Risk of ruling out severe acute respiratory syndrome by ruling in another diagnosis: Variable incidence of atypical bacteria coinfection based on diagnostic assays
Identifieur interne : 003D41 ( Main/Exploration ); précédent : 003D40; suivant : 003D42Risk of ruling out severe acute respiratory syndrome by ruling in another diagnosis: Variable incidence of atypical bacteria coinfection based on diagnostic assays
Auteurs : George Zahariadis ; Ted A. Gooley [États-Unis] ; Phyllis Ryall [Canada] ; Christine Hutchinson [Canada] ; Mary I. Latchford [Canada] ; Margaret A. Fearon [Canada] ; Frances B. Jamieson [Canada] ; Susan Richardson [Canada] ; Theodore Kuschak ; Barbara Mederski [Canada]Source :
- Canadian Respiratory Journal : Journal of the Canadian Thoracic Society [ 1198-2241 ] ; 2006.
Descripteurs français
- KwdFr :
- Adolescent, Adulte, Adulte d'âge moyen, Chlamydophila pneumoniae (isolement et purification), Femelle, Humains, Infections à Chlamydophila (), Infections à Chlamydophila (diagnostic), Mycoplasma pneumoniae (isolement et purification), Mâle, Pneumopathie bactérienne (), Pneumopathie bactérienne (diagnostic), Pneumopathie bactérienne (épidémiologie), Pneumopathie à mycoplasmes (), Pneumopathie à mycoplasmes (diagnostic), Sujet âgé, Sujet âgé de 80 ans ou plus, Syndrome respiratoire aigu sévère (), Syndrome respiratoire aigu sévère (diagnostic), Syndrome respiratoire aigu sévère (épidémiologie), Virus du SRAS (isolement et purification), Études rétrospectives.
- MESH :
- diagnostic : Infections à Chlamydophila, Pneumopathie bactérienne, Pneumopathie à mycoplasmes, Syndrome respiratoire aigu sévère.
- isolement et purification : Chlamydophila pneumoniae, Mycoplasma pneumoniae, Virus du SRAS.
- épidémiologie : Pneumopathie bactérienne, Syndrome respiratoire aigu sévère.
- Adolescent, Adulte, Adulte d'âge moyen, Femelle, Humains, Infections à Chlamydophila, Mâle, Pneumopathie bactérienne, Pneumopathie à mycoplasmes, Sujet âgé, Sujet âgé de 80 ans ou plus, Syndrome respiratoire aigu sévère, Études rétrospectives.
English descriptors
- KwdEn :
- Adolescent, Adult, Aged, Aged, 80 and over, Chlamydophila Infections (complications), Chlamydophila Infections (diagnosis), Chlamydophila pneumoniae (isolation & purification), Female, Humans, Male, Middle Aged, Mycoplasma pneumoniae (isolation & purification), Pneumonia, Bacterial (complications), Pneumonia, Bacterial (diagnosis), Pneumonia, Bacterial (epidemiology), Pneumonia, Mycoplasma (complications), Pneumonia, Mycoplasma (diagnosis), Retrospective Studies, SARS Virus (isolation & purification), Severe Acute Respiratory Syndrome (complications), Severe Acute Respiratory Syndrome (diagnosis), Severe Acute Respiratory Syndrome (epidemiology).
- MESH :
- complications : Chlamydophila Infections, Pneumonia, Bacterial, Pneumonia, Mycoplasma, Severe Acute Respiratory Syndrome.
- diagnosis : Chlamydophila Infections, Pneumonia, Bacterial, Pneumonia, Mycoplasma, Severe Acute Respiratory Syndrome.
- epidemiology : Pneumonia, Bacterial, Severe Acute Respiratory Syndrome.
- isolation & purification : Chlamydophila pneumoniae, Mycoplasma pneumoniae, SARS Virus.
- Adolescent, Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Retrospective Studies.
Abstract
Severe acute respiratory syndrome (SARS) caused the first epidemic of the 21st century and continues to threaten the global community.
To assess the incidence of coinfection in patients confirmed to have SARS-associated coronavirus (SARS-CoV) infection, and thus, to determine the risk of ruling out SARS by ruling in another diagnosis.
