GrippeEspagneV1, Main, Exploration, bibRecord, 000416

Community-acquired respiratory coinfection in critically ill patients with pandemic 2009 influenza A(H1N1) virus.

Identifieur interne : 000416 ( Main/Exploration ); précédent : 000415; suivant : 000417

Community-acquired respiratory coinfection in critically ill patients with pandemic 2009 influenza A(H1N1) virus.

Auteurs : Ignacio Martín-Loeches [Espagne] ; Ana Sanchez-Corral [Espagne] ; Emili Diaz [Espagne] ; Rosa María Granada [Espagne] ; Rafael Zaragoza [Espagne] ; Christian Villavicencio [Espagne] ; Antonio Albaya [Espagne] ; Enrique Cerdá [Espagne] ; Rosa María Catalán [Espagne] ; Pilar Luque [Espagne] ; Amparo Paredes [Espagne] ; Inés Navarrete [Espagne] ; Jordi Rello [Espagne] ; Alejandro Rodríguez [Espagne]

Source :

Chest [ 1931-3543 ] ; 2011.

RBID : pubmed:20930007

Descripteurs français

KwdFr :
- Adulte (MeSH), Adulte d'âge moyen (MeSH), Analyse de régression (MeSH), Comorbidité (MeSH), Espagne (épidémiologie), Femelle (MeSH), Grippe humaine (épidémiologie), Humains (MeSH), Infections communautaires (thérapie), Infections communautaires (virologie), Infections communautaires (épidémiologie), Infections de l'appareil respiratoire (thérapie), Infections de l'appareil respiratoire (virologie), Infections de l'appareil respiratoire (épidémiologie), Maladie grave (MeSH), Mâle (MeSH), Prévalence (MeSH), Sous-type H1N1 du virus de la grippe A (MeSH), Unités de soins intensifs (statistiques et données numériques), Ventilation artificielle (MeSH), Études prospectives (MeSH), Études rétrospectives (MeSH).
MESH :
- statistiques et données numériques : Unités de soins intensifs.
- thérapie : Infections communautaires, Infections de l'appareil respiratoire.
- virologie : Infections communautaires, Infections de l'appareil respiratoire.
- épidémiologie : Espagne, Grippe humaine, Infections communautaires, Infections de l'appareil respiratoire.
- Adulte, Adulte d'âge moyen, Analyse de régression, Comorbidité, Femelle, Humains, Maladie grave, Mâle, Prévalence, Sous-type H1N1 du virus de la grippe A, Ventilation artificielle, Études prospectives, Études rétrospectives.
Wicri :
- geographic : Espagne.

English descriptors

KwdEn :
- Adult (MeSH), Community-Acquired Infections (epidemiology), Community-Acquired Infections (therapy), Community-Acquired Infections (virology), Comorbidity (MeSH), Critical Illness (MeSH), Female (MeSH), Humans (MeSH), Influenza A Virus, H1N1 Subtype (MeSH), Influenza, Human (epidemiology), Intensive Care Units (statistics & numerical data), Male (MeSH), Middle Aged (MeSH), Prevalence (MeSH), Prospective Studies (MeSH), Regression Analysis (MeSH), Respiration, Artificial (MeSH), Respiratory Tract Infections (epidemiology), Respiratory Tract Infections (therapy), Respiratory Tract Infections (virology), Retrospective Studies (MeSH), Spain (epidemiology).
MESH :
- geographic , epidemiology : Spain.
- epidemiology : Community-Acquired Infections, Influenza, Human, Respiratory Tract Infections.
- statistics & numerical data : Intensive Care Units.
- therapy : Community-Acquired Infections, Respiratory Tract Infections.
- virology : Community-Acquired Infections, Respiratory Tract Infections.
- Adult, Comorbidity, Critical Illness, Female, Humans, Influenza A Virus, H1N1 Subtype, Male, Middle Aged, Prevalence, Prospective Studies, Regression Analysis, Respiration, Artificial, Retrospective Studies.

Abstract

BACKGROUND

Little is known about the impact of community-acquired respiratory coinfection in patients with pandemic 2009 influenza A(H1N1) virus infection.

METHODS

This was a prospective, observational, multicenter study conducted in 148 Spanish ICUs.

