Aetiology of community-acquired pneumonia among adults in an H1N1 pandemic year: the role of respiratory viruses
Identifieur interne : 001F37 ( Main/Exploration ); précédent : 001F36; suivant : 001F38Aetiology of community-acquired pneumonia among adults in an H1N1 pandemic year: the role of respiratory viruses
Auteurs : A. Sangil [Espagne] ; E. Calbo [Espagne] ; A. Robles [Espagne] ; S. Benet [Espagne] ; M. E. Viladot [Espagne] ; V. Pascual [Espagne] ; E. Cuchí [Espagne] ; J. Pérez [Espagne] ; B. Barreiro [Espagne] ; B. Sánchez [Espagne] ; J. Torres [Espagne] ; L. Canales [Espagne] ; J. A. De Marcos [Espagne] ; J. Garau [Espagne]Source :
- European Journal of Clinical Microbiology & Infectious Diseases [ 0934-9723 ] ; 2012-10-01.
Abstract
Abstract: This study aimed to determine the aetiology of community-acquired pneumonia (CAP) by adding polymerase chain reaction (PCR) to conventional methods and to describe the clinical and laboratory features between patients with bacterial pneumonia (BP) and viral pneumonia (VP). Adults with CAP admitted from November 2009 to October 2010 were included. Demographics, comorbidities, severity and clinical features were recorded. Conventional microbiological methods included blood and sputum cultures, acute and convalescent serologic samples, and antigen urinary detection. New methods included multiplex PCR for Mycoplasma pneumoniae, Legionella pneumophila, Chlamydophila pneumoniae, Bordetella pertussis and 15 respiratory viruses. A total of 169 patients were included. Using conventional methods, we identified a pathogen in 51 % of cases. With PCR, up to 70 % of cases had an aetiological diagnosis. Forty-five patients had BP (34 %), 22 had VP (17 %) and 25 (19 %) had co-infection (BP and VP). Pneumococci and respiratory syncytial virus (RSV) were the most frequently identified pathogens. Procalcitonin (PCT) and C-reactive protein (CRP) median values were significantly higher in BP than in VP patients. Shaking chills, higher CURB score and shock were significantly more frequent in BP. A viral infection was identified in more than one-third of patients with CAP. Clinical and laboratory features could help to differentiate between VP and BP and to guide empirical therapy.
Url:
DOI: 10.1007/s10096-012-1626-6
Affiliations:
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Barreiro</name><affiliation wicri:level="3"><country xml:lang="fr">Espagne</country><wicri:regionArea>Service of Pneumology, Hospital Universitari Mútua Terrassa, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Sanchez, B" sort="Sanchez, B" uniqKey="Sanchez B" first="B." last="Sánchez">B. Sánchez</name><affiliation wicri:level="3"><country xml:lang="fr">Espagne</country><wicri:regionArea>Intensive Care, Hospital Universitari Mútua Terrassa, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Torres, J" sort="Torres, J" uniqKey="Torres J" first="J." last="Torres">J. 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De Marcos</name><affiliation wicri:level="3"><country xml:lang="fr">Espagne</country><wicri:regionArea>Radiology Unit, Hospital Universitari Mútua Terrassa, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Garau, J" sort="Garau, J" uniqKey="Garau J" first="J." last="Garau">J. 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Adults with CAP admitted from November 2009 to October 2010 were included. Demographics, comorbidities, severity and clinical features were recorded. Conventional microbiological methods included blood and sputum cultures, acute and convalescent serologic samples, and antigen urinary detection. New methods included multiplex PCR for Mycoplasma pneumoniae, Legionella pneumophila, Chlamydophila pneumoniae, Bordetella pertussis and 15 respiratory viruses. A total of 169 patients were included. Using conventional methods, we identified a pathogen in 51 % of cases. With PCR, up to 70 % of cases had an aetiological diagnosis. Forty-five patients had BP (34 %), 22 had VP (17 %) and 25 (19 %) had co-infection (BP and VP). Pneumococci and respiratory syncytial virus (RSV) were the most frequently identified pathogens. Procalcitonin (PCT) and C-reactive protein (CRP) median values were significantly higher in BP than in VP patients. Shaking chills, higher CURB score and shock were significantly more frequent in BP. A viral infection was identified in more than one-third of patients with CAP. Clinical and laboratory features could help to differentiate between VP and BP and to guide empirical therapy.</div></front></TEI><affiliations><list><country><li>Espagne</li></country><region><li>Catalogne</li></region><settlement><li>Barcelone</li></settlement></list><tree><country name="Espagne"><region name="Catalogne"><name sortKey="Sangil, A" sort="Sangil, A" uniqKey="Sangil A" first="A." last="Sangil">A. Sangil</name></region><name sortKey="Barreiro, B" sort="Barreiro, B" uniqKey="Barreiro B" first="B." last="Barreiro">B. Barreiro</name><name sortKey="Benet, S" sort="Benet, S" uniqKey="Benet S" first="S." last="Benet">S. Benet</name><name sortKey="Calbo, E" sort="Calbo, E" uniqKey="Calbo E" first="E." last="Calbo">E. Calbo</name><name sortKey="Calbo, E" sort="Calbo, E" uniqKey="Calbo E" first="E." last="Calbo">E. Calbo</name><name sortKey="Calbo, E" sort="Calbo, E" uniqKey="Calbo E" first="E." last="Calbo">E. Calbo</name><name sortKey="Canales, L" sort="Canales, L" uniqKey="Canales L" first="L." last="Canales">L. Canales</name><name sortKey="Cuchi, E" sort="Cuchi, E" uniqKey="Cuchi E" first="E." last="Cuchí">E. Cuchí</name><name sortKey="De Marcos, J A" sort="De Marcos, J A" uniqKey="De Marcos J" first="J. A." last="De Marcos">J. A. De Marcos</name><name sortKey="Garau, J" sort="Garau, J" uniqKey="Garau J" first="J." last="Garau">J. Garau</name><name sortKey="Garau, J" sort="Garau, J" uniqKey="Garau J" first="J." last="Garau">J. Garau</name><name sortKey="Pascual, V" sort="Pascual, V" uniqKey="Pascual V" first="V." last="Pascual">V. Pascual</name><name sortKey="Pascual, V" sort="Pascual, V" uniqKey="Pascual V" first="V." last="Pascual">V. Pascual</name><name sortKey="Perez, J" sort="Perez, J" uniqKey="Perez J" first="J." last="Pérez">J. Pérez</name><name sortKey="Robles, A" sort="Robles, A" uniqKey="Robles A" first="A." last="Robles">A. Robles</name><name sortKey="Sanchez, B" sort="Sanchez, B" uniqKey="Sanchez B" first="B." last="Sánchez">B. Sánchez</name><name sortKey="Sangil, A" sort="Sangil, A" uniqKey="Sangil A" first="A." last="Sangil">A. Sangil</name><name sortKey="Sangil, A" sort="Sangil, A" uniqKey="Sangil A" first="A." last="Sangil">A. Sangil</name><name sortKey="Torres, J" sort="Torres, J" uniqKey="Torres J" first="J." last="Torres">J. Torres</name><name sortKey="Viladot, M E" sort="Viladot, M E" uniqKey="Viladot M" first="M. E." last="Viladot">M. E. Viladot</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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