GrippeBelgiqueV4, Main, Exploration, bibRecord, 000054

Invasive pulmonary aspergillosis is a frequent complication of critically ill H1N1 patients: a retrospective study.

Identifieur interne : 000054 ( Main/Exploration ); précédent : 000053; suivant : 000055

Invasive pulmonary aspergillosis is a frequent complication of critically ill H1N1 patients: a retrospective study.

Auteurs : Joost Wauters [Belgique] ; Ingrid Baar ; Philippe Meersseman ; Wouter Meersseman ; Karolien Dams ; Rudi De Paep ; Katrien Lagrou ; Alexander Wilmer ; Philippe Jorens ; Greet Hermans

Source :

Intensive care medicine [ 1432-1238 ] ; 2012.

RBID : pubmed:22895826

Descripteurs français

KwdFr :
- Adulte, Adulte d'âge moyen, Aspergillose pulmonaire invasive (épidémiologie), Aspergillose pulmonaire invasive (étiologie), Belgique (épidémiologie), Facteurs de risque, Femelle, Glucocorticoïdes (effets indésirables), Grippe humaine (traitement médicamenteux), Grippe humaine (épidémiologie), Humains, Modèles logistiques, Mâle, Pneumopathie virale (traitement médicamenteux), Prescription inappropriée, Sous-type H1N1 du virus de la grippe A, Surinfection (épidémiologie), Surinfection (étiologie), Syndrome de détresse respiratoire de l'adulte (traitement médicamenteux), Syndrome de détresse respiratoire de l'adulte (virologie), Unités de soins intensifs, Études rétrospectives.
MESH :
- effets indésirables : Glucocorticoïdes.
- traitement médicamenteux : Grippe humaine, Pneumopathie virale, Syndrome de détresse respiratoire de l'adulte.
- virologie : Syndrome de détresse respiratoire de l'adulte.
- épidémiologie : Aspergillose pulmonaire invasive, Belgique, Grippe humaine, Surinfection.
- étiologie : Aspergillose pulmonaire invasive, Surinfection.
- Adulte, Adulte d'âge moyen, Facteurs de risque, Femelle, Humains, Modèles logistiques, Mâle, Prescription inappropriée, Sous-type H1N1 du virus de la grippe A, Unités de soins intensifs, Études rétrospectives.
Wicri :
- geographic : Belgique.

English descriptors

KwdEn :
- Adult, Belgium (epidemiology), Female, Glucocorticoids (adverse effects), Humans, Inappropriate Prescribing, Influenza A Virus, H1N1 Subtype, Influenza, Human (drug therapy), Influenza, Human (epidemiology), Intensive Care Units, Invasive Pulmonary Aspergillosis (epidemiology), Invasive Pulmonary Aspergillosis (etiology), Logistic Models, Male, Middle Aged, Pneumonia, Viral (drug therapy), Respiratory Distress Syndrome, Adult (drug therapy), Respiratory Distress Syndrome, Adult (virology), Retrospective Studies, Risk Factors, Superinfection (epidemiology), Superinfection (etiology).
MESH :
- chemical , adverse effects : Glucocorticoids.
- geographic , epidemiology : Belgium.
- drug therapy : Influenza, Human, Pneumonia, Viral, Respiratory Distress Syndrome, Adult.
- epidemiology : Influenza, Human, Invasive Pulmonary Aspergillosis, Superinfection.
- etiology : Invasive Pulmonary Aspergillosis, Superinfection.
- virology : Respiratory Distress Syndrome, Adult.
- Adult, Female, Humans, Inappropriate Prescribing, Influenza A Virus, H1N1 Subtype, Intensive Care Units, Logistic Models, Male, Middle Aged, Retrospective Studies, Risk Factors.

Abstract

PURPOSE

Despite their controversial role, corticosteroids (CS) are frequently administered to patients with H1N1 virus infection with severe respiratory failure secondary to viral pneumonia. We hypothesized that invasive pulmonary aspergillosis (IPA) is a frequent complication in critically ill patients with H1N1 virus infection and that CS may contribute to this complication.

METHODS

We retrospectively selected all adult patients with confirmed H1N1 virus infection admitted to the intensive care unit (ICU) of two tertiary care hospitals from September 2009 to March 2011. Differences in baseline factors, risk factors, and outcome parameters were studied between patients with and without IPA.

RESULTS

Of 40 critically ill patients with confirmed H1N1, 9 (23 %) developed IPA 3 days after ICU admission. Five patients had proven and four had probable IPA. Significantly more IPA patients received CS within 7 days before ICU admission (78 versus 23 %, p = 0.002). IPA patients also received significantly higher doses of CS before ICU admission [hydrocortisone equivalent 800 (360-2,635) versus 0 (0-0) mg, p = 0.005]. On multivariate analysis, use of CS before ICU admission was independently associated with IPA [odds ratio (OR) 14.4 (2.0-101.6), p = 0.007].

