Clinical management of respiratory syndrome in patients hospitalized for suspected Middle East respiratory syndrome coronavirus infection in the Paris area from 2013 to 2016
Identifieur interne : 000320 ( Pmc/Curation ); précédent : 000319; suivant : 000321Clinical management of respiratory syndrome in patients hospitalized for suspected Middle East respiratory syndrome coronavirus infection in the Paris area from 2013 to 2016
Auteurs : A. Bleibtreu [France] ; S. Jaureguiberry [France] ; N. Houhou [France] ; D. Boutolleau [France] ; H. Guillot [France] ; D. Vallois [France] ; J. C. Lucet [France] ; J. Robert [France] ; B. Mourvillier [France] ; J. Delemazure [France] ; M. Jaspard [France] ; F. X. Lescure [France] ; C. Rioux [France] ; E. Caumes [France] ; Y. Yazdanapanah [France]Source :
- BMC Infectious Diseases [ 1471-2334 ] ; 2018.
Abstract
Patients with suspected Middle East respiratory syndrome coronavirus (MERS-CoV) infection should be hospitalized in isolation wards to avoid transmission. This suspicion can also lead to medical confusion and inappropriate management of acute respiratory syndrome due to causes other than MERS-CoV.
We studied the characteristics and outcome of patients hospitalized for suspected MERS-CoV infection in the isolation wards of two referral infectious disease departments in the Paris area between January 2013 and December 2016.
Of 93 adult patients (49 male (52.6%), median age 63.4 years) hospitalized, 82 out of 93 adult patients had returned from Saudi Arabia, and 74 of them were pilgrims (Hajj). Chest X-ray findings were abnormal in 72 (77%) patients. The 93 patients were negative for MERS-CoV RT-PCR, and 70 (75.2%) patients had documented infection, 47 (50.5%) viral, 22 (23.6%) bacterial and one
The management of patients with possible MERS-CoV infection requires medical facilities with trained personnel, and rapid access to virological results. Empirical treatment with neuraminidase inhibitors and an association of antibiotics effective against
The online version of this article (10.1186/s12879-018-3223-5) contains supplementary material, which is available to authorized users.
Url:
DOI: 10.1186/s12879-018-3223-5
PubMed: 30012113
PubMed Central: 6048819
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Bleibtreu</name><affiliation wicri:level="1"><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2217 0017</institution-id><institution-id institution-id-type="GRID">grid.7452.4</institution-id><institution>APHP, Hôpital Bichat Claude Bernard,</institution><institution>Service des Maladies Infectieuses et Tropicales, Paris Diderot University,</institution></institution-wrap>Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Paris</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="GRID">grid.50550.35</institution-id><institution-id institution-id-type="ISNI">0000 0001 2175 4109</institution-id><institution>APHP, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix,</institution><institution>Service des Maladies Infectieuses et Tropicales,</institution></institution-wrap>Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Paris</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff6"><institution-wrap><institution-id institution-id-type="ISNI">0000000121866389</institution-id><institution-id institution-id-type="GRID">grid.7429.8</institution-id><institution>INSERM, IAME, UMR 1137,</institution></institution-wrap>Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Paris</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff7"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2217 0017</institution-id><institution-id institution-id-type="GRID">grid.7452.4</institution-id><institution>Univ Paris Diderot, IAME, UMR 1137, Sorbonne Paris Cité,</institution></institution-wrap>Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Paris</wicri:regionArea></affiliation></author><author><name sortKey="Jaureguiberry, S" sort="Jaureguiberry, S" uniqKey="Jaureguiberry S" first="S." last="Jaureguiberry">S. Jaureguiberry</name><affiliation wicri:level="1"><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="GRID">grid.50550.35</institution-id><institution-id institution-id-type="ISNI">0000 0001 2175 4109</institution-id><institution>APHP, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix,</institution><institution>Service des Maladies Infectieuses et Tropicales,</institution></institution-wrap>Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Paris</wicri:regionArea></affiliation></author><author><name