The present report is a retrospective study evaluating the incidence and impact of laboratory-confirmed SARS-CoV and other pulmonary pathogens in 117 patients. These patients were evaluated in a Toronto, Ontario, community hospital identified as the epicentre for the second SARS outbreak.
Coinfection with other pulmonary pathogens occured in patients with SARS. Seventy-three per cent of the patient population evaluated had laboratory-confirmed SARS-CoV infection. Serology showing acute or recent
Diagnostic assays for well-recognized pulmonary pathogens have limitations, and ruling out SARS-CoV by ruling in another pulmonary pathogen carries significant risk. Despite positive serology for atypical pathogens, in a setting where clinical suspicion for SARS is high, specific tests for SARS should be performed to confirm or exclude a diagnosis.
Url:
PubMed: 16470249
PubMed Central: 2539008
Affiliations:
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Gooley</name><affiliation wicri:level="2"><nlm:aff id="af2-0130017"> Fred Hutchinson Cancer Research Center, Seattle, Washington, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea> Fred Hutchinson Cancer Research Center, Seattle, Washington</wicri:regionArea><placeName><region type="state">Washington (État)</region></placeName></affiliation></author><author><name sortKey="Ryall, Phyllis" sort="Ryall, Phyllis" uniqKey="Ryall P" first="Phyllis" last="Ryall">Phyllis Ryall</name><affiliation wicri:level="2"><nlm:aff id="af3-0130017"> North York General Hospital, Toronto, Ontario</nlm:aff><country>Canada</country><placeName><region type="province">Ontario</region></placeName><wicri:cityArea> North York General Hospital, Toronto</wicri:cityArea></affiliation></author><author><name sortKey="Hutchinson, Christine" sort="Hutchinson, Christine" uniqKey="Hutchinson C" first="Christine" last="Hutchinson">Christine Hutchinson</name><affiliation wicri:level="2"><nlm:aff id="af3-0130017"> North York General Hospital, Toronto, Ontario</nlm:aff><country>Canada</country><placeName><region type="province">Ontario</region></placeName><wicri:cityArea> North York General Hospital, Toronto</wicri:cityArea></affiliation></author><author><name sortKey="Latchford, Mary I" sort="Latchford, Mary I" uniqKey="Latchford M" first="Mary I" last="Latchford">Mary I. Latchford</name><affiliation wicri:level="2"><nlm:aff id="af3-0130017"> North York General Hospital, Toronto, Ontario</nlm:aff><country>Canada</country><placeName><region type="province">Ontario</region></placeName><wicri:cityArea> North York General Hospital, Toronto</wicri:cityArea></affiliation></author><author><name sortKey="Fearon, Margaret A" sort="Fearon, Margaret A" uniqKey="Fearon M" first="Margaret A" last="Fearon">Margaret A. Fearon</name><affiliation wicri:level="2"><nlm:aff id="af4-0130017"> Ministry of Health and Long-Term Care – Laboratories Branch, Toronto, Ontario</nlm:aff><country>Canada</country><placeName><region type="province">Ontario</region></placeName><wicri:cityArea> Ministry of Health and Long-Term Care – Laboratories Branch, Toronto</wicri:cityArea></affiliation></author><author><name sortKey="Jamieson, Frances B" sort="Jamieson, Frances B" uniqKey="Jamieson F" first="Frances B" last="Jamieson">Frances B. Jamieson</name><affiliation wicri:level="2"><nlm:aff id="af4-0130017"> Ministry of Health and Long-Term Care – Laboratories Branch, Toronto, Ontario</nlm:aff><country>Canada</country><placeName><region type="province">Ontario</region></placeName><wicri:cityArea> Ministry of Health and Long-Term Care – Laboratories Branch, Toronto</wicri:cityArea></affiliation></author><author><name sortKey="Richardson, Susan" sort="Richardson, Susan" uniqKey="Richardson S" first="Susan" last="Richardson">Susan Richardson</name><affiliation wicri:level="2"><nlm:aff id="af5-0130017"> The Hospital for Sick Children, Toronto, Ontario</nlm:aff><country>Canada</country><placeName><region type="province">Ontario</region></placeName><wicri:cityArea> The Hospital for Sick Children, Toronto</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="af6-0130017"> University of