CONCLUSIONS

IPA was diagnosed in 23 % of critically ill patients with H1N1 virus infection after a median of 3 days after ICU admission. Our data suggest that use of CS 7 days before ICU admission is an independent risk factor for fungal superinfection. These findings may have consequences for clinical practice as they point out the need for increased awareness of IPA, especially in those critically ill H1N1 patients already receiving CS.

DOI: 10.1007/s00134-012-2673-2
PubMed: 22895826

Affiliations:

Belgique

Links toward previous steps (curation, corpus...)

to stream Main, to step Corpus: 000053
to stream Main, to step Curation: 000053

Le document en format XML

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<term>Modèles logistiques</term>
<term>Mâle</term>
<term>Pneumopathie virale (traitement médicamenteux)</term>
<term>Prescription inappropriée</term>
<term>Sous-type H1N1 du virus de la grippe A</term>
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<front><div type="abstract" xml:lang="en"><p><b>PURPOSE</b>
</p>
<p>Despite their controversial role, corticosteroids (CS) are frequently administered to patients with H1N1 virus infection with severe respiratory failure secondary to viral pneumonia. We hypothesized that invasive pulmonary aspergillosis (IPA) is a frequent complication in critically ill patients with H1N1 virus infection and that CS may contribute to this complication.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>METHODS</b>
</p>
<p>We retrospectively selected all adult patients with confirmed H1N1 virus infection admitted to the intensive care unit (ICU) of two tertiary care hospitals from September 2009 to March 2011. Differences in baseline factors, risk factors, and outcome parameters were studied between patients with and without IPA.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>RESULTS</b>
</p>
<p>Of 40 critically ill patients with confirmed H1N1, 9 (23 %) developed IPA 3 days after ICU admission. Five patients had proven and four had probable IPA. Significantly more IPA patients received CS within 7 days before ICU admission (78 versus 23 %, p = 0.002). IPA patients also received significantly higher doses of CS before ICU admission [hydrocortisone equivalent 800 (360-2,635) versus 0 (0-0) mg, p = 0.005]. On multivariate analysis, use of CS before ICU admission was independently associated with IPA [odds ratio (OR) 14.4 (2.0-101.6), p = 0.007].</p>
</div>
<div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b>
</p>
<p>IPA was diagnosed in 23 % of critically ill patients with H1N1 virus infection after a median of 3 days after ICU admission. Our data suggest that use of CS 7 days before ICU admission is an independent risk factor for fungal superinfection. These findings may have consequences for clinical practice as they point out the need for increased awareness of IPA, especially in those critically ill H1N1 patients already receiving CS.</p>
</div>
</front>
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<Day>10</Day>
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<Issue>11</Issue>
<PubDate><Year>2012</Year>
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<Title>Intensive care medicine</Title>
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<Abstract><AbstractText Label="PURPOSE" NlmCategory="OBJECTIVE">Despite their controversial role, corticosteroids (CS) are frequently administered to patients with H1N1 virus infection with severe respiratory failure secondary to viral pneumonia. We hypothesized that invasive pulmonary aspergillosis (IPA) is a frequent complication in critically ill patients with H1N1 virus infection and that CS may contribute to this complication.</AbstractText>
<AbstractText Label="METHODS" NlmCategory="METHODS">We retrospectively selected all adult patients with confirmed H1N1 virus infection admitted to the intensive care unit (ICU) of two tertiary care hospitals from September 2009 to March 2011. Differences in baseline factors, risk factors, and outcome parameters were studied between patients with and without IPA.</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="RESULTS">Of 40 critically ill patients with confirmed H1N1, 9 (23 %) developed IPA 3 days after ICU admission. Five patients had proven and four had probable IPA. Significantly more IPA patients received CS within 7 days before ICU admission (78 versus 23 %, p = 0.002). IPA patients also received significantly higher doses of CS before ICU admission [hydrocortisone equivalent 800 (360-2,635) versus 0 (0-0) mg, p = 0.005]. On multivariate analysis, use of CS before ICU admission was independently associated with IPA [odds ratio (OR) 14.4 (2.0-101.6), p = 0.007].</AbstractText>
<AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">IPA was diagnosed in 23 % of critically ill patients with H1N1 virus infection after a median of 3 days after ICU admission. Our data suggest that use of CS 7 days before ICU admission is an independent risk factor for fungal superinfection. These findings may have consequences for clinical practice as they point out the need for increased awareness of IPA, especially in those critically ill H1N1 patients already receiving CS.</AbstractText>
</Abstract>
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<CommentsCorrectionsList><CommentsCorrections RefType="CommentIn"><RefSource>Intensive Care Med. 2013 Apr;39(4):790</RefSource>
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   |texte=   Invasive pulmonary aspergillosis is a frequent complication of critically ill H1N1 patients: a retrospective study.
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Invasive pulmonary aspergillosis is a frequent complication of critically ill H1N1 patients: a retrospective study.

Invasive pulmonary aspergillosis is a frequent complication of critically ill H1N1 patients: a retrospective study.

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