Incidence and characteristics of viral community-acquired pneumonia in adults
Identifieur interne : 001D68 ( Istex/Corpus ); précédent : 001D67; suivant : 001D69Incidence and characteristics of viral community-acquired pneumonia in adults
Auteurs : L C Jennings ; T P Anderson ; K A Beynon ; A. Chua ; R T R. Laing ; A M Werno ; S A Young ; S T Chambers ; D R MurdochSource :
- Thorax [ 0040-6376 ] ; 2008-01.
English descriptors
- Teeft :
- Adenovirus, Aetiology, Antibody detection, Antigen testing, Bacterial infections, Biobank cohort, Blood cultures, Canterbury health laboratories, Cell culture, Christchurch, Christchurch hospital, Clin, Clin microbiol, Concomitant pneumococcal infection, Control group, Control patients, Copd, Coronavirus, Curbage, Curbage score, Current smoking status, Diagnostic tests, Disease severity, Extensive array, Full battery, Grand island, Greater rise, Haemophilus, Human coronavirus, Human metapneumovirus, Imagen reagents, Immunofluorescence, Important causes, Independent associations, Infection, Influenza, Influenza infection, Influenza pneumonia, Influenza season, Influenza vaccination, Influenzae, Interaction terms, Legionella, Legionella pneumophila, Logistic regression analysis, Monthly distribution, More pathogens, Multivariate analysis, Myalgia, Mycoplasma pneumoniae, Nasopharyngeal, Nasopharyngeal swabs, Other studies, Parainfluenza, Parainfluenza virus, Parainfluenza viruses, Passive smoking, Passive smoking exposure, Past year, Pathogen, Picornavirus infections, Pneumococcal, Pneumococcal infection, Pneumococcal pneumonia, Pneumonia, Pneumonia severity index, Pneumoniae, Polymerase chain reaction, Polymicrobial infection, Polymicrobial infections, Primary care, Pulmonary disease, Reciprocal antibody titres, Respiratory infection table, Respiratory syncytial virus, Respiratory syndrome, Respiratory tract infection, Respiratory tract infections, Respiratory virus, Respiratory viruses, Rhinovirus, Rhinovirus infection, Rhinovirus infections, Risk class, Roche diagnostics, Serum samples, Several variables, Severe disease, Severe pneumonia, Smoker, Sputum, Streptococcus, Streptococcus pneumoniae, Study group, Swab, Syncytial, Syncytial virus, Thorax, Throat swabs, Tract infections, True infection, Viral, Viral aetiology, Viral causes, Viral diagnosis, Viral infection, Viral infections, Viral pathogens, Viral pneumonia, Virus, Year increase.
Abstract
Background: In adults, viral causes of community-acquired pneumonia (CAP) are poorly characterised. The aims of this study were to characterise the viral aetiology of CAP in adults by using an extensive array of viral diagnostic tests and to compare the characteristics of viral pneumonia with those of pneumococcal pneumonia. Methods: Adults admitted to Christchurch Hospital over a 1-year period with CAP were included in the study. Microbiological testing methods included blood and sputum cultures, urinary antigen testing for Streptococcus pneumoniae and Legionella pneumophila, antibody detection in paired sera and detection of respiratory viruses in nasopharyngeal swabs by immunofluorescence, culture and PCR. Results: Of 304 patients with CAP, a viral diagnosis was made in 88 (29%), with rhinoviruses and influenza A being the most common. Two or more pathogens were detected in 49 (16%) patients, 45 of whom had mixed viral and bacterial infections. There were no reliable clinical predictors of viral pneumonia, although several variables were independently associated with some aetiologies. The presence of myalgia was associated with pneumonia caused by any respiratory virus (OR 3.62, 95% CI 1.29 to 10.12) and influenza pneumonia (OR 190.72, 95% CI 3.68 to 9891.91). Mixed rhinovirus/pneumococcal infection was associated with severe disease. Conclusions: Virus-associated CAP is common in adults. Polymicrobial infections involving bacterial and viral pathogens are frequent and may be associated with severe pneumonia.
