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Incidence of respiratory viruses in patients with community-acquired pneumonia admitted to the intensive care unit: results from the Severe Influenza Pneumonia Surveillance (SIPS) project

  • T. Wiemken
  • P. Peyrani
  • K. Bryant
  • R. R. Kelley
  • J. Summersgill
  • F. Arnold
  • R. Carrico
  • W. P. McKinney
  • C. Jonsson
  • K. Carrico
  • J. Ramirez
Article

Abstract

Few patients with community-acquired pneumonia (CAP) require admission to the intensive care unit (ICU-CAP). However, they represent the most severe form of the disease. An understanding of the etiologic agents of ICU-CAP may lead to better treatment decisions and patient outcomes. The objective of this study was to determine the incidence of respiratory viruses in patients with ICU-CAP. This was an observational study conducted in six Kentucky hospitals from December 2008 through October 2011. A case of ICU-CAP was defined as a patient admitted to an ICU with the diagnosis of CAP. The Luminex xTAG multiplex polymerase chain reaction (PCR) assay was used for viral identification. A total of 468 adult and pediatric patients with ICU-CAP were enrolled in the study. A total of 92 adult patients (23 %) and 14 pediatric patients (19 %) had a respiratory virus identified. Influenza was the most common virus identified in adults and the second most common in pediatric patients. This study suggests that respiratory viruses may be common etiologic agents of pneumonia in patients with ICU-CAP. The Centers for Disease Control and Prevention (CDC) recommend empiric anti-influenza therapy during the winter for hospitalized patients with CAP. This study supports this recommendation in patients with ICU-CAP.

Keywords

Influenza Influenza Virus Etiologic Agent Multiplex Polymerase Chain Reaction Respiratory Virus 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

This work was supported by a grant from the U.S. Department of Homeland Security, Science and Technology Directorate, through a technology development and deployment program managed by the National Institute for Hometown Security. The funding source did not have a role in the study design, analysis, or manuscript writing/revision.

The authors would like to thank Cassandra J. Wiemken, Esq. for her editorial assistance.

The authors would like to thank the following SIPS participants for their hard work and dedication: from Spring View Hospital, Lebanon, Kentucky: Kathleen Ferriell, Kim Whisman, and Jennifer Simms; from Trover Regional Medical Center, Madisonville, Kentucky: Tammy Merrill, Amber Mitchell, and Sheryl Stockton; from Highlands Regional Medical Center, Prestonsburg, Kentucky: Norcie Blackburn and Rich Pinson.

Conflict of interest

None of the authors have any conflicts of interest to report with respect to this manuscript.