RESULTS

Severe respiratory syndrome was present in 645 ICU patients. Coinfection occurred in 113 (17.5%) of patients. Streptococcus pneumoniae (in 62 patients [54.8%]) was identified as the most prevalent bacteria. Patients with coinfection at ICU admission were older (47.5±15.7 vs 43.8±14.2 years, P<.05) and presented a higher APACHE (Acute Physiology and Chronic Health Evaluation) II score (16.1±7.3 vs 13.3±7.1, P<.05) and Sequential Organ Failure Assessment (SOFA) score (7.0±3.8 vs 5.2±3.5, P<.05). No differences in comorbidities were observed. Patients who had coinfection required vasopressors (63.7% vs 39.3%, P<.05) and invasive mechanical ventilation (69% vs 58.5%, P<.05) more frequently. ICU length of stay was 3 days longer in patients who had coinfection than in patients who did not (11 [interquartile range, 5-23] vs 8 [interquartile range 4-17], P=.01). Coinfection was associated with increased ICU mortality (26.2% vs 15.5%; OR, 1.94; 95% CI, 1.21-3.09), but Cox regression analysis adjusted by potential confounders did not confirm a significant association between coinfection and ICU mortality.

CONCLUSIONS

During the 2009 pandemics, the role played by bacterial coinfection in bringing patients to the ICU was not clear, S pneumoniae being the most common pathogen. This work provides clear evidence that bacterial coinfection is a contributor to increased consumption of health resources by critical patients infected with the virus and is the virus that causes critical illness in the vast majority of cases.

DOI: 10.1378/chest.10-1396
PubMed: 20930007

Affiliations:

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

to stream Main, to step Corpus: 00437
to stream Main, to step Curation: 000437

Le document en format XML

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<author><name sortKey="Martin Loeches, Ignacio" sort="Martin Loeches, Ignacio" uniqKey="Martin Loeches I" first="Ignacio" last="Martín-Loeches">Ignacio Martín-Loeches</name>
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<author><name sortKey="Granada, Rosa Maria" sort="Granada, Rosa Maria" uniqKey="Granada R" first="Rosa María" last="Granada">Rosa María Granada</name>
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<author><name sortKey="Villavicencio, Christian" sort="Villavicencio, Christian" uniqKey="Villavicencio C" first="Christian" last="Villavicencio">Christian Villavicencio</name>
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<author><name sortKey="Albaya, Antonio" sort="Albaya, Antonio" uniqKey="Albaya A" first="Antonio" last="Albaya">Antonio Albaya</name>
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<author><name sortKey="Cerda, Enrique" sort="Cerda, Enrique" uniqKey="Cerda E" first="Enrique" last="Cerdá">Enrique Cerdá</name>
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<author><name sortKey="Catalan, Rosa Maria" sort="Catalan, Rosa Maria" uniqKey="Catalan R" first="Rosa María" last="Catalán">Rosa María Catalán</name>
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<author><name sortKey="Luque, Pilar" sort="Luque, Pilar" uniqKey="Luque P" first="Pilar" last="Luque">Pilar Luque</name>
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<author><name sortKey="Paredes, Amparo" sort="Paredes, Amparo" uniqKey="Paredes A" first="Amparo" last="Paredes">Amparo Paredes</name>
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<author><name sortKey="Navarrete, Ines" sort="Navarrete, Ines" uniqKey="Navarrete I" first="Inés" last="Navarrete">Inés Navarrete</name>
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<country xml:lang="fr">Espagne</country>
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<wicri:noRegion>Granada</wicri:noRegion>
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<author><name sortKey="Rello, Jordi" sort="Rello, Jordi" uniqKey="Rello J" first="Jordi" last="Rello">Jordi Rello</name>
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<country xml:lang="fr">Espagne</country>
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<placeName><settlement type="city">Barcelone</settlement>
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<author><name sortKey="Rodriguez, Alejandro" sort="Rodriguez, Alejandro" uniqKey="Rodriguez A" first="Alejandro" last="Rodríguez">Alejandro Rodríguez</name>
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<country xml:lang="fr">Espagne</country>
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<sourceDesc><biblStruct><analytic><title xml:lang="en">Community-acquired respiratory coinfection in critically ill patients with pandemic 2009 influenza A(H1N1) virus.</title>
<author><name sortKey="Martin Loeches, Ignacio" sort="Martin Loeches, Ignacio" uniqKey="Martin Loeches I" first="Ignacio" last="Martín-Loeches">Ignacio Martín-Loeches</name>
<affiliation wicri:level="1"><nlm:affiliation>Critical Care Department, Joan XXIII University Hospital, University Rovira i Virgili, IISPV, CIBER Enfermedades Respiratorias (CIBERes), Tarragona, Spain. Electronic address: drmartinloeches@gmail.com.</nlm:affiliation>
<country xml:lang="fr">Espagne</country>
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<author><name sortKey="Sanchez Corral, Ana" sort="Sanchez Corral, Ana" uniqKey="Sanchez Corral A" first="Ana" last="Sanchez-Corral">Ana Sanchez-Corral</name>
<affiliation wicri:level="3"><nlm:affiliation>Critical Care Department, Vall d'Hebron University Hospital, Barcelona, Spain.</nlm:affiliation>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Critical Care Department, Vall d'Hebron University Hospital, Barcelona</wicri:regionArea>
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<author><name sortKey="Diaz, Emili" sort="Diaz, Emili" uniqKey="Diaz E" first="Emili" last="Diaz">Emili Diaz</name>
<affiliation wicri:level="1"><nlm:affiliation>Critical Care Department, Joan XXIII University Hospital, University Rovira i Virgili, IISPV, CIBER Enfermedades Respiratorias (CIBERes), Tarragona, Spain.</nlm:affiliation>
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<author><name sortKey="Granada, Rosa Maria" sort="Granada, Rosa Maria" uniqKey="Granada R" first="Rosa María" last="Granada">Rosa María Granada</name>
<affiliation wicri:level="3"><nlm:affiliation>Critical Care Department, Hospital Universitario de Bellvitge, Barcelona, Spain.</nlm:affiliation>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Critical Care Department, Hospital Universitario de Bellvitge, Barcelona</wicri:regionArea>