Url:
DOI: 10.1136/thx.2006.075077
Links to Exploration step
ISTEX:CA4BD10DFF12B9145218C47F66F79E6C56B36D4DLe document en format XML
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Pathology, Christchurch School of Medicine and Health Sciences, Christchurch, New Zealand</mods:affiliation></affiliation></author><author><name sortKey="Murdoch, D R" sort="Murdoch, D R" uniqKey="Murdoch D" first="D R" last="Murdoch">D R Murdoch</name><affiliation><mods:affiliation>Canterbury Health Laboratories, Christchurch, New Zealand</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Pathology, Christchurch School of Medicine and Health Sciences, Christchurch, New Zealand</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Thorax</title><title level="j" type="abbrev">Thorax</title><idno type="ISSN">0040-6376</idno><idno type="eISSN">1468-3296</idno><imprint><publisher>BMJ Publishing Group Ltd and British Thoracic Society</publisher><date type="published" when="2008-01">2008-01</date><biblScope unit="volume">63</biblScope><biblScope unit="issue">1</biblScope><biblScope unit="page" 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rise</term><term>Haemophilus</term><term>Human coronavirus</term><term>Human metapneumovirus</term><term>Imagen reagents</term><term>Immunofluorescence</term><term>Important causes</term><term>Independent associations</term><term>Infection</term><term>Influenza</term><term>Influenza infection</term><term>Influenza pneumonia</term><term>Influenza season</term><term>Influenza vaccination</term><term>Influenzae</term><term>Interaction terms</term><term>Legionella</term><term>Legionella pneumophila</term><term>Logistic regression analysis</term><term>Monthly distribution</term><term>More pathogens</term><term>Multivariate analysis</term><term>Myalgia</term><term>Mycoplasma pneumoniae</term><term>Nasopharyngeal</term><term>Nasopharyngeal swabs</term><term>Other studies</term><term>Parainfluenza</term><term>Parainfluenza virus</term><term>Parainfluenza viruses</term><term>Passive smoking</term><term>Passive smoking exposure</term><term>Past year</term><term>Pathogen</term><term>Picornavirus infections</term><term>Pneumococcal</term><term>Pneumococcal infection</term><term>Pneumococcal pneumonia</term><term>Pneumonia</term><term>Pneumonia severity index</term><term>Pneumoniae</term><term>Polymerase chain reaction</term><term>Polymicrobial infection</term><term>Polymicrobial infections</term><term>Primary care</term><term>Pulmonary disease</term><term>Reciprocal antibody titres</term><term>Respiratory infection table</term><term>Respiratory syncytial virus</term><term>Respiratory syndrome</term><term>Respiratory tract infection</term><term>Respiratory tract infections</term><term>Respiratory virus</term><term>Respiratory viruses</term><term>Rhinovirus</term><term>Rhinovirus infection</term><term>Rhinovirus infections</term><term>Risk class</term><term>Roche diagnostics</term><term>Serum samples</term><term>Several variables</term><term>Severe disease</term><term>Severe pneumonia</term><term>Smoker</term><term>Sputum</term><term>Streptococcus</term><term>Streptococcus pneumoniae</term><term>Study group</term><term>Swab</term><term>Syncytial</term><term>Syncytial virus</term><term>Thorax</term><term>Throat swabs</term><term>Tract infections</term><term>True infection</term><term>Viral</term><term>Viral aetiology</term><term>Viral causes</term><term>Viral diagnosis</term><term>Viral infection</term><term>Viral infections</term><term>Viral pathogens</term><term>Viral pneumonia</term><term>Virus</term><term>Year increase</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">Background: In adults, viral causes of community-acquired pneumonia (CAP) are poorly characterised. The aims of this study were to characterise the viral aetiology of CAP in adults by using an extensive array of viral diagnostic tests and to compare the characteristics of viral pneumonia with those of pneumococcal pneumonia. Methods: Adults admitted to Christchurch Hospital over a 1-year period with CAP were included in the study. Microbiological testing methods included blood and sputum cultures, urinary antigen testing for Streptococcus pneumoniae and Legionella pneumophila, antibody detection in paired sera and detection of respiratory viruses in nasopharyngeal swabs by immunofluorescence, culture and PCR. Results: Of 304 patients