sortKey="Houhou, N" sort="Houhou, N" uniqKey="Houhou N" first="N." last="Houhou">N. Houhou</name><affiliation wicri:level="1"><nlm:aff id="Aff3"><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 8588 831X</institution-id><institution-id institution-id-type="GRID">grid.411119.d</institution-id><institution>Virology Department,</institution><institution>APHP-Bichat-Claude Bernard Hospital,</institution></institution-wrap>Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Paris</wicri:regionArea></affiliation></author><author><name sortKey="Boutolleau, D" sort="Boutolleau, D" uniqKey="Boutolleau D" first="D." last="Boutolleau">D. Boutolleau</name><affiliation wicri:level="1"><nlm:aff id="Aff4"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2175 4109</institution-id><institution-id institution-id-type="GRID">grid.50550.35</institution-id><institution>AP-HP, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Service de Virologie, et Sorbonne Universités, UPMC Univ Paris 06, CR7, CIMI, INSERM U1135,</institution></institution-wrap>Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Paris</wicri:regionArea></affiliation></author><author><name sortKey="Guillot, H" sort="Guillot, H" uniqKey="Guillot H" first="H." last="Guillot">H. Guillot</name><affiliation wicri:level="1"><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="GRID">grid.50550.35</institution-id><institution-id institution-id-type="ISNI">0000 0001 2175 4109</institution-id><institution>APHP, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix,</institution><institution>Service des Maladies Infectieuses et Tropicales,</institution></institution-wrap>Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Paris</wicri:regionArea></affiliation></author><author><name sortKey="Vallois, D" sort="Vallois, D" uniqKey="Vallois D" first="D." last="Vallois">D. Vallois</name><affiliation wicri:level="1"><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2217 0017</institution-id><institution-id institution-id-type="GRID">grid.7452.4</institution-id><institution>APHP, Hôpital Bichat Claude Bernard,</institution><institution>Service des Maladies Infectieuses et Tropicales, Paris Diderot University,</institution></institution-wrap>Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Paris</wicri:regionArea></affiliation></author><author><name sortKey="Lucet, J C" sort="Lucet, J C" uniqKey="Lucet J" first="J. C." last="Lucet">J. C. Lucet</name><affiliation wicri:level="1"><nlm:aff id="Aff5"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2217 0017</institution-id><institution-id institution-id-type="GRID">grid.7452.4</institution-id><institution>APHP, Infection control unit, Bichat Claude Bernard hospital,</institution><institution>Paris Diderot University,</institution></institution-wrap>Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Paris</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff6"><institution-wrap><institution-id institution-id-type="ISNI">0000000121866389</institution-id><institution-id institution-id-type="GRID">grid.7429.8</institution-id><institution>INSERM, IAME, UMR 1137,</institution></institution-wrap>Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Paris</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff7"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2217 0017</institution-id><institution-id institution-id-type="GRID">grid.7452.4</institution-id><institution>Univ Paris Diderot, IAME, UMR 1137, Sorbonne Paris Cité,</institution></institution-wrap>Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Paris</wicri:regionArea></affiliation></author><author><name sortKey="Robert, J" sort="Robert, J" uniqKey="Robert J" first="J." last="Robert">J. Robert</name><affiliation wicri:level="1"><nlm:aff id="Aff8"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2175 4109</institution-id><institution-id institution-id-type="GRID">grid.50550.35</institution-id><institution>AP-HP, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Bactériologie-Hygiène Hospitalière,</institution></institution-wrap>Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Paris</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff9"><institution-wrap><institution-id institution-id-type="GRID">grid.463810.8</institution-id><institution>Faculté de Médecine P. & M. Curie Paris-6 - Site Pitié,</institution><institution>Centre