<placeName><settlement type="city">Barcelone</settlement>
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<author><name sortKey="Zaragoza, Rafael" sort="Zaragoza, Rafael" uniqKey="Zaragoza R" first="Rafael" last="Zaragoza">Rafael Zaragoza</name>
<affiliation wicri:level="1"><nlm:affiliation>Critical Care Department, Hospital Universitario Dr. Peset, Valencia, Spain.</nlm:affiliation>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Critical Care Department, Hospital Universitario Dr. Peset, Valencia</wicri:regionArea>
<wicri:noRegion>Valencia</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Villavicencio, Christian" sort="Villavicencio, Christian" uniqKey="Villavicencio C" first="Christian" last="Villavicencio">Christian Villavicencio</name>
<affiliation wicri:level="1"><nlm:affiliation>Critical Care Department, Joan XXIII University Hospital, University Rovira i Virgili, IISPV, CIBER Enfermedades Respiratorias (CIBERes), Tarragona, Spain.</nlm:affiliation>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Critical Care Department, Joan XXIII University Hospital, University Rovira i Virgili, IISPV, CIBER Enfermedades Respiratorias (CIBERes), Tarragona</wicri:regionArea>
<wicri:noRegion>Tarragona</wicri:noRegion>
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<author><name sortKey="Albaya, Antonio" sort="Albaya, Antonio" uniqKey="Albaya A" first="Antonio" last="Albaya">Antonio Albaya</name>
<affiliation wicri:level="1"><nlm:affiliation>Critical Care Department, Hospital Universitario de Guadalajara, Guadalajara, Spain.</nlm:affiliation>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Critical Care Department, Hospital Universitario de Guadalajara, Guadalajara</wicri:regionArea>
<wicri:noRegion>Guadalajara</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Cerda, Enrique" sort="Cerda, Enrique" uniqKey="Cerda E" first="Enrique" last="Cerdá">Enrique Cerdá</name>
<affiliation wicri:level="3"><nlm:affiliation>Critical Care Department, Hospital Infanta Cristina, Madrid, Spain.</nlm:affiliation>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Critical Care Department, Hospital Infanta Cristina, Madrid</wicri:regionArea>
<placeName><settlement type="city">Madrid</settlement>
<region nuts="2" type="region">Communauté de Madrid</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Catalan, Rosa Maria" sort="Catalan, Rosa Maria" uniqKey="Catalan R" first="Rosa María" last="Catalán">Rosa María Catalán</name>
<affiliation wicri:level="1"><nlm:affiliation>Critical Care Department, Hospital General de Vic, Consorci Hospitalari de Vic, Vic, Spain.</nlm:affiliation>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Critical Care Department, Hospital General de Vic, Consorci Hospitalari de Vic, Vic</wicri:regionArea>
<wicri:noRegion>Vic</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Luque, Pilar" sort="Luque, Pilar" uniqKey="Luque P" first="Pilar" last="Luque">Pilar Luque</name>
<affiliation wicri:level="1"><nlm:affiliation>Critical Care Department, Hospital Clinico Universitario Lozano Blesa, Zaragoza, Spain.</nlm:affiliation>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Critical Care Department, Hospital Clinico Universitario Lozano Blesa, Zaragoza</wicri:regionArea>
<wicri:noRegion>Zaragoza</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Paredes, Amparo" sort="Paredes, Amparo" uniqKey="Paredes A" first="Amparo" last="Paredes">Amparo Paredes</name>
<affiliation wicri:level="3"><nlm:affiliation>Critical Care Department, Hospital Sur de Alcorcón, Madrid, Spain.</nlm:affiliation>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Critical Care Department, Hospital Sur de Alcorcón, Madrid</wicri:regionArea>
<placeName><settlement type="city">Madrid</settlement>
<region nuts="2" type="region">Communauté de Madrid</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Navarrete, Ines" sort="Navarrete, Ines" uniqKey="Navarrete I" first="Inés" last="Navarrete">Inés Navarrete</name>
<affiliation wicri:level="1"><nlm:affiliation>Critical Care Department, Hospital Universitario Virgen de las Nieves, Granada, Spain.</nlm:affiliation>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Critical Care Department, Hospital Universitario Virgen de las Nieves, Granada</wicri:regionArea>
<wicri:noRegion>Granada</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Rello, Jordi" sort="Rello, Jordi" uniqKey="Rello J" first="Jordi" last="Rello">Jordi Rello</name>
<affiliation wicri:level="3"><nlm:affiliation>Critical Care Department, Vall d'Hebron University Hospital, Institut de Recerca Vall d'Hebron, CIBER Enfermedades Respiratorias (CIBERes), Universitat Autónoma de Barcelona, Barcelona, Spain.</nlm:affiliation>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Critical Care Department, Vall d'Hebron University Hospital, Institut de Recerca Vall d'Hebron, CIBER Enfermedades Respiratorias (CIBERes), Universitat Autónoma de Barcelona, Barcelona</wicri:regionArea>