with CAP, a viral diagnosis was made in 88 (29%), with rhinoviruses and influenza A being the most common. Two or more pathogens were detected in 49 (16%) patients, 45 of whom had mixed viral and bacterial infections. There were no reliable clinical predictors of viral pneumonia, although several variables were independently associated with some aetiologies. The presence of myalgia was associated with pneumonia caused by any respiratory virus (OR 3.62, 95% CI 1.29 to 10.12) and influenza pneumonia (OR 190.72, 95% CI 3.68 to 9891.91). Mixed rhinovirus/pneumococcal infection was associated with severe disease. Conclusions: Virus-associated CAP is common in adults. Polymicrobial infections involving bacterial and viral pathogens are frequent and may be associated with severe pneumonia.</div></front></TEI><istex><corpusName>bmj</corpusName><keywords><teeft><json:string>viral</json:string><json:string>rhinovirus</json:string><json:string>pneumoniae</json:string><json:string>pneumococcal</json:string><json:string>pathogen</json:string><json:string>pneumonia</json:string><json:string>christchurch</json:string><json:string>nasopharyngeal</json:string><json:string>severe disease</json:string><json:string>coronavirus</json:string><json:string>copd</json:string><json:string>rhinovirus infection</json:string><json:string>immunofluorescence</json:string><json:string>influenza</json:string><json:string>swab</json:string><json:string>clin</json:string><json:string>legionella</json:string><json:string>thorax</json:string><json:string>viral 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season</json:string><json:string>respiratory tract infection</json:string><json:string>pneumonia severity index</json:string><json:string>year increase</json:string><json:string>other studies</json:string><json:string>influenza infection</json:string><json:string>logistic regression analysis</json:string><json:string>viral infection</json:string><json:string>virus</json:string><json:string>important causes</json:string><json:string>respiratory infection table</json:string><json:string>disease severity</json:string><json:string>greater rise</json:string><json:string>past year</json:string><json:string>current smoking status</json:string><json:string>grand island</json:string><json:string>independent associations</json:string><json:string>mycoplasma pneumoniae</json:string><json:string>interaction terms</json:string><json:string>imagen reagents</json:string><json:string>roche diagnostics</json:string><json:string>parainfluenza virus</json:string><json:string>true infection</json:string><json:string>cell culture</json:string><json:string>human coronavirus</json:string><json:string>syncytial virus</json:string><json:string>respiratory syndrome</json:string><json:string>monthly distribution</json:string><json:string>full battery</json:string><json:string>antigen testing</json:string><json:string>several variables</json:string><json:string>more pathogens</json:string><json:string>viral diagnosis</json:string><json:string>multivariate analysis</json:string><json:string>blood cultures</json:string><json:string>antibody detection</json:string><json:string>primary care</json:string><json:string>picornavirus infections</json:string><json:string>respiratory tract infections</json:string><json:string>polymicrobial infection</json:string><json:string>rhinovirus infections</json:string><json:string>legionella pneumophila</json:string><json:string>extensive array</json:string><json:string>viral aetiology</json:string><json:string>viral causes</json:string><json:string>biobank cohort</json:string><json:string>study group</json:string><json:string>serum samples</json:string></teeft></keywords><author><json:item><name>L C Jennings</name><affiliations><json:string>Canterbury Health Laboratories, Christchurch, New Zealand</json:string><json:string>Department of Pathology, Christchurch School of Medicine and Health Sciences, Christchurch, New Zealand</json:string></affiliations></json:item><json:item><name>T P Anderson</name><affiliations><json:string>Canterbury Health Laboratories, Christchurch, New Zealand</json:string></affiliations></json:item><json:item><name>K A Beynon</name><affiliations><json:string>Canterbury Health Laboratories, Christchurch, New Zealand</json:string></affiliations></json:item><json:item><name>A Chua</name><affiliations><json:string>Canterbury