d’Immunologie et des Maladies Infectieuses (CIMI) - E13,</institution></institution-wrap>Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Paris</wicri:regionArea></affiliation></author><author><name sortKey="Mourvillier, B" sort="Mourvillier, B" uniqKey="Mourvillier B" first="B." last="Mourvillier">B. Mourvillier</name><affiliation wicri:level="1"><nlm:aff id="Aff6"><institution-wrap><institution-id institution-id-type="ISNI">0000000121866389</institution-id><institution-id institution-id-type="GRID">grid.7429.8</institution-id><institution>INSERM, IAME, UMR 1137,</institution></institution-wrap>Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Paris</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff7"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2217 0017</institution-id><institution-id institution-id-type="GRID">grid.7452.4</institution-id><institution>Univ Paris Diderot, IAME, UMR 1137, Sorbonne Paris Cité,</institution></institution-wrap>Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Paris</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff10"><institution-wrap><institution-id institution-id-type="GRID">grid.411119.d</institution-id><institution-id institution-id-type="ISNI">0000 0000 8588 831X</institution-id><institution>APHP- Hôpital Bichat Claude Bernard,</institution><institution>Service de Réanimation médicale et Infectieuse,</institution></institution-wrap>Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Paris</wicri:regionArea></affiliation></author><author><name sortKey="Delemazure, J" sort="Delemazure, J" uniqKey="Delemazure J" first="J." last="Delemazure">J. Delemazure</name><affiliation wicri:level="1"><nlm:aff id="Aff11"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2175 4109</institution-id><institution-id institution-id-type="GRID">grid.50550.35</institution-id><institution>Service de pneumologie et réanimation Département R3S,</institution><institution>AP-HP, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, unité de Soin de Réadaptation Post Réanimation (SRPR),</institution></institution-wrap>Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Paris</wicri:regionArea></affiliation></author><author><name sortKey="Jaspard, M" sort="Jaspard, M" uniqKey="Jaspard M" first="M." last="Jaspard">M. Jaspard</name><affiliation wicri:level="1"><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="GRID">grid.50550.35</institution-id><institution-id institution-id-type="ISNI">0000 0001 2175 4109</institution-id><institution>APHP, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix,</institution><institution>Service des Maladies Infectieuses et Tropicales,</institution></institution-wrap>Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Paris</wicri:regionArea></affiliation></author><author><name sortKey="Lescure, F X" sort="Lescure, F X" uniqKey="Lescure F" first="F. X." last="Lescure">F. X. Lescure</name><affiliation wicri:level="1"><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2217 0017</institution-id><institution-id institution-id-type="GRID">grid.7452.4</institution-id><institution>APHP, Hôpital Bichat Claude Bernard,</institution><institution>Service des Maladies Infectieuses et Tropicales, Paris Diderot University,</institution></institution-wrap>Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Paris</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff6"><institution-wrap><institution-id institution-id-type="ISNI">0000000121866389</institution-id><institution-id institution-id-type="GRID">grid.7429.8</institution-id><institution>INSERM, IAME, UMR 1137,</institution></institution-wrap>Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Paris</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff7"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2217 0017</institution-id><institution-id institution-id-type="GRID">grid.7452.4</institution-id><institution>Univ Paris Diderot, IAME, UMR 1137, Sorbonne Paris Cité,</institution></institution-wrap>Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Paris</wicri:regionArea></affiliation></author><author><name sortKey="Rioux, C" sort="Rioux, C" uniqKey="Rioux C" first="C." last="Rioux">C. Rioux</name><affiliation wicri:level="1"><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2217 0017</institution-id><institution-id institution-id-type="GRID">grid.7452.4</institution-id><institution>APHP, Hôpital Bichat Claude Bernard,</institution><institution>Service