiology, Academical Medical Centre, University of Amsterdam, Amsterdam, the Netherlands</nlm:aff><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Department of Medical Microbiology, Academical Medical Centre, University of Amsterdam, Amsterdam</wicri:regionArea><placeName><settlement type="city">Amsterdam</settlement><region nuts="2" type="province">Hollande-Septentrionale</region></placeName><orgName type="university">Université d'Amsterdam</orgName></affiliation><affiliation wicri:level="3"><nlm:aff id="I3">Academical Medical Centre, Room L1-245, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands</nlm:aff><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Academical Medical Centre, Room L1-245, Meibergdreef 9, 1105 AZ, Amsterdam</wicri:regionArea><placeName><settlement type="city">Amsterdam</settlement><region nuts="2" type="province">Hollande-Septentrionale</region></placeName></affiliation></author><author><name sortKey="Biemond, Bart J" sort="Biemond, Bart J" uniqKey="Biemond B" first="Bart J" last="Biemond">Bart J. Biemond</name><affiliation wicri:level="4"><nlm:aff id="I2">Department of Hematology, Academical Medical Centre, University of Amsterdam, Amsterdam, the Netherlands</nlm:aff><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Department of Hematology, Academical Medical Centre, University of Amsterdam, Amsterdam</wicri:regionArea><placeName><settlement type="city">Amsterdam</settlement><region nuts="2" type="province">Hollande-Septentrionale</region></placeName><orgName type="university">Université d'Amsterdam</orgName></affiliation></author><author><name sortKey="Schinkel, Janke" sort="Schinkel, Janke" uniqKey="Schinkel J" first="Janke" last="Schinkel">Janke Schinkel</name><affiliation wicri:level="4"><nlm:aff id="I1">Department of Medical Microbiology, Academical Medical Centre, University of Amsterdam, Amsterdam, the Netherlands</nlm:aff><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Department of Medical Microbiology, Academical Medical Centre, University of Amsterdam, Amsterdam</wicri:regionArea><placeName><settlement type="city">Amsterdam</settlement><region nuts="2" type="province">Hollande-Septentrionale</region></placeName><orgName type="university">Université d'Amsterdam</orgName></affiliation></author><author><name sortKey="Koekkoek, Sylvie M" sort="Koekkoek, Sylvie M" uniqKey="Koekkoek S" first="Sylvie M" last="Koekkoek">Sylvie M. Koekkoek</name><affiliation wicri:level="4"><nlm:aff id="I1">Department of Medical Microbiology, Academical Medical Centre, University of Amsterdam, Amsterdam, the Netherlands</nlm:aff><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Department of Medical Microbiology, Academical Medical Centre, University of Amsterdam, Amsterdam</wicri:regionArea><placeName><settlement type="city">Amsterdam</settlement><region nuts="2" type="province">Hollande-Septentrionale</region></placeName><orgName type="university">Université d'Amsterdam</orgName></affiliation></author><author><name sortKey="Molenkamp, Richard" sort="Molenkamp, Richard" uniqKey="Molenkamp R" first="Richard" last="Molenkamp">Richard Molenkamp</name><affiliation wicri:level="4"><nlm:aff id="I1">Department of Medical Microbiology, Academical Medical Centre, University of Amsterdam, Amsterdam, the Netherlands</nlm:aff><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Department of Medical Microbiology, Academical Medical Centre, University of Amsterdam, Amsterdam</wicri:regionArea><placeName><settlement type="city">Amsterdam</settlement><region nuts="2" type="province">Hollande-Septentrionale</region></placeName><orgName type="university">Université d'Amsterdam</orgName></affiliation></author><author><name sortKey="De Jong, Menno D" sort="De Jong, Menno D" uniqKey="De Jong M" first="Menno D" last="De Jong">Menno D. De Jong</name><affiliation wicri:level="4"><nlm:aff id="I1">Department of Medical Microbiology, Academical Medical Centre, University of Amsterdam, Amsterdam, the Netherlands</nlm:aff><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Department of Medical Microbiology, Academical Medical Centre, University of Amsterdam, Amsterdam</wicri:regionArea><placeName><settlement type="city">Amsterdam</settlement><region nuts="2" type="province">Hollande-Septentrionale</region></placeName><orgName