Health Laboratories, Christchurch, New Zealand</json:string></affiliations></json:item><json:item><name>R T R Laing</name><affiliations><json:string>Canterbury Respiratory Research Group, University of Otago, Christchurch, New Zealand</json:string></affiliations></json:item><json:item><name>A M Werno</name><affiliations><json:string>Canterbury Health Laboratories, Christchurch, New Zealand</json:string><json:string>Department of Pathology, Christchurch School of Medicine and Health Sciences, Christchurch, New Zealand</json:string></affiliations></json:item><json:item><name>S A Young</name><affiliations><json:string>Canterbury Health Laboratories, Christchurch, New Zealand</json:string></affiliations></json:item><json:item><name>S T Chambers</name><affiliations><json:string>Department of Pathology, Christchurch School of Medicine and Health Sciences, Christchurch, New Zealand</json:string></affiliations></json:item><json:item><name>D R Murdoch</name><affiliations><json:string>Canterbury Health Laboratories, Christchurch, New Zealand</json:string><json:string>Department of Pathology, Christchurch School of Medicine and Health Sciences, Christchurch, New Zealand</json:string></affiliations></json:item></author><articleId><json:string>tx75077</json:string></articleId><arkIstex>ark:/67375/NVC-860G67NX-J</arkIstex><language><json:string>eng</json:string></language><originalGenre><json:string>research-article</json:string></originalGenre><abstract>Background: In adults, viral causes of community-acquired pneumonia (CAP) are poorly characterised. The aims of this study were to characterise the viral aetiology of CAP in adults by using an extensive array of viral diagnostic tests and to compare the characteristics of viral pneumonia with those of pneumococcal pneumonia. Methods: Adults admitted to Christchurch Hospital over a 1-year period with CAP were included in the study. Microbiological testing methods included blood and sputum cultures, urinary antigen testing for Streptococcus pneumoniae and Legionella pneumophila, antibody detection in paired sera and detection of respiratory viruses in nasopharyngeal swabs by immunofluorescence, culture and PCR. Results: Of 304 patients with CAP, a viral diagnosis was made in 88 (29%), with rhinoviruses and influenza A being the most common. Two or more pathogens were detected in 49 (16%) patients, 45 of whom had mixed viral and bacterial infections. There were no reliable clinical predictors of viral pneumonia, although several variables were independently associated with some aetiologies. The presence of myalgia was associated with pneumonia caused by any respiratory virus (OR 3.62, 95% CI 1.29 to 10.12) and influenza pneumonia (OR 190.72, 95% CI 3.68 to 9891.91). Mixed rhinovirus/pneumococcal infection was associated with severe disease. Conclusions: Virus-associated CAP is common in adults. Polymicrobial infections involving bacterial and viral pathogens are frequent and may be associated with severe pneumonia.</abstract><qualityIndicators><score>9.46</score><pdfWordCount>4796</pdfWordCount><pdfCharCount>34169</pdfCharCount><pdfVersion>1.2</pdfVersion><pdfPageCount>7</pdfPageCount><pdfPageSize>595.276 x 793.701 pts</pdfPageSize><refBibsNative>true</refBibsNative><abstractWordCount>222</abstractWordCount><abstractCharCount>1537</abstractCharCount><keywordCount>0</keywordCount></qualityIndicators><title>Incidence and characteristics of viral community-acquired pneumonia in adults</title><pmid><json:string>17573440</json:string></pmid><genre><json:string>research-article</json:string></genre><host><title>Thorax</title><language><json:string>unknown</json:string></language><issn><json:string>0040-6376</json:string></issn><eissn><json:string>1468-3296</json:string></eissn><publisherId><json:string>thx</json:string></publisherId><volume>63</volume><issue>1</issue><pages><first>42</first></pages><genre><json:string>journal</json:string></genre><subject><json:item><value>Drugs: infectious diseases</value></json:item><json:item><value>Influenza</value></json:item><json:item><value>Pneumonia (infectious disease)</value></json:item><json:item><value>TB and other respiratory infections</value></json:item><json:item><value>Pneumonia (respiratory medicine)</value></json:item></subject></host><namedEntities><unitex><date><json:string>2007-06-15</json:string><json:string>from