tetano
Editor, Senior Moderator
Clin Microbiol Infect. 2015 Feb 19. pii: S1198-743X(15)00302-X. doi: 10.1016/j.cmi.2015.02.014. [Epub ahead of print]
[h=1]Viruses detected by systematic multiplex polymerase chain reaction in adults with suspected community-acquired pneumonia attending emergency departments in France.[/h] Das D[SUP]1[/SUP], Le Floch H[SUP]2[/SUP], Houhou N[SUP]3[/SUP], Epelboin L[SUP]4[/SUP], Hausfater P[SUP]5[/SUP], Khalil A[SUP]6[/SUP], Ray P[SUP]7[/SUP], Duval X[SUP]8[/SUP], Claessens YE[SUP]9[/SUP], Leport C[SUP]10[/SUP]; the ESCAPED Study Group.
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] Infectious agents associated with community-acquired pneumonia (CAP) are understudied. This study attempted to identify viruses from the upper respiratory tract in adults visiting emergency departments (ED) for clinically suspected CAP.
[h=4]METHODS:[/h] Adults with suspected CAP enrolled in the ESCAPED study (impact of computed tomography on CAP diagnosis) had prospective nasopharyngeal (NP) samples studied by multiplex PCR (targeting 15 viruses and 4 intracellular bacteria). An adjudication committee composed of infectiologists, pneumologists, radiologists blinded to PCR results reviewed patient records, including computed tomography and day 28 follow-up to categorize final diagnostic probability as definite, probable, possible, or excluded CAP.
[h=4]RESULTS:[/h] Among the 254 patients enrolled, 78 (31%) had positive PCR, which detected viruses in 72/254 (28%) and intracellular bacteria in 8 (3%) patients. PCR was positive in 44/125 (35%) patients with definite CAP and 21/83 (25%) patients with excluded CAP. The most frequent organisms were influenza virus A/B in 27 (11%), rhinovirus in 20 (8%), coronavirus in 7 (3%), respiratory syncytial virus in 7 (3%) and <i>Mycoplasma pneumoniae</i> in 8 (3%) of 254 patients. Proportion of rhinovirus was higher in patients with excluded CAP compared to other diagnostic categories (<I>P</I>=0.01). No such difference was observed for influenza virus.
[h=4]CONCLUSIONS:[/h] Viruses seem common in adults attending ED with suspected CAP. A concomitant clinical, radiological and biological analysis of the patient's chart can contribute to either confirm their role, or suggest upper respiratory tract infection or shedding. Their imputability and impact in early management of CAP deserves further studies.
Copyright ? 2015. Published by Elsevier Ltd.
[h=4]KEYWORDS:[/h] community-acquired pneumonia; emergency departments; multiplex PCR; nasopharyngeal swabs; viruses
PMID: 25704448 [PubMed - as supplied by publisher]
[h=1]Viruses detected by systematic multiplex polymerase chain reaction in adults with suspected community-acquired pneumonia attending emergency departments in France.[/h] Das D[SUP]1[/SUP], Le Floch H[SUP]2[/SUP], Houhou N[SUP]3[/SUP], Epelboin L[SUP]4[/SUP], Hausfater P[SUP]5[/SUP], Khalil A[SUP]6[/SUP], Ray P[SUP]7[/SUP], Duval X[SUP]8[/SUP], Claessens YE[SUP]9[/SUP], Leport C[SUP]10[/SUP]; the ESCAPED Study Group.
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] Infectious agents associated with community-acquired pneumonia (CAP) are understudied. This study attempted to identify viruses from the upper respiratory tract in adults visiting emergency departments (ED) for clinically suspected CAP.
[h=4]METHODS:[/h] Adults with suspected CAP enrolled in the ESCAPED study (impact of computed tomography on CAP diagnosis) had prospective nasopharyngeal (NP) samples studied by multiplex PCR (targeting 15 viruses and 4 intracellular bacteria). An adjudication committee composed of infectiologists, pneumologists, radiologists blinded to PCR results reviewed patient records, including computed tomography and day 28 follow-up to categorize final diagnostic probability as definite, probable, possible, or excluded CAP.
[h=4]RESULTS:[/h] Among the 254 patients enrolled, 78 (31%) had positive PCR, which detected viruses in 72/254 (28%) and intracellular bacteria in 8 (3%) patients. PCR was positive in 44/125 (35%) patients with definite CAP and 21/83 (25%) patients with excluded CAP. The most frequent organisms were influenza virus A/B in 27 (11%), rhinovirus in 20 (8%), coronavirus in 7 (3%), respiratory syncytial virus in 7 (3%) and <i>Mycoplasma pneumoniae</i> in 8 (3%) of 254 patients. Proportion of rhinovirus was higher in patients with excluded CAP compared to other diagnostic categories (<I>P</I>=0.01). No such difference was observed for influenza virus.
[h=4]CONCLUSIONS:[/h] Viruses seem common in adults attending ED with suspected CAP. A concomitant clinical, radiological and biological analysis of the patient's chart can contribute to either confirm their role, or suggest upper respiratory tract infection or shedding. Their imputability and impact in early management of CAP deserves further studies.
Copyright ? 2015. Published by Elsevier Ltd.
[h=4]KEYWORDS:[/h] community-acquired pneumonia; emergency departments; multiplex PCR; nasopharyngeal swabs; viruses
PMID: 25704448 [PubMed - as supplied by publisher]