<placeName><settlement type="city">Barcelone</settlement>
<region nuts="2" type="region">Catalogne</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Rodriguez, Alejandro" sort="Rodriguez, Alejandro" uniqKey="Rodriguez A" first="Alejandro" last="Rodríguez">Alejandro Rodríguez</name>
<affiliation wicri:level="1"><nlm:affiliation>Critical Care Department, Joan XXIII University Hospital, University Rovira i Virgili, IISPV, CIBER Enfermedades Respiratorias (CIBERes), Tarragona, Spain.</nlm:affiliation>
<country xml:lang="fr">Espagne</country>
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<imprint><date when="2011" type="published">2011</date>
</imprint>
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</sourceDesc>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term>
<term>Community-Acquired Infections (epidemiology)</term>
<term>Community-Acquired Infections (therapy)</term>
<term>Community-Acquired Infections (virology)</term>
<term>Comorbidity (MeSH)</term>
<term>Critical Illness (MeSH)</term>
<term>Female (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Influenza A Virus, H1N1 Subtype (MeSH)</term>
<term>Influenza, Human (epidemiology)</term>
<term>Intensive Care Units (statistics & numerical data)</term>
<term>Male (MeSH)</term>
<term>Middle Aged (MeSH)</term>
<term>Prevalence (MeSH)</term>
<term>Prospective Studies (MeSH)</term>
<term>Regression Analysis (MeSH)</term>
<term>Respiration, Artificial (MeSH)</term>
<term>Respiratory Tract Infections (epidemiology)</term>
<term>Respiratory Tract Infections (therapy)</term>
<term>Respiratory Tract Infections (virology)</term>
<term>Retrospective Studies (MeSH)</term>
<term>Spain (epidemiology)</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Adulte (MeSH)</term>
<term>Adulte d'âge moyen (MeSH)</term>
<term>Analyse de régression (MeSH)</term>
<term>Comorbidité (MeSH)</term>
<term>Espagne (épidémiologie)</term>
<term>Femelle (MeSH)</term>
<term>Grippe humaine (épidémiologie)</term>
<term>Humains (MeSH)</term>
<term>Infections communautaires (thérapie)</term>
<term>Infections communautaires (virologie)</term>
<term>Infections communautaires (épidémiologie)</term>
<term>Infections de l'appareil respiratoire (thérapie)</term>
<term>Infections de l'appareil respiratoire (virologie)</term>
<term>Infections de l'appareil respiratoire (épidémiologie)</term>
<term>Maladie grave (MeSH)</term>
<term>Mâle (MeSH)</term>
<term>Prévalence (MeSH)</term>
<term>Sous-type H1N1 du virus de la grippe A (MeSH)</term>
<term>Unités de soins intensifs (statistiques et données numériques)</term>
<term>Ventilation artificielle (MeSH)</term>
<term>Études prospectives (MeSH)</term>
<term>Études rétrospectives (MeSH)</term>
</keywords>
<keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Spain</term>
</keywords>
<keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Community-Acquired Infections</term>
<term>Influenza, Human</term>
<term>Respiratory Tract Infections</term>
</keywords>
<keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Intensive Care Units</term>
</keywords>
<keywords scheme="MESH" qualifier="statistiques et données numériques" xml:lang="fr"><term>Unités de soins intensifs</term>
</keywords>
<keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Community-Acquired Infections</term>
<term>Respiratory Tract Infections</term>
</keywords>
<keywords scheme="MESH" qualifier="thérapie" xml:lang="fr"><term>Infections communautaires</term>
<term>Infections de l'appareil respiratoire</term>
</keywords>
<keywords scheme="MESH" qualifier="virologie" xml:lang="fr"><term>Infections communautaires</term>
<term>Infections de l'appareil respiratoire</term>
</keywords>
<keywords scheme="MESH" qualifier="virology" xml:lang="en"><term>Community-Acquired Infections</term>
<term>Respiratory Tract Infections</term>
</keywords>
<keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Espagne</term>
<term>Grippe humaine</term>
<term>Infections communautaires</term>
<term>Infections de l'appareil respiratoire</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Adult</term>
<term>Comorbidity</term>
<term>Critical Illness</term>
<term>Female</term>
<term>Humans</term>
<term>Influenza A Virus, H1N1 Subtype</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Prevalence</term>
<term>Prospective Studies</term>
<term>Regression Analysis</term>
<term>Respiration, Artificial</term>
<term>Retrospective Studies</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr"><term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Analyse de régression</term>
<term>Comorbidité</term>
<term>Femelle</term>
<term>Humains</term>
<term>Maladie grave</term>