July 1999 to July 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uri="https://api.istex.fr/ark:/67375/NVC-860G67NX-J/fulltext.tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Incidence and characteristics of viral community-acquired pneumonia in adults</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher scheme="https://publisher-list.data.istex.fr">BMJ Publishing Group Ltd and British Thoracic Society</publisher><availability><licence><p>2008 BMJ Publishing Group and British Thoracic Society</p></licence><p scheme="https://loaded-corpus.data.istex.fr/ark:/67375/XBH-7M42M2QJ-2">bmj</p></availability><date>2007-06-15</date></publicationStmt><notesStmt><note type="research-article" scheme="https://content-type.data.istex.fr/ark:/67375/XTP-1JC4F85T-7">research-article</note><note type="journal" scheme="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Incidence and characteristics of viral community-acquired pneumonia in adults</title><author xml:id="author-0000"><persName><forename type="first">L C</forename><surname>Jennings</surname></persName><affiliation>Canterbury Health Laboratories, Christchurch, New Zealand</affiliation><affiliation>Department of Pathology, Christchurch School of Medicine and Health Sciences, Christchurch, New Zealand</affiliation></author><author xml:id="author-0001"><persName><forename type="first">T P</forename><surname>Anderson</surname></persName><affiliation>Canterbury Health Laboratories, Christchurch, New Zealand</affiliation></author><author xml:id="author-0002"><persName><forename type="first">K A</forename><surname>Beynon</surname></persName><affiliation>Canterbury Health Laboratories, Christchurch, New Zealand</affiliation></author><author xml:id="author-0003"><persName><forename type="first">A</forename><surname>Chua</surname></persName><affiliation>Canterbury Health Laboratories, Christchurch, New Zealand</affiliation></author><author xml:id="author-0004"><persName><forename type="first">R T R</forename><surname>Laing</surname></persName><affiliation>Canterbury Respiratory Research Group, University of Otago, Christchurch, New Zealand</affiliation></author><author xml:id="author-0005"><persName><forename type="first">A M</forename><surname>Werno</surname></persName><affiliation>Canterbury Health Laboratories, Christchurch, New Zealand</affiliation><affiliation>Department of Pathology, Christchurch School of Medicine and Health Sciences, Christchurch, New Zealand</affiliation></author><author xml:id="author-0006"><persName><forename type="first">S A</forename><surname>Young</surname></persName><affiliation>Canterbury Health Laboratories, Christchurch, New Zealand</affiliation></author><author xml:id="author-0007"><persName><forename type="first">S T</forename><surname>Chambers</surname></persName><affiliation>Department of Pathology, Christchurch School of Medicine and Health Sciences, Christchurch, New Zealand</affiliation></author><author xml:id="author-0008"><persName><forename type="first">D R</forename><surname>Murdoch</surname></persName><affiliation>Canterbury Health Laboratories, Christchurch, New Zealand</affiliation><affiliation>Department of Pathology, Christchurch School of Medicine and Health Sciences, Christchurch, New Zealand</affiliation></author><idno type="istex">CA4BD10DFF12B9145218C47F66F79E6C56B36D4D</idno><idno type="ark">ark:/67375/NVC-860G67NX-J</idno><idno type="DOI">10.1136/thx.2006.075077</idno><idno type="href">thoraxjnl-63-42.pdf</idno><idno type="article-id">tx75077</idno><idno type="PMID">17573440</idno><idno type="local">thoraxjnl;63/1/42</idno></analytic><monogr><title level="j">Thorax</title><title level="j" type="abbrev">Thorax</title><idno type="pISSN">0040-6376</idno><idno type="eISSN">1468-3296</idno><idno type="publisher-id">thx</idno><idno type="PublisherID-hwp">thoraxjnl</idno><idno type="PublisherID-nlm-ta">Thorax</idno><imprint><publisher>BMJ Publishing Group Ltd and British Thoracic Society</publisher><date type="published" when="2008-01"></date><biblScope unit="volume">63</biblScope><biblScope unit="issue">1</biblScope><biblScope unit="page" from="42">42</biblScope></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2007-06-15</date></creation><langUsage><language ident="en">en</language></langUsage><abstract><p>Background: In adults, viral causes of community-acquired pneumonia (CAP) are poorly characterised. The