Toronto, Toronto, Ontario</nlm:aff><country>Canada</country><placeName><region type="province">Ontario</region></placeName><wicri:cityArea> University of Toronto, Toronto</wicri:cityArea></affiliation></author><author><name sortKey="Kuschak, Theodore" sort="Kuschak, Theodore" uniqKey="Kuschak T" first="Theodore" last="Kuschak">Theodore Kuschak</name><affiliation><nlm:aff id="af7-0130017"> Health Canada National Microbiology Laboratory, Winnipeg, Manitoba</nlm:aff><wicri:noCountry code="subfield">Manitoba</wicri:noCountry></affiliation></author><author><name sortKey="Mederski, Barbara" sort="Mederski, Barbara" uniqKey="Mederski B" first="Barbara" last="Mederski">Barbara Mederski</name><affiliation wicri:level="2"><nlm:aff id="af3-0130017"> North York General Hospital, Toronto, Ontario</nlm:aff><country>Canada</country><placeName><region type="province">Ontario</region></placeName><wicri:cityArea> North York General Hospital, Toronto</wicri:cityArea></affiliation></author></analytic><series><title level="j">Canadian Respiratory Journal : Journal of the Canadian Thoracic Society</title><idno type="ISSN">1198-2241</idno><idno type="eISSN">1916-7245</idno><imprint><date when="2006">2006</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Chlamydophila Infections (complications)</term><term>Chlamydophila Infections (diagnosis)</term><term>Chlamydophila pneumoniae (isolation & purification)</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Mycoplasma pneumoniae (isolation & purification)</term><term>Pneumonia, Bacterial (complications)</term><term>Pneumonia, Bacterial (diagnosis)</term><term>Pneumonia, Bacterial (epidemiology)</term><term>Pneumonia, Mycoplasma (complications)</term><term>Pneumonia, Mycoplasma (diagnosis)</term><term>Retrospective Studies</term><term>SARS Virus (isolation & purification)</term><term>Severe Acute Respiratory Syndrome (complications)</term><term>Severe Acute Respiratory Syndrome (diagnosis)</term><term>Severe Acute Respiratory Syndrome (epidemiology)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Chlamydophila pneumoniae (isolement et purification)</term><term>Femelle</term><term>Humains</term><term>Infections à Chlamydophila ()</term><term>Infections à Chlamydophila (diagnostic)</term><term>Mycoplasma pneumoniae (isolement et purification)</term><term>Mâle</term><term>Pneumopathie bactérienne ()</term><term>Pneumopathie bactérienne (diagnostic)</term><term>Pneumopathie bactérienne (épidémiologie)</term><term>Pneumopathie à mycoplasmes ()</term><term>Pneumopathie à mycoplasmes (diagnostic)</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Syndrome respiratoire aigu sévère ()</term><term>Syndrome respiratoire aigu sévère (diagnostic)</term><term>Syndrome respiratoire aigu sévère (épidémiologie)</term><term>Virus du SRAS (isolement et purification)</term><term>Études rétrospectives</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Chlamydophila Infections</term><term>Pneumonia, Bacterial</term><term>Pneumonia, Mycoplasma</term><term>Severe Acute Respiratory Syndrome</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Chlamydophila Infections</term><term>Pneumonia, Bacterial</term><term>Pneumonia, Mycoplasma</term><term>Severe Acute Respiratory Syndrome</term></keywords><keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Infections à Chlamydophila</term><term>Pneumopathie bactérienne</term><term>Pneumopathie à mycoplasmes</term><term>Syndrome respiratoire aigu sévère</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Pneumonia, Bacterial</term><term>Severe Acute Respiratory Syndrome</term></keywords><keywords scheme="MESH" qualifier="isolation & purification" xml:lang="en"><term>Chlamydophila pneumoniae</term><term>Mycoplasma pneumoniae</term><term>SARS Virus</term></keywords><keywords scheme="MESH" qualifier="isolement et purification" xml:lang="fr"><term>Chlamydophila pneumoniae</term><term>Mycoplasma pneumoniae</term><term>Virus du SRAS</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Pneumopathie bactérienne</term><term>Syndrome respiratoire aigu sévère</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Retrospective Studies</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Femelle</term><term>Humains</term><term>Infections à Chlamydophila</term><term>Mâle</term><term>Pneumopathie bactérienne</term><term>Pneumopathie à mycoplasmes</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Syndrome respiratoire aigu sévère</term><term>Études rétrospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>BACKGROUND</title><p>Severe acute respiratory syndrome (SARS) caused the first epidemic of the 21st century and continues to threaten the global community.