<term>Mâle</term>
<term>Prévalence</term>
<term>Sous-type H1N1 du virus de la grippe A</term>
<term>Ventilation artificielle</term>
<term>Études prospectives</term>
<term>Études rétrospectives</term>
</keywords>
<keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Espagne</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b>
</p>
<p>Little is known about the impact of community-acquired respiratory coinfection in patients with pandemic 2009 influenza A(H1N1) virus infection.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>METHODS</b>
</p>
<p>This was a prospective, observational, multicenter study conducted in 148 Spanish ICUs.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>RESULTS</b>
</p>
<p>Severe respiratory syndrome was present in 645 ICU patients. Coinfection occurred in 113 (17.5%) of patients. Streptococcus pneumoniae (in 62 patients [54.8%]) was identified as the most prevalent bacteria. Patients with coinfection at ICU admission were older (47.5±15.7 vs 43.8±14.2 years, P<.05) and presented a higher APACHE (Acute Physiology and Chronic Health Evaluation) II score (16.1±7.3 vs 13.3±7.1, P<.05) and Sequential Organ Failure Assessment (SOFA) score (7.0±3.8 vs 5.2±3.5, P<.05). No differences in comorbidities were observed. Patients who had coinfection required vasopressors (63.7% vs 39.3%, P<.05) and invasive mechanical ventilation (69% vs 58.5%, P<.05) more frequently. ICU length of stay was 3 days longer in patients who had coinfection than in patients who did not (11 [interquartile range, 5-23] vs 8 [interquartile range 4-17], P=.01). Coinfection was associated with increased ICU mortality (26.2% vs 15.5%; OR, 1.94; 95% CI, 1.21-3.09), but Cox regression analysis adjusted by potential confounders did not confirm a significant association between coinfection and ICU mortality.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b>
</p>
<p>During the 2009 pandemics, the role played by bacterial coinfection in bringing patients to the ICU was not clear, S pneumoniae being the most common pathogen. This work provides clear evidence that bacterial coinfection is a contributor to increased consumption of health resources by critical patients infected with the virus and is the virus that causes critical illness in the vast majority of cases.</p>
</div>
</front>
</TEI>
<pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">20930007</PMID>
<DateCompleted><Year>2011</Year>
<Month>04</Month>
<Day>21</Day>
</DateCompleted>
<DateRevised><Year>2018</Year>
<Month>03</Month>
<Day>24</Day>
</DateRevised>
<Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1931-3543</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>139</Volume>
<Issue>3</Issue>
<PubDate><Year>2011</Year>
<Month>03</Month>
</PubDate>
</JournalIssue>
<Title>Chest</Title>
<ISOAbbreviation>Chest</ISOAbbreviation>
</Journal>
<ArticleTitle>Community-acquired respiratory coinfection in critically ill patients with pandemic 2009 influenza A(H1N1) virus.</ArticleTitle>
<Pagination><MedlinePgn>555-562</MedlinePgn>
</Pagination>
<ELocationID EIdType="pii" ValidYN="Y">S0012-3692(11)60122-0</ELocationID>
<ELocationID EIdType="doi" ValidYN="Y">10.1378/chest.10-1396</ELocationID>
<Abstract><AbstractText Label="BACKGROUND">Little is known about the impact of community-acquired respiratory coinfection in patients with pandemic 2009 influenza A(H1N1) virus infection.</AbstractText>
<AbstractText Label="METHODS">This was a prospective, observational, multicenter study conducted in 148 Spanish ICUs.</AbstractText>
<AbstractText Label="RESULTS">Severe respiratory syndrome was present in 645 ICU patients. Coinfection occurred in 113 (17.5%) of patients. Streptococcus pneumoniae (in 62 patients [54.8%]) was identified as the most prevalent bacteria. Patients with coinfection at ICU admission were older (47.5±15.7 vs 43.8±14.2 years, P<.05) and presented a higher APACHE (Acute Physiology and Chronic Health Evaluation) II score (16.1±7.3 vs 13.3±7.1, P<.05) and Sequential Organ Failure Assessment (SOFA) score (7.0±3.8 vs 5.2±3.5, P<.05). No differences in comorbidities were observed. Patients who had coinfection required vasopressors (63.7% vs 39.3%, P<.05) and invasive mechanical ventilation (69% vs 58.5%, P<.05) more frequently. ICU length of stay was 3 days longer in patients who had coinfection than in patients who did not (11 [interquartile range, 5-23] vs 8 [interquartile range 4-17], P=.01). Coinfection was associated with increased ICU mortality (26.2% vs 15.5%; OR, 1.94; 95% CI, 1.21-3.09), but Cox regression analysis adjusted by potential confounders did not confirm a significant association between coinfection and ICU mortality.</AbstractText>