aims of this study were to characterise the viral aetiology of CAP in adults by using an extensive array of viral diagnostic tests and to compare the characteristics of viral pneumonia with those of pneumococcal pneumonia. Methods: Adults admitted to Christchurch Hospital over a 1-year period with CAP were included in the study. Microbiological testing methods included blood and sputum cultures, urinary antigen testing for Streptococcus pneumoniae and Legionella pneumophila, antibody detection in paired sera and detection of respiratory viruses in nasopharyngeal swabs by immunofluorescence, culture and PCR. Results: Of 304 patients with CAP, a viral diagnosis was made in 88 (29%), with rhinoviruses and influenza A being the most common. Two or more pathogens were detected in 49 (16%) patients, 45 of whom had mixed viral and bacterial infections. There were no reliable clinical predictors of viral pneumonia, although several variables were independently associated with some aetiologies. The presence of myalgia was associated with pneumonia caused by any respiratory virus (OR 3.62, 95% CI 1.29 to 10.12) and influenza pneumonia (OR 190.72, 95% CI 3.68 to 9891.91). Mixed rhinovirus/pneumococcal infection was associated with severe disease. Conclusions: Virus-associated CAP is common in adults. Polymicrobial infections involving bacterial and viral pathogens are frequent and may be associated with severe pneumonia.</p></abstract><textClass><keywords scheme="Journal Subject"><list><head>hwp-journal-coll</head><item><term>Drugs: infectious diseases</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>hwp-journal-coll</head><item><term>Influenza</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>hwp-journal-coll</head><item><term>Pneumonia (infectious disease)</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>hwp-journal-coll</head><item><term>TB and other respiratory infections</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>hwp-journal-coll</head><item><term>Pneumonia (respiratory medicine)</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2007-06-15">Created</change><change when="2008-01">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/ark:/67375/NVC-860G67NX-J/fulltext.txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus bmj" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="no"</istex:xmlDeclaration><istex:docType PUBLIC="-//NLM//DTD Journal Archiving and Interchange DTD v2.3 20070202//EN" URI="archivearticle.dtd" name="istex:docType"></istex:docType><istex:document><article article-type="research-article" xml:lang="EN"><front><journal-meta><journal-id journal-id-type="hwp">thoraxjnl</journal-id><journal-id journal-id-type="nlm-ta">Thorax</journal-id><journal-id journal-id-type="publisher-id">thx</journal-id><journal-title>Thorax</journal-title><abbrev-journal-title abbrev-type="publisher">Thorax</abbrev-journal-title><issn pub-type="ppub">0040-6376</issn><issn pub-type="epub">1468-3296</issn><publisher><publisher-name>BMJ Publishing Group Ltd and British Thoracic Society</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">tx75077</article-id><article-id pub-id-type="doi">10.1136/thx.2006.075077</article-id><article-id pub-id-type="other">thoraxjnl;63/1/42</article-id><article-id pub-id-type="other">thoraxjnl;thx.2006.075077</article-id><article-id pub-id-type="pmid">17573440</article-id><article-id pub-id-type="other">42</article-id><article-id pub-id-type="other">thx.2006.075077</article-id><article-categories><subj-group subj-group-type="heading"><subject>Respiratory infection</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Drugs: infectious diseases</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Influenza</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Pneumonia (infectious disease)</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>TB and other respiratory infections</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Pneumonia (respiratory medicine)</subject></subj-group></article-categories><title-group><article-title>Incidence and characteristics of viral community-acquired pneumonia in adults</article-title><alt-title alt-title-type="running-head">Respiratory infection</alt-title></title-group><contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Jennings</surname><given-names>L C</given-names></name><xref ref-type="aff" rid="aff1">1</xref><xref