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
- 828 Downloads
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.
KeywordsInfluenza Influenza Virus Etiologic Agent Multiplex Polymerase Chain Reaction Respiratory Virus
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.
- 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/
- 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
- 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.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.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
- 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.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
- 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