<AbstractText Label="CONCLUSIONS">During the 2009 pandemics, the role played by bacterial coinfection in bringing patients to the ICU was not clear, S pneumoniae being the most common pathogen. This work provides clear evidence that bacterial coinfection is a contributor to increased consumption of health resources by critical patients infected with the virus and is the virus that causes critical illness in the vast majority of cases.</AbstractText>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Martín-Loeches</LastName>
<ForeName>Ignacio</ForeName>
<Initials>I</Initials>
<AffiliationInfo><Affiliation>Critical Care Department, Joan XXIII University Hospital, University Rovira i Virgili, IISPV, CIBER Enfermedades Respiratorias (CIBERes), Tarragona, Spain. Electronic address: drmartinloeches@gmail.com.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Sanchez-Corral</LastName>
<ForeName>Ana</ForeName>
<Initials>A</Initials>
<AffiliationInfo><Affiliation>Critical Care Department, Vall d'Hebron University Hospital, Barcelona, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Diaz</LastName>
<ForeName>Emili</ForeName>
<Initials>E</Initials>
<AffiliationInfo><Affiliation>Critical Care Department, Joan XXIII University Hospital, University Rovira i Virgili, IISPV, CIBER Enfermedades Respiratorias (CIBERes), Tarragona, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Granada</LastName>
<ForeName>Rosa María</ForeName>
<Initials>RM</Initials>
<AffiliationInfo><Affiliation>Critical Care Department, Hospital Universitario de Bellvitge, Barcelona, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Zaragoza</LastName>
<ForeName>Rafael</ForeName>
<Initials>R</Initials>
<AffiliationInfo><Affiliation>Critical Care Department, Hospital Universitario Dr. Peset, Valencia, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Villavicencio</LastName>
<ForeName>Christian</ForeName>
<Initials>C</Initials>
<AffiliationInfo><Affiliation>Critical Care Department, Joan XXIII University Hospital, University Rovira i Virgili, IISPV, CIBER Enfermedades Respiratorias (CIBERes), Tarragona, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Albaya</LastName>
<ForeName>Antonio</ForeName>
<Initials>A</Initials>
<AffiliationInfo><Affiliation>Critical Care Department, Hospital Universitario de Guadalajara, Guadalajara, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Cerdá</LastName>
<ForeName>Enrique</ForeName>
<Initials>E</Initials>
<AffiliationInfo><Affiliation>Critical Care Department, Hospital Infanta Cristina, Madrid, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Catalán</LastName>
<ForeName>Rosa María</ForeName>
<Initials>RM</Initials>
<AffiliationInfo><Affiliation>Critical Care Department, Hospital General de Vic, Consorci Hospitalari de Vic, Vic, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Luque</LastName>
<ForeName>Pilar</ForeName>
<Initials>P</Initials>
<AffiliationInfo><Affiliation>Critical Care Department, Hospital Clinico Universitario Lozano Blesa, Zaragoza, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Paredes</LastName>
<ForeName>Amparo</ForeName>
<Initials>A</Initials>
<AffiliationInfo><Affiliation>Critical Care Department, Hospital Sur de Alcorcón, Madrid, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Navarrete</LastName>
<ForeName>Inés</ForeName>
<Initials>I</Initials>
<AffiliationInfo><Affiliation>Critical Care Department, Hospital Universitario Virgen de las Nieves, Granada, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Rello</LastName>
<ForeName>Jordi</ForeName>
<Initials>J</Initials>
<AffiliationInfo><Affiliation>Critical Care Department, Vall d'Hebron University Hospital, Institut de Recerca Vall d'Hebron, CIBER Enfermedades Respiratorias (CIBERes), Universitat Autónoma de Barcelona, Barcelona, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Rodríguez</LastName>
<ForeName>Alejandro</ForeName>
<Initials>A</Initials>
<AffiliationInfo><Affiliation>Critical Care Department, Joan XXIII University Hospital, University Rovira i Virgili, IISPV, CIBER Enfermedades Respiratorias (CIBERes), Tarragona, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><CollectiveName>H1N1 SEMICYUC Working Group</CollectiveName>
</Author>
</AuthorList>
<Language>eng</Language>
<PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType>
<PublicationType UI="D016448">Multicenter Study</PublicationType>
</PublicationTypeList>
<ArticleDate DateType="Electronic"><Year>2010</Year>
<Month>10</Month>
<Day>07</Day>
</ArticleDate>
</Article>
<MedlineJournalInfo><Country>United States</Country>
<MedlineTA>Chest</MedlineTA>
<NlmUniqueID>0231335</NlmUniqueID>
<ISSNLinking>0012-3692</ISSNLinking>
</MedlineJournalInfo>
<CitationSubset>AIM</CitationSubset>
<CitationSubset>IM</CitationSubset>
<MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D017714" MajorTopicYN="N">Community-Acquired Infections</DescriptorName>
<QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName>