ref-type="aff" rid="aff2">2</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Anderson</surname><given-names>T P</given-names></name><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Beynon</surname><given-names>K A</given-names></name><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Chua</surname><given-names>A</given-names></name><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Laing</surname><given-names>R T R</given-names></name><xref ref-type="aff" rid="aff3">3</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Werno</surname><given-names>A M</given-names></name><xref ref-type="aff" rid="aff1">1</xref><xref ref-type="aff" rid="aff2">2</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Young</surname><given-names>S A</given-names></name><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Chambers</surname><given-names>S T</given-names></name><xref ref-type="aff" rid="aff2">2</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Murdoch</surname><given-names>D R</given-names></name><xref ref-type="aff" rid="aff1">1</xref><xref ref-type="aff" rid="aff2">2</xref></contrib></contrib-group><aff id="aff1"><label>1</label><addr-line>Canterbury Health Laboratories, Christchurch, New Zealand</addr-line> </aff><aff id="aff2"><label>2</label><addr-line>Department of Pathology, Christchurch School of Medicine and Health Sciences, Christchurch, New Zealand</addr-line> </aff><aff id="aff3"><label>3</label><addr-line>Canterbury Respiratory Research Group, University of Otago, Christchurch, New Zealand</addr-line> </aff><author-notes><corresp>Dr L C Jennings, Canterbury Health Laboratories, P O Box 151, Christchurch, New Zealand; <email xlink:type="simple">lance.jennings@cdhb.govt.nz</email></corresp></author-notes><pub-date pub-type="ppub"><month>1</month><year>2008</year></pub-date><pub-date pub-type="epub-original"><day>15</day><month>6</month><year>2007</year></pub-date><pub-date pub-type="epub"><day>15</day><month>6</month><year>2007</year></pub-date><volume>63</volume><volume-id pub-id-type="other">63</volume-id><volume-id pub-id-type="other">63</volume-id><issue>1</issue><issue-id pub-id-type="other">thoraxjnl;63/1</issue-id><issue-id pub-id-type="other">1</issue-id><issue-id pub-id-type="other">63/1</issue-id><fpage>42</fpage><history><date date-type="received"><day>21</day><month>11</month><year>2006</year></date><date date-type="accepted"><day>22</day><month>5</month><year>2007</year></date></history><permissions><copyright-statement>2008 BMJ Publishing Group and British Thoracic Society</copyright-statement><copyright-year>2008</copyright-year></permissions><self-uri content-type="pdf" xlink:role="full-text" xlink:href="thoraxjnl-63-42.pdf"></self-uri><abstract><sec><title>Background:</title><p>In adults, viral causes of community-acquired pneumonia (CAP) are poorly characterised. The aims of this study were to characterise the viral aetiology of CAP in adults by using an extensive array of viral diagnostic tests and to compare the characteristics of viral pneumonia with those of pneumococcal pneumonia.</p></sec><sec><title>Methods:</title><p>Adults admitted to Christchurch Hospital over a 1-year period with CAP were included in the study. Microbiological testing methods included blood and sputum cultures, urinary antigen testing for <italic>Streptococcus pneumoniae</italic> and <italic>Legionella pneumophila</italic>, antibody detection in paired sera and detection of respiratory viruses in nasopharyngeal swabs by immunofluorescence, culture and PCR.</p></sec><sec><title>Results:</title><p>Of 304 patients with CAP, a viral diagnosis was made in 88 (29%), with rhinoviruses and influenza A being the most common. Two or more pathogens were detected in 49 (16%) patients, 45 of whom had mixed viral and bacterial infections. There were no reliable clinical predictors of viral pneumonia, although several variables were independently associated with some aetiologies. The presence of myalgia was associated with pneumonia caused by any respiratory virus (OR 3.62, 95% CI 1.29 to 10.12) and influenza pneumonia (OR 190.72, 95% CI 3.68 to 9891.91). Mixed rhinovirus/pneumococcal infection was associated with severe disease.</p></sec><sec><title>Conclusions:</title><p>Virus-associated CAP is common in adults. Polymicrobial infections involving bacterial and viral pathogens are frequent and may be associated with severe pneumonia.