</p></sec><sec><title>OBJECTIVE</title><p>To assess the incidence of coinfection in patients confirmed to have SARS-associated coronavirus (SARS-CoV) infection, and thus, to determine the risk of ruling out SARS by ruling in another diagnosis.</p></sec><sec><title>METHODS</title><p>The present report is a retrospective study evaluating the incidence and impact of laboratory-confirmed SARS-CoV and other pulmonary pathogens in 117 patients. These patients were evaluated in a Toronto, Ontario, community hospital identified as the epicentre for the second SARS outbreak.</p></sec><sec><title>RESULTS</title><p>Coinfection with other pulmonary pathogens occured in patients with SARS. Seventy-three per cent of the patient population evaluated had laboratory-confirmed SARS-CoV infection. Serology showing acute or recent <italic>Chlamydophila pneumoniae</italic> or <italic>Mycoplasma pneumoniae</italic> infection revealed an incidence of 30% and 9%, respectively, in those with SARS. These rates are similar to previously published studies on coinfection in pneumonia. All nucleic acid diagnostic assays were negative for <italic>C pneumoniae</italic> and <italic>M pneumoniae</italic> in respiratory samples from patients with SARS having serological evidence for these atypical pathogens.</p></sec><sec><title>CONCLUSIONS</title><p>Diagnostic assays for well-recognized pulmonary pathogens have limitations, and ruling out SARS-CoV by ruling in another pulmonary pathogen carries significant risk. Despite positive serology for atypical pathogens, in a setting where clinical suspicion for SARS is high, specific tests for SARS should be performed to confirm or exclude a diagnosis.</p></sec></div></front></TEI><affiliations><list><country><li>Canada</li><li>États-Unis</li></country><region><li>Ontario</li><li>Washington (État)</li></region></list><tree><noCountry><name sortKey="Kuschak, Theodore" sort="Kuschak, Theodore" uniqKey="Kuschak T" first="Theodore" last="Kuschak">Theodore Kuschak</name><name sortKey="Zahariadis, George" sort="Zahariadis, George" uniqKey="Zahariadis G" first="George" last="Zahariadis">George Zahariadis</name></noCountry><country name="États-Unis"><region name="Washington (État)"><name sortKey="Gooley, Ted A" sort="Gooley, Ted A" uniqKey="Gooley T" first="Ted A" last="Gooley">Ted A. Gooley</name></region></country><country name="Canada"><region name="Ontario"><name sortKey="Ryall, Phyllis" sort="Ryall, Phyllis" uniqKey="Ryall P" first="Phyllis" last="Ryall">Phyllis Ryall</name></region><name sortKey="Fearon, Margaret A" sort="Fearon, Margaret A" uniqKey="Fearon M" first="Margaret A" last="Fearon">Margaret A. Fearon</name><name sortKey="Hutchinson, Christine" sort="Hutchinson, Christine" uniqKey="Hutchinson C" first="Christine" last="Hutchinson">Christine Hutchinson</name><name sortKey="Jamieson, Frances B" sort="Jamieson, Frances B" uniqKey="Jamieson F" first="Frances B" last="Jamieson">Frances B. Jamieson</name><name sortKey="Latchford, Mary I" sort="Latchford, Mary I" uniqKey="Latchford M" first="Mary I" last="Latchford">Mary I. Latchford</name><name sortKey="Mederski, Barbara" sort="Mederski, Barbara" uniqKey="Mederski B" first="Barbara" last="Mederski">Barbara Mederski</name><name sortKey="Richardson, Susan" sort="Richardson, Susan" uniqKey="Richardson S" first="Susan" last="Richardson">Susan Richardson</name><name sortKey="Richardson, Susan" sort="Richardson, Susan" uniqKey="Richardson S" first="Susan" last="Richardson">Susan Richardson</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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