<QualifierName UI="Q000628" MajorTopicYN="N">therapy</QualifierName>
<QualifierName UI="Q000821" MajorTopicYN="N">virology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D015897" MajorTopicYN="N">Comorbidity</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D016638" MajorTopicYN="Y">Critical Illness</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D053118" MajorTopicYN="Y">Influenza A Virus, H1N1 Subtype</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D007251" MajorTopicYN="N">Influenza, Human</DescriptorName>
<QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D007362" MajorTopicYN="N">Intensive Care Units</DescriptorName>
<QualifierName UI="Q000706" MajorTopicYN="N">statistics & numerical data</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D015995" MajorTopicYN="N">Prevalence</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D011446" MajorTopicYN="N">Prospective Studies</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D012044" MajorTopicYN="N">Regression Analysis</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D012121" MajorTopicYN="N">Respiration, Artificial</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D012141" MajorTopicYN="N">Respiratory Tract Infections</DescriptorName>
<QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName>
<QualifierName UI="Q000628" MajorTopicYN="N">therapy</QualifierName>
<QualifierName UI="Q000821" MajorTopicYN="N">virology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D013030" MajorTopicYN="N" Type="Geographic">Spain</DescriptorName>
<QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName>
</MeshHeading>
</MeshHeadingList>
</MedlineCitation>
<PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2010</Year>
<Month>10</Month>
<Day>9</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
<PubMedPubDate PubStatus="pubmed"><Year>2010</Year>
<Month>10</Month>
<Day>12</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
<PubMedPubDate PubStatus="medline"><Year>2011</Year>
<Month>4</Month>
<Day>22</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
</History>
<PublicationStatus>ppublish</PublicationStatus>
<ArticleIdList><ArticleId IdType="pubmed">20930007</ArticleId>
<ArticleId IdType="pii">S0012-3692(11)60122-0</ArticleId>
<ArticleId IdType="doi">10.1378/chest.10-1396</ArticleId>
</ArticleIdList>
</PubmedData>
</pubmed>
<affiliations><list><country><li>Espagne</li>
</country>
<region><li>Catalogne</li>
<li>Communauté de Madrid</li>
</region>
<settlement><li>Barcelone</li>
<li>Madrid</li>
</settlement>
</list>
<tree><country name="Espagne"><noRegion><name sortKey="Martin Loeches, Ignacio" sort="Martin Loeches, Ignacio" uniqKey="Martin Loeches I" first="Ignacio" last="Martín-Loeches">Ignacio Martín-Loeches</name>
</noRegion>
<name sortKey="Albaya, Antonio" sort="Albaya, Antonio" uniqKey="Albaya A" first="Antonio" last="Albaya">Antonio Albaya</name>
<name sortKey="Catalan, Rosa Maria" sort="Catalan, Rosa Maria" uniqKey="Catalan R" first="Rosa María" last="Catalán">Rosa María Catalán</name>
<name sortKey="Cerda, Enrique" sort="Cerda, Enrique" uniqKey="Cerda E" first="Enrique" last="Cerdá">Enrique Cerdá</name>
<name sortKey="Diaz, Emili" sort="Diaz, Emili" uniqKey="Diaz E" first="Emili" last="Diaz">Emili Diaz</name>
<name sortKey="Granada, Rosa Maria" sort="Granada, Rosa Maria" uniqKey="Granada R" first="Rosa María" last="Granada">Rosa María Granada</name>
<name sortKey="Luque, Pilar" sort="Luque, Pilar" uniqKey="Luque P" first="Pilar" last="Luque">Pilar Luque</name>
<name sortKey="Navarrete, Ines" sort="Navarrete, Ines" uniqKey="Navarrete I" first="Inés" last="Navarrete">Inés Navarrete</name>
<name sortKey="Paredes, Amparo" sort="Paredes, Amparo" uniqKey="Paredes A" first="Amparo" last="Paredes">Amparo Paredes</name>
<name sortKey="Rello, Jordi" sort="Rello, Jordi" uniqKey="Rello J" first="Jordi" last="Rello">Jordi Rello</name>
<name sortKey="Rodriguez, Alejandro" sort="Rodriguez, Alejandro" uniqKey="Rodriguez A" first="Alejandro" last="Rodríguez">Alejandro Rodríguez</name>
<name sortKey="Sanchez Corral, Ana" sort="Sanchez Corral, Ana" uniqKey="Sanchez Corral A" first="Ana" last="Sanchez-Corral">Ana Sanchez-Corral</name>
<name sortKey="Villavicencio, Christian" sort="Villavicencio, Christian" uniqKey="Villavicencio C" first="Christian" last="Villavicencio">Christian Villavicencio</name>
<name sortKey="Zaragoza, Rafael" sort="Zaragoza, Rafael" uniqKey="Zaragoza R" first="Rafael" last="Zaragoza">Rafael Zaragoza</name>
</country>
</tree>
</affiliations>
</record>

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Community-acquired respiratory coinfection in critically ill patients with pandemic 2009 influenza A(H1N1) virus.

Community-acquired respiratory coinfection in critically ill patients with pandemic 2009 influenza A(H1N1) virus.

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