</p></sec></abstract></article-meta></front></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Incidence and characteristics of viral community-acquired pneumonia in adults</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>Incidence and characteristics of viral community-acquired pneumonia in adults</title></titleInfo><name type="personal"><namePart type="given">L C</namePart><namePart type="family">Jennings</namePart><affiliation>Canterbury Health Laboratories, Christchurch, New Zealand</affiliation><affiliation>Department of Pathology, Christchurch School of Medicine and Health Sciences, Christchurch, New Zealand</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">T P</namePart><namePart type="family">Anderson</namePart><affiliation>Canterbury Health Laboratories, Christchurch, New Zealand</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">K A</namePart><namePart type="family">Beynon</namePart><affiliation>Canterbury Health Laboratories, Christchurch, New Zealand</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">A</namePart><namePart type="family">Chua</namePart><affiliation>Canterbury Health Laboratories, Christchurch, New Zealand</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">R T R</namePart><namePart type="family">Laing</namePart><affiliation>Canterbury Respiratory Research Group, University of Otago, Christchurch, New Zealand</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">A M</namePart><namePart type="family">Werno</namePart><affiliation>Canterbury Health Laboratories, Christchurch, New Zealand</affiliation><affiliation>Department of Pathology, Christchurch School of Medicine and Health Sciences, Christchurch, New Zealand</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">S A</namePart><namePart type="family">Young</namePart><affiliation>Canterbury Health Laboratories, Christchurch, New Zealand</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">S T</namePart><namePart type="family">Chambers</namePart><affiliation>Department of Pathology, Christchurch School of Medicine and Health Sciences, Christchurch, New Zealand</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">D R</namePart><namePart type="family">Murdoch</namePart><affiliation>Canterbury Health Laboratories, Christchurch, New Zealand</affiliation><affiliation>Department of Pathology, Christchurch School of Medicine and Health Sciences, Christchurch, New Zealand</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="research-article" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-1JC4F85T-7">research-article</genre><originInfo><publisher>BMJ Publishing Group Ltd and British Thoracic Society</publisher><dateIssued encoding="w3cdtf">2008-01</dateIssued><dateCreated encoding="w3cdtf">2007-06-15</dateCreated><copyrightDate encoding="w3cdtf">2008</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><abstract>Background: In adults, viral causes of community-acquired pneumonia (CAP) are poorly characterised. The aims of this study were to characterise the viral aetiology of CAP in adults by using an extensive array of viral diagnostic tests and to compare the characteristics of viral pneumonia with those of pneumococcal pneumonia. Methods: Adults admitted to Christchurch Hospital over a 1-year period with CAP were included in the study. Microbiological testing methods included blood and sputum cultures, urinary antigen testing for Streptococcus pneumoniae and Legionella pneumophila, antibody detection in paired sera and detection of respiratory viruses in nasopharyngeal swabs by immunofluorescence, culture and PCR. Results: Of 304 patients with CAP, a viral diagnosis was made in 88 (29%), with rhinoviruses and influenza A being the most common. Two or more pathogens were detected in 49 (16%) patients, 45 of whom had mixed viral and bacterial infections. There were no reliable clinical predictors of viral pneumonia, although several variables were independently associated with some aetiologies. The presence of myalgia was associated with pneumonia caused by any respiratory virus (OR 3.62, 95% CI 1.29 to 10.12) and influenza pneumonia (OR 190.72, 95% CI 3.68 to 9891.91). Mixed rhinovirus/pneumococcal infection was associated with severe disease. Conclusions: Virus-associated CAP is common in adults. 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