Influenza virus infections among patients attending emergency department according to main reason to presenting to ED: A 3-year prospective observational study during seasonal epidemic periods

被引:23
作者
Casalino, Enrique [1 ,2 ,3 ,4 ]
Antoniol, Stephanie [1 ,2 ,3 ,4 ]
Fidouh, Nadhira [5 ]
Choquet, Christophe [1 ,2 ,3 ,4 ]
Lucet, Jean-Christophe [6 ]
Duval, Xavier [7 ,8 ]
Visseaux, Benoit [5 ,8 ]
Pereira, Laurent [1 ,2 ,3 ,4 ]
机构
[1] Grp Univ Paris Nord Val Seine, Emergency Dept, AP HP, Paris, France
[2] Univ Paris Diderot, Sorbonne Paris Cite, Rech Clin Coordonne Ville Hop EA 7334, Methodol & Soc REMES, Paris, France
[3] Study Grp Efficiency & Qual, Emergency Dept, Paris, France
[4] Nonscheduled Activ Dept, Paris, France
[5] Grp Univ Paris Nord Val Seine, AP HP, Virol Dept, Paris, France
[6] Bichat Claude Bernard Hosp, AP HP, Infect Control Unit, Paris, France
[7] Hop Univ Bichat, AP HP, Inserm CIC 1425, Paris, France
[8] Univ Paris Diderot, Sorbonne Paris Cite, INSERM, IAME,UMR 1137, Paris, France
关键词
BACTERIAL COINFECTION; PANDEMIC INFLUENZA; CASE DEFINITIONS; CRITICAL ILLNESS; PNEUMONIA; HOSPITALIZATION; COMPLICATIONS; OUTCOMES; ASSOCIATION; MULTICENTER;
D O I
10.1371/journal.pone.0182191
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Objective The role of influenza virus in patients presenting at ED during seasonal-epidemic periods has not previously been specified. Our objective was to determine its frequency according to clinical presentation. Methods This is a prospective observational study conducted during three-consecutive seasonal Influenza epidemics (2013-2015), including patients presenting i) community-acquired pneumonia (CAP); ii) severe acute symptoms (SAS): respiratory failure (RF), hemodynamic failure (HF), cardiac failure (CF), and miscellaneous symptoms (M); iii) symptoms suggesting influenza (PSSI). Patients were tested for influenza using specific PCR on naso-pharyngeal swabs. Results Of 1,239 patients, virological samples were taken from 784 (63.3%), 213 (27.2%) of whom were positive for the influenza virus: CAP 52/177 (29.4%), SAS 115/447 (25.7%) and PSSI 46/160 (28.8%) (p = 0.6). In the SAS group positivity rates were: RF 76/263 (28.9%), HF 5/29 (17.2%), CF 15/68 (22.1%), and M 19/87 (21.8%) (p = 0.3). Among the major diagnostic categories, the influenza virus positivity rates were: asthma 60/231 (26%), acute exacerbation of chronic obstructive pulmonary disease 18/86 (20.9%), HIV 5/21 (23.8%) and cardiac failure 33/131 (25.2%). The positivity of the samples has not been associated (p>0.1) nor the presence of signs of severity or admission rate in medical ward nor intensive care unit. Conclusions Our results indicate that during seasonal influenza epidemics, Influenza virus-positivity rate is similar in patients attending ED for influenza-compatible clinical features, patients with acute symptoms including pneumonia, respiratory, hemodynamic and cardiac distress, and patients presenting for acute decompensation of chronic respiratory and cardiac diseases.
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