Viral community-acquired pneumonia in nonimmunocompromised adults

被引:110
作者
de Roux, AD