des Maladies Infectieuses et Tropicales, Paris Diderot University,</institution></institution-wrap>Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Paris</wicri:regionArea></affiliation></author><author><name sortKey="Caumes, E" sort="Caumes, E" uniqKey="Caumes E" first="E." last="Caumes">E. Caumes</name><affiliation wicri:level="1"><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="GRID">grid.50550.35</institution-id><institution-id institution-id-type="ISNI">0000 0001 2175 4109</institution-id><institution>APHP, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix,</institution><institution>Service des Maladies Infectieuses et Tropicales,</institution></institution-wrap>Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Paris</wicri:regionArea></affiliation></author><author><name sortKey="Yazdanapanah, Y" sort="Yazdanapanah, Y" uniqKey="Yazdanapanah Y" first="Y." last="Yazdanapanah">Y. Yazdanapanah</name><affiliation wicri:level="1"><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2217 0017</institution-id><institution-id institution-id-type="GRID">grid.7452.4</institution-id><institution>APHP, Hôpital Bichat Claude Bernard,</institution><institution>Service des Maladies Infectieuses et Tropicales, Paris Diderot University,</institution></institution-wrap>Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Paris</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff6"><institution-wrap><institution-id institution-id-type="ISNI">0000000121866389</institution-id><institution-id institution-id-type="GRID">grid.7429.8</institution-id><institution>INSERM, IAME, UMR 1137,</institution></institution-wrap>Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Paris</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff7"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2217 0017</institution-id><institution-id institution-id-type="GRID">grid.7452.4</institution-id><institution>Univ Paris Diderot, IAME, UMR 1137, Sorbonne Paris Cité,</institution></institution-wrap>Paris, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Paris</wicri:regionArea></affiliation></author></analytic><series><title level="j">BMC Infectious Diseases</title><idno type="eISSN">1471-2334</idno><imprint><date when="2018">2018</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p id="Par1">Patients with suspected Middle East respiratory syndrome coronavirus (MERS-CoV) infection should be hospitalized in isolation wards to avoid transmission. This suspicion can also lead to medical confusion and inappropriate management of acute respiratory syndrome due to causes other than MERS-CoV.</p></sec><sec><title>Methods</title><p id="Par2">We studied the characteristics and outcome of patients hospitalized for suspected MERS-CoV infection in the isolation wards of two referral infectious disease departments in the Paris area between January 2013 and December 2016.</p></sec><sec><title>Results</title><p id="Par3">Of 93 adult patients (49 male (52.6%), median age 63.4 years) hospitalized, 82 out of 93 adult patients had returned from Saudi Arabia, and 74 of them were pilgrims (Hajj). Chest X-ray findings were abnormal in 72 (77%) patients. The 93 patients were negative for MERS-CoV RT-PCR, and 70 (75.2%) patients had documented infection, 47 (50.5%) viral, 22 (23.6%) bacterial and one <italic>Plasmodium falciparum</italic> malaria. Microbiological analysis identified <italic>Rhinovirus</italic> (27.9%), <italic>Influenza</italic> virus (26.8%), <italic>Legionella pneumophila</italic> (7.5%), <italic>Streptococcus pneumoniae</italic> (7.5%), and non-MERS-coronavirus (6.4%). Antibiotics were initiated in 81 (87%) cases, with two antibiotics in 63 patients (67.7%). The median duration of hospitalization and isolation was 3 days (1–33) and 24 h (8–92), respectively. Time of isolation decreased over time (<italic>P</italic> < 0.01). Two patients (2%) died.</p></sec><sec><title>Conclusion</title><p id="Par4">The management of patients with possible MERS-CoV infection requires medical facilities with trained personnel, and rapid access to virological results. Empirical treatment with neuraminidase inhibitors and an association of antibiotics effective against <italic>S. pneumoniae</italic> and <italic>L. pneumophila</italic> are the cornerstones of the management of patients hospitalized for suspected MERS-CoV infection.