References

  1. 1.
    World Health Organization (WHO) (2008) The top 10 causes of death. Fact sheet no. 310. Updated June 2011. Available online at: http://www.who.int/mediacentre/factsheets/fs310/en/
  2. 2.
    Jennings LC, Anderson TP, Beynon KA, Chua A, Laing RT, Werno AM, Young SA, Chambers ST, Murdoch DR (2008) Incidence and characteristics of viral community-acquired pneumonia in adults. Thorax 63(1):42–48, Epub 2007/06/19PubMedCrossRefGoogle Scholar
  3. 3.
    Gambarino S, Mantovani S, Astegiano S, Libertucci D, Solidoro P, Baldi S, Cavallo R, Bergallo M, Costa C (2009) Lower respiratory tract viral infections in hospitalized adult patients. Minerva Med 100(5):349–355, Epub 2009/11/17PubMedGoogle Scholar
  4. 4.
    Albuquerque MC, Pena GP, Varella RB, Gallucci G, Erdman D, Santos N (2009) Novel respiratory virus infections in children, Brazil. Emerg Infect Dis 15(5):806–808, Epub 2009/05/01PubMedCrossRefGoogle Scholar
  5. 5.
    Chun JK, Lee JH, Kim HS, Cheong HM, Kim KS, Kang C, Kim DS (2009) Establishing a surveillance network for severe lower respiratory tract infections in Korean infants and young children. Eur J Clin Microbiol Infect Dis 28(7):841–844, Epub 2009/02/05PubMedCrossRefGoogle Scholar
  6. 6.
    Cilla G, Oñate E, Perez-Yarza EG, Montes M, Vicente D, Perez-Trallero E (2008) Viruses in community-acquired pneumonia in children aged less than 3 years old: high rate of viral coinfection. J Med Virol 80(10):1843–1849, Epub 2008/08/21PubMedCrossRefGoogle Scholar
  7. 7.
    Berkley JA, Munywoki P, Ngama M, Kazungu S, Abwao J, Bett A, Lassauniére R, Kresfelder T, Cane PA, Venter M, Scott JA, Nokes DJ (2010) Viral etiology of severe pneumonia among Kenyan infants and children. JAMA 303(20):2051–2057, Epub 2010/05/27PubMedCrossRefGoogle Scholar
  8. 8.
    Nascimento-Carvalho CM, Ribeiro CT, Cardoso MR, Barral A, Araújo-Neto CA, Oliveira JR, Sobral LS, Viriato D, Souza AL, Saukkoriipi A, Paldanius M, Vainionpää R, Leinonen M, Ruuskanen O (2008) The role of respiratory viral infections among children hospitalized for community-acquired pneumonia in a developing country. Pediatr Infect Dis J 27(10):939–941, Epub 2008/08/30PubMedCrossRefGoogle Scholar
  9. 9.
    Pabbaraju K, Tokaryk KL, Wong S, Fox JD (2008) Comparison of the Luminex xTAG respiratory viral panel with in-house nucleic acid amplification tests for diagnosis of respiratory virus infections. J Clin Microbiol 46(9):3056–3062, Epub 2008/07/18PubMedCrossRefGoogle Scholar
  10. 10.
    Choi SH, Hong SB, Ko GB, Lee Y, Park HJ, Park SY, Moon SM, Cho OH, Park KH, Chong YP, Kim SH, Huh JW, Sung H, Do KH, Lee SO, Kim MN, Jeong JY, Lim CM, Kim YS, Woo JH, Koh Y (2012) Viral infection in patients with severe pneumonia requiring intensive care unit admission. Am J Respir Crit Care Med 186(4):325–332, Epub 2012/06/16PubMedCrossRefGoogle Scholar
  11. 11.
    Fiore AE, Fry A, Shay D, Gubareva L, Bresee JS, Uyeki TM; Centers for Disease Control and Prevention (CDC) (2011) Antiviral agents for the treatment and chemoprophylaxis of influenza—recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 60(1):1–24PubMedGoogle Scholar
  12. 12.
    Dellit TH, Owens RC, McGowan JE Jr, Gerding DN, Weinstein RA, Burke JP, Huskins WC, Paterson DL, Fishman NO, Carpenter CF, Brennan PJ, Billeter M, Hooton TM; Infectious Diseases Society of America; Society for Healthcare Epidemiology of America (2007) Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship. Clin Infect Dis 44(2):159–177, Epub 2006/12/19PubMedCrossRefGoogle Scholar
  13. 13.
    Louie JK, Roy-Burman A, Guardia-Labar L, Boston EJ, Kiang D, Padilla T, Yagi S, Messenger S, Petru AM, Glaser CA, Schnurr DP (2009) Rhinovirus associated with severe lower respiratory tract infections in children. Pediatr Infect Dis J 28(4):337–339, Epub 2009/03/05PubMedCrossRefGoogle Scholar
  14. 14.
    Calvo C, Casas I, García-García ML, Pozo F, Reyes N, Cruz N, García-Cuenllas L, Pérez-Breña P (2010) Role of rhinovirus C respiratory infections in sick and healthy children in Spain. Pediatr Infect Dis J 29(8):717–720, Epub 2010/03/23PubMedCrossRefGoogle Scholar
  15. 15.
    Minosse C, Selleri M, Zaniratti MS, Cappiello G, Longo R, Schifano E, Spanò A, Petrosillo N, Lauria FN, Puro V, Capobianchi MR (2008) Frequency of detection of respiratory viruses in the lower respiratory tract of hospitalized adults. J Clin Virol 42(2):215–220, Epub 2008/03/18PubMedCrossRefGoogle Scholar
  16. 16.
    Cevey-Macherel M, Galetto-Lacour A, Gervaix A, Siegrist CA, Bille J, Bescher-Ninet B, Kaiser L, Krahenbuhl JD, Gehri M (2009) Etiology of community-acquired pneumonia in hospitalized children based on WHO clinical guidelines. Eur J Pediatr 168(12):1429–1436, Epub 2009/02/25PubMedCrossRefGoogle Scholar
  17. 17.
    Brand HK, de Groot R, Galama JM, Brouwer ML, Teuwen K, Hermans PW, Melchers WJ, Warris A (2012) Infection with multiple viruses is not associated with increased disease severity in children with bronchiolitis. Pediatr Pulmonol 47(4):393–400, Epub 2011/09/09PubMedCrossRefGoogle Scholar
  18. 18.
    Sandrock C, Stollenwerk N (2008) Acute febrile respiratory illness in the ICU: reducing disease transmission. Chest 133(5):1221–1231, Epub 2008/05/08PubMedCrossRefGoogle Scholar
  19. 19.
    Tsagris V, Nika A, Kyriakou D, Kapetanakis I, Harahousou E, Stripeli F, Maltezou H, Tsolia M (2012) Influenza A/H1N1/2009 outbreak in a neonatal intensive care unit. J Hosp Infect 81(1):36–40, Epub 2012/04/03PubMedCrossRefGoogle Scholar
  20. 20.
    Jaeger JL, Patel M, Dharan N, Hancock K, Meites E, Mattson C, Gladden M, Sugerman D, Doshi S, Blau D, Harriman K, Whaley M, Sun H, Ginsberg M, Kao AS, Kriner P, Lindstrom S, Jain S, Katz J, Finelli L, Olsen SJ, Kallen AJ (2011) Transmission of 2009 pandemic influenza A (H1N1) virus among healthcare personnel—Southern California, 2009. Infect Control Hosp Epidemiol 32(12):1149–1157, Epub 2011/11/15PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • T. Wiemken
    • 1
    • 6
  • P. Peyrani
    • 1
  • K. Bryant
    • 2
  • R. R. Kelley
    • 1
  • J. Summersgill
    • 1
  • F. Arnold
    • 1
  • R. Carrico
    • 1
  • W. P. McKinney
    • 3
    • 4
  • C. Jonsson
    • 5
  • K. Carrico
    • 1
  • J. Ramirez
    • 1
  1. 1.Division of Infectious DiseasesUniversity of LouisvilleLouisvilleUSA
  2. 2.Division of Pediatric Infectious DiseasesKosair Children’s HospitalLouisvilleUSA
  3. 3.Department of Health Promotion and Behavioral Sciences, School of Public Health and Information SciencesUniversity of LouisvilleLouisvilleUSA
  4. 4.Center for Health Hazards Preparedness, School of Public Health and Information SciencesUniversity of LouisvilleLouisvilleUSA
  5. 5.Center for Predictive Medicine, Department of Microbiology and ImmunologyUniversity of LouisvilleLouisvilleUSA
  6. 6.Division of Infectious Diseases, Clinical and Translational Research Support CenterUniversity of LouisvilleLouisvilleUSA

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