tetano
Editor, Senior Moderator
J Microbiol Immunol Infect. 2019 Jun 19. pii: S1684-1182(18)30233-0. doi: 10.1016/j.jmii.2019.05.007. [Epub ahead of print]
[h=1]Characteristics of community-acquired respiratory viruses infections except seasonal influenza in transplant recipients and non-transplant critically ill patients.[/h] Lee KH[SUP]1[/SUP], Yoo SG[SUP]1[/SUP], Cho Y[SUP]2[/SUP], Kwon DE[SUP]1[/SUP], La Y[SUP]1[/SUP], Han SH[SUP]3[/SUP], Kim MS[SUP]4[/SUP], Choi JS[SUP]4[/SUP], Kim SI[SUP]4[/SUP], Kim YS[SUP]4[/SUP], Min YH[SUP]5[/SUP], Cheong JW[SUP]5[/SUP], Kim JS[SUP]5[/SUP], Song YG[SUP]1[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]BACKGROUND/PURPOSE:[/h] Transplant recipients are vulnerable to life-threatening community-acquired respiratory viruses (CA-RVs) infection (CA-RVI). Even if non-transplant critically ill patients in intensive care unit (ICU) have serious CA-RVI, comparison between these groups remains unclear. We aimed to evaluate clinical characteristics and mortality of CA-RVI except seasonal influenza A/B in transplant recipients and non-transplant critically ill patients in ICU.
[h=4]METHODS:[/h] We collected 37,777 CA-RVs multiplex real-time reverse transcription-polymerase chain reaction test results of individuals aged ≥18 years from November 2012 to November 2017. The CA-RVs tests included adenovirus, coronavirus 229E/NL63/OC43, human bocavirus, human metapneumovirus, parainfluenza virus 1/2/3, rhinovirus, and respiratory syncytial virus A/B.
[h=4]RESULTS:[/h] We found 286 CA-RVI cases, including 85 solid organ transplantation recipients (G1), 61 hematopoietic stem cell transplantation recipients (G2), and 140 non-transplant critically ill patients in ICU (G3), excluding those with repeated isolation within 30 days. Adenovirus positive rate and infection cases were most prominent in G2 (p < 0.001). The median time interval between transplantation and CA-RVI was 30 and 20 months in G1 and G2, respectively. All-cause in-hospital mortality was significantly higher in G3 than in G1 or G2 (51.4% vs. 28.2% or 39.3%, p = 0.002, respectively). The mechanical ventilation (MV) was the independent risk factor associated with all-cause in-hospital mortality in all three groups (hazard ratio, 3.37, 95% confidence interval, 2.04-5.56, p < 0.001).
[h=4]CONCLUSIONS:[/h] This study highlights the importance of CA-RVs diagnosis in transplant recipients even in long-term posttransplant period, and in non-transplant critically ill patients in ICU with MV.
Copyright ? 2019. Published by Elsevier B.V.
[h=4]KEYWORDS:[/h] Community-acquired respiratory viruses; Critically ill patients; Hematopoietic stem cell transplantation; Mortality; Solid organ transplantation
PMID: 31262511 DOI: 10.1016/j.jmii.2019.05.007
[h=1]Characteristics of community-acquired respiratory viruses infections except seasonal influenza in transplant recipients and non-transplant critically ill patients.[/h] Lee KH[SUP]1[/SUP], Yoo SG[SUP]1[/SUP], Cho Y[SUP]2[/SUP], Kwon DE[SUP]1[/SUP], La Y[SUP]1[/SUP], Han SH[SUP]3[/SUP], Kim MS[SUP]4[/SUP], Choi JS[SUP]4[/SUP], Kim SI[SUP]4[/SUP], Kim YS[SUP]4[/SUP], Min YH[SUP]5[/SUP], Cheong JW[SUP]5[/SUP], Kim JS[SUP]5[/SUP], Song YG[SUP]1[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]BACKGROUND/PURPOSE:[/h] Transplant recipients are vulnerable to life-threatening community-acquired respiratory viruses (CA-RVs) infection (CA-RVI). Even if non-transplant critically ill patients in intensive care unit (ICU) have serious CA-RVI, comparison between these groups remains unclear. We aimed to evaluate clinical characteristics and mortality of CA-RVI except seasonal influenza A/B in transplant recipients and non-transplant critically ill patients in ICU.
[h=4]METHODS:[/h] We collected 37,777 CA-RVs multiplex real-time reverse transcription-polymerase chain reaction test results of individuals aged ≥18 years from November 2012 to November 2017. The CA-RVs tests included adenovirus, coronavirus 229E/NL63/OC43, human bocavirus, human metapneumovirus, parainfluenza virus 1/2/3, rhinovirus, and respiratory syncytial virus A/B.
[h=4]RESULTS:[/h] We found 286 CA-RVI cases, including 85 solid organ transplantation recipients (G1), 61 hematopoietic stem cell transplantation recipients (G2), and 140 non-transplant critically ill patients in ICU (G3), excluding those with repeated isolation within 30 days. Adenovirus positive rate and infection cases were most prominent in G2 (p < 0.001). The median time interval between transplantation and CA-RVI was 30 and 20 months in G1 and G2, respectively. All-cause in-hospital mortality was significantly higher in G3 than in G1 or G2 (51.4% vs. 28.2% or 39.3%, p = 0.002, respectively). The mechanical ventilation (MV) was the independent risk factor associated with all-cause in-hospital mortality in all three groups (hazard ratio, 3.37, 95% confidence interval, 2.04-5.56, p < 0.001).
[h=4]CONCLUSIONS:[/h] This study highlights the importance of CA-RVs diagnosis in transplant recipients even in long-term posttransplant period, and in non-transplant critically ill patients in ICU with MV.
Copyright ? 2019. Published by Elsevier B.V.
[h=4]KEYWORDS:[/h] Community-acquired respiratory viruses; Critically ill patients; Hematopoietic stem cell transplantation; Mortality; Solid organ transplantation
PMID: 31262511 DOI: 10.1016/j.jmii.2019.05.007