</p></sec><sec><title>Electronic supplementary material</title><p>The online version of this article (10.1186/s12879-018-3223-5) contains supplementary material, which is available to authorized users.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Zaki, Am" uniqKey="Zaki A">AM Zaki</name></author><author><name sortKey="Van Boheemen, S" uniqKey="Van Boheemen S">S van Boheemen</name></author><author><name sortKey="Bestebroer, Tm" uniqKey="Bestebroer T">TM Bestebroer</name></author><author><name sortKey="Osterhaus, Adme" uniqKey="Osterhaus A">ADME Osterhaus</name></author><author><name sortKey="Fouchier, Ram" uniqKey="Fouchier R">RAM 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Jauréguiberry</name></author><author><name sortKey="Boutolleau, D" uniqKey="Boutolleau D">D Boutolleau</name></author><author><name sortKey="Grandsire, E" uniqKey="Grandsire E">E Grandsire</name></author><author><name sortKey="Kofman, T" uniqKey="Kofman T">T Kofman</name></author><author><name sortKey="Deback, C" uniqKey="Deback C">C Deback</name></author><author><name sortKey="Ait Arkoub, Z" uniqKey="Ait Arkoub Z">Z Aït-Arkoub</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">BMC Infect Dis</journal-id><journal-id journal-id-type="iso-abbrev">BMC Infect. Dis</journal-id><journal-title-group><journal-title>BMC Infectious Diseases</journal-title></journal-title-group><issn pub-type="epub">1471-2334</issn><publisher><publisher-name>BioMed Central</publisher-name><publisher-loc>London</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">30012113</article-id><article-id pub-id-type="pmc">6048819</article-id><article-id pub-id-type="publisher-id">3223</article-id><article-id pub-id-type="doi">10.1186/s12879-018-3223-5</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title>Clinical management of respiratory syndrome in patients hospitalized for suspected Middle East respiratory syndrome coronavirus infection in the Paris area from 2013 to 2016</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">http://orcid.org/0000-0001-5145-4174</contrib-id><name><surname>Bleibtreu</surname><given-names>A.</given-names></name><address><email>alexandre.bleibtreu@aphp.fr</email></address><xref ref-type="aff" rid="Aff1">1</xref><xref ref-type="aff" rid="Aff2">2</xref><xref ref-type="aff" rid="Aff6">6</xref><xref ref-type="aff" rid="Aff7">7</xref></contrib><contrib contrib-type="author"><name><surname>Jaureguiberry</surname><given-names>S.</given-names></name><address><email>stephane.jaureguiberry@aphp.fr</email></address><xref ref-type="aff" rid="Aff2">2</xref></contrib><contrib contrib-type="author"><name><surname>Houhou</surname><given-names>N.</given-names></name><address><email>nadira.houhou@aphp.fr</email></address><xref ref-type="aff" rid="Aff3">3</xref></contrib><contrib contrib-type="author"><name><surname>Boutolleau</surname><given-names>D.</given-names></name><address><email>david.boutolleau@aphp.fr</email></address><xref ref-type="aff" rid="Aff4">4</xref></contrib><contrib contrib-type="author"><name><surname>Guillot</surname><given-names>H.</given-names></name><address><email>helene.guillot@aphp.fr</email></address><xref ref-type="aff" rid="Aff2">2</xref></contrib><contrib contrib-type="author"><name><surname>Vallois</surname><given-names>D.</given-names></name><address><email>dorothee.vallois@aphp.fr</email></address><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Lucet</surname><given-names>J. C.</given-names></name><address><email>jean-christophe.lucet@aphp.fr</email></address><xref ref-type="aff" rid="Aff5">5</xref><xref ref-type="aff" rid="Aff6">6</xref><xref ref-type="aff" rid="Aff7">7</xref></contrib><contrib contrib-type="author"><name><surname>Robert</surname><given-names>J.</given-names></name><address><email>jerome.robert@aphp.fr</email></address><xref ref-type="aff" rid="Aff8">8</xref><xref ref-type="aff" rid="Aff9">9</xref></contrib><contrib contrib-type="author"><name><surname>Mourvillier</surname><given-names>B.</given-names></name><address><email>bruno.mourvillier@aphp.fr</email></address><xref ref-type="aff" rid="Aff6">6</xref><xref ref-type="aff" rid="Aff7">7</xref><xref ref-type="aff" rid="Aff10">10</xref></contrib><contrib contrib-type="author"><name><surname>Delemazure</surname><given-names>J.</given-names></name><address><email>julie.delemazure@aphp.fr</email></address><xref ref-type="aff" rid="Aff11">11</xref></contrib><contrib contrib-type="author"><name><surname>Jaspard</surname><given-names>M.