type="university">Université d'Amsterdam</orgName></affiliation></author><author><name sortKey="Visser, Caroline E" sort="Visser, Caroline E" uniqKey="Visser C" first="Caroline E" last="Visser">Caroline E. Visser</name><affiliation wicri:level="4"><nlm:aff id="I1">Department of Medical Microbiology, Academical Medical Centre, University of Amsterdam, Amsterdam, the Netherlands</nlm:aff><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Department of Medical Microbiology, Academical Medical Centre, University of Amsterdam, Amsterdam</wicri:regionArea><placeName><settlement type="city">Amsterdam</settlement><region nuts="2" type="province">Hollande-Septentrionale</region></placeName><orgName type="university">Université d'Amsterdam</orgName></affiliation></author></analytic><series><title level="j">Virology Journal</title><idno type="eISSN">1743-422X</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>During febrile neutropenia in only 30 to 60 percent an infectious agent is identified. This diagnostic gap could hypothetically be reduced with the broad implementation of molecular detection techniques like PCR, which has revolutionized the detection of infectious diseases during the last two decades.</p></sec><sec><title>Findings</title><p>We performed a longitudinal prospective study (N = 81) of neutropenic patients to assess the role of respiratory viruses in neutropenic fever and to determine the clinical relevance of blind screening for these viruses. Respiratory viruses were recovered in 14% of the patients prior to neutropenia. In 13% of neutropenic patients without fever and in 19% of those with fever, a respiratory virus was detected. Comparing different sample types; nasal swabs performed significantly better (16/117 = 43%), than throat swabs (6/106 = 6%). Throat gurgles did not show significant differences from the latter sample types.</p></sec><sec><title>Conclusions</title><p>Blind diagnostic screening for respiratory viruses before or during neutropenia is not useful. 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sortKey="Lyngroth, Al" uniqKey="Lyngroth A">AL Lyngroth</name></author><author><name sortKey="Pripp, Ah" uniqKey="Pripp A">AH Pripp</name></author><author><name sortKey="Bjorvatn, B" uniqKey="Bjorvatn B">B Bjorvatn</name></author><author><name sortKey="Bakke, Ps" uniqKey="Bakke P">PS Bakke</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kim, Yj" uniqKey="Kim Y">YJ Kim</name></author><author><name sortKey="Boeckh, M" uniqKey="Boeckh M">M Boeckh</name></author><author><name sortKey="Englund, Ja" uniqKey="Englund J">JA Englund</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Falsey, Ar" uniqKey="Falsey A">AR Falsey</name></author><author><name sortKey="Formica, Ma" uniqKey="Formica M">MA Formica</name></author><author><name sortKey="Walsh, Ee" uniqKey="Walsh E">EE Walsh</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Pays-Bas</li></country><region><li>Hollande-Septentrionale</li></region><settlement><li>Amsterdam</li></settlement><orgName><li>Université d'Amsterdam</li></orgName></list><tree><country name="Pays-Bas"><region name="Hollande-Septentrionale"><name sortKey="Jansen, Rogier R" sort="Jansen, Rogier R" uniqKey="Jansen R" first="Rogier R" last="Jansen">Rogier R. Jansen</name></region><name sortKey="Biemond, Bart J" sort="Biemond, Bart J" uniqKey="Biemond B" first="Bart J" last="Biemond">Bart J. Biemond</name><name sortKey="De Jong, Menno D" sort="De Jong, Menno D" uniqKey="De Jong M" first="Menno D" last="De Jong">Menno D. De Jong</name><name sortKey="Jansen, Rogier R" sort="Jansen, Rogier R" uniqKey="Jansen R" first="Rogier R" last="Jansen">Rogier R. Jansen</name><name sortKey="Koekkoek, Sylvie M" sort="Koekkoek, Sylvie M" uniqKey="Koekkoek S" first="Sylvie M" last="Koekkoek">Sylvie M. Koekkoek</name><name sortKey="Molenkamp, Richard" sort="Molenkamp, Richard" uniqKey="Molenkamp R" first="Richard" last="Molenkamp">Richard Molenkamp</name><name sortKey="Schinkel, Janke" sort="Schinkel, Janke" uniqKey="Schinkel J" first="Janke" last="Schinkel">Janke Schinkel</name><name sortKey="Visser, Caroline E" sort="Visser, Caroline E" uniqKey="Visser C" first="Caroline E" last="Visser">Caroline E. 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