</given-names></name><address><email>marie.jaspard@aphp.fr</email></address><xref ref-type="aff" rid="Aff2">2</xref></contrib><contrib contrib-type="author"><name><surname>Lescure</surname><given-names>F. X.</given-names></name><address><email>xavier.lescure@aphp.fr</email></address><xref ref-type="aff" rid="Aff1">1</xref><xref ref-type="aff" rid="Aff6">6</xref><xref ref-type="aff" rid="Aff7">7</xref></contrib><contrib contrib-type="author"><name><surname>Rioux</surname><given-names>C.</given-names></name><address><email>christophe.rioux@aphp.fr</email></address><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author" equal-contrib="yes"><name><surname>Caumes</surname><given-names>E.</given-names></name><address><email>eric.caumes@aphp.fr</email></address><xref ref-type="aff" rid="Aff2">2</xref></contrib><contrib contrib-type="author" equal-contrib="yes"><name><surname>Yazdanapanah</surname><given-names>Y.</given-names></name><address><email>yazdan.yazdanpanah@aphp.fr</email></address><xref ref-type="aff" rid="Aff1">1</xref><xref ref-type="aff" rid="Aff6">6</xref><xref ref-type="aff" rid="Aff7">7</xref></contrib><aff id="Aff1"><label>1</label><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2217 0017</institution-id><institution-id institution-id-type="GRID">grid.7452.4</institution-id><institution>APHP, Hôpital Bichat Claude Bernard,</institution><institution>Service des Maladies Infectieuses et Tropicales, Paris Diderot University,</institution></institution-wrap>Paris, France</aff><aff id="Aff2"><label>2</label><institution-wrap><institution-id institution-id-type="GRID">grid.50550.35</institution-id><institution-id institution-id-type="ISNI">0000 0001 2175 4109</institution-id><institution>APHP, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix,</institution><institution>Service des Maladies Infectieuses et Tropicales,</institution></institution-wrap>Paris, France</aff><aff id="Aff3"><label>3</label><institution-wrap><institution-id institution-id-type="ISNI">0000 0000 8588 831X</institution-id><institution-id institution-id-type="GRID">grid.411119.d</institution-id><institution>Virology Department,</institution><institution>APHP-Bichat-Claude Bernard Hospital,</institution></institution-wrap>Paris, France</aff><aff id="Aff4"><label>4</label><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2175 4109</institution-id><institution-id institution-id-type="GRID">grid.50550.35</institution-id><institution>AP-HP, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Service de Virologie, et Sorbonne Universités, UPMC Univ Paris 06, CR7, CIMI, INSERM U1135,</institution></institution-wrap>Paris, France</aff><aff id="Aff5"><label>5</label><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2217 0017</institution-id><institution-id institution-id-type="GRID">grid.7452.4</institution-id><institution>APHP, Infection control unit, Bichat Claude Bernard hospital,</institution><institution>Paris Diderot University,</institution></institution-wrap>Paris, France</aff><aff id="Aff6"><label>6</label><institution-wrap><institution-id institution-id-type="ISNI">0000000121866389</institution-id><institution-id institution-id-type="GRID">grid.7429.8</institution-id><institution>INSERM, IAME, UMR 1137,</institution></institution-wrap>Paris, France</aff><aff id="Aff7"><label>7</label><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2217 0017</institution-id><institution-id institution-id-type="GRID">grid.7452.4</institution-id><institution>Univ Paris Diderot, IAME, UMR 1137, Sorbonne Paris Cité,</institution></institution-wrap>Paris, France</aff><aff id="Aff8"><label>8</label><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2175 4109</institution-id><institution-id institution-id-type="GRID">grid.50550.35</institution-id><institution>AP-HP, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Bactériologie-Hygiène Hospitalière,</institution></institution-wrap>Paris, France</aff><aff id="Aff9"><label>9</label><institution-wrap><institution-id institution-id-type="GRID">grid.463810.8</institution-id><institution>Faculté de Médecine P. & M. Curie Paris-6 - Site Pitié,</institution><institution>Centre d’Immunologie et des Maladies Infectieuses (CIMI) - E13,</institution></institution-wrap>Paris, France</aff><aff id="Aff10"><label>10</label><institution-wrap><institution-id institution-id-type="GRID">grid.411119.d</institution-id><institution-id institution-id-type="ISNI">0000 0000 8588 831X</institution-id><institution>APHP- Hôpital Bichat Claude Bernard,</institution><institution>Service de Réanimation médicale et Infectieuse,</institution></institution-wrap>Paris, France</aff><aff id="Aff11"><label>11</label><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 2175 4109</institution-id><institution-id institution-id-type="GRID">grid.50550.35</institution-id><institution>Service de pneumologie et réanimation Département R3S,</institution><institution>AP-HP, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, unité de Soin de Réadaptation Post Réanimation (SRPR),</institution></institution-wrap>Paris, France</aff></contrib-group><pub-date pub-type="epub"><day>16</day><month>7</month><year>2018</year></pub-date><pub-date pub-type="pmc-release"><day>16</day><month>7</month><year>2018</year></pub-date><pub-date pub-type="collection"><year>2018</year></pub-date><volume>18</volume><elocation-id>331</elocation-id><history><date date-type="received"><day>30</day><month>8</month><year>2017</year></date><date date-type="accepted"><day>28</day><month>6</month><year>2018</year></date></history><permissions><copyright-statement>© The Author(s). 2018</copyright-statement><license license-type="OpenAccess"><license-p><bold>Open Access</bold>This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">http://creativecommons.org/licenses/by/4.0/</ext-link>), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/publicdomain/zero/1.0/">http://creativecommons.org/publicdomain/zero/1.0/</ext-link>) applies to the data made available in this article, unless otherwise stated.</license-p></license></permissions><abstract id="Abs1"><sec><title>Background</title><p id="Par1">Patients with suspected Middle East respiratory syndrome coronavirus (MERS-CoV) infection should be hospitalized in isolation wards to avoid transmission. This suspicion can also lead to medical confusion and inappropriate management of acute respiratory syndrome due to causes other than MERS-CoV.</p></sec><sec><title>Methods</title><p id="Par2">We studied the characteristics and outcome of patients hospitalized for suspected MERS-CoV infection in the isolation wards of two referral infectious disease departments in the Paris area between January 2013 and December 2016.</p></sec><sec><title>Results</title><p id="Par3">Of 93 adult patients (49 male (52.6%), median age 63.4 years) hospitalized, 82 out of 93 adult patients had returned from Saudi Arabia, and 74 of them were pilgrims (Hajj). Chest X-ray findings were abnormal in 72 (77%) patients. The 93 patients were negative for MERS-CoV RT-PCR, and 70 (75.2%) patients had documented infection, 47 (50.5%) viral, 22 (23.6%) bacterial and one <italic>Plasmodium falciparum</italic> malaria. Microbiological analysis identified <italic>Rhinovirus</italic> (27.9%), <italic>Influenza</italic> virus (26.8%), <italic>Legionella pneumophila</italic> (7.5%), <italic>Streptococcus pneumoniae</italic> (7.5%), and non-MERS-coronavirus (6.4%). Antibiotics were initiated in 81 (87%) cases, with two antibiotics in 63 patients (67.7%). The median duration of hospitalization and isolation was 3 days (1–33) and 24 h (8–92), respectively. Time of isolation decreased over time (<italic>P</italic> < 0.01). Two patients (2%) died.</p></sec><sec><title>Conclusion</title><p id="Par4">The management of patients with possible MERS-CoV infection requires medical facilities with trained personnel, and rapid access to virological results. Empirical treatment with neuraminidase inhibitors and an association of antibiotics effective against <italic>S. pneumoniae</italic> and <italic>L. pneumophila</italic> are the cornerstones of the management of patients hospitalized for suspected MERS-CoV infection.</p></sec><sec><title>Electronic supplementary material</title><p>The online version of this article (10.1186/s12879-018-3223-5) contains supplementary material, which is available to authorized users.</p></sec></abstract><kwd-group xml:lang="en"><title>Keywords</title><kwd>Middle East respiratory syndrome coronavirus (MERS-CoV)</kwd><kwd>Pilgrims</kwd><kwd>Saudi Arabia</kwd><kwd>Isolation ward</kwd><kwd>Respiratory tract infection</kwd><kwd>Legionella</kwd></kwd-group><custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name><meta-value>© The Author(s) 2018</meta-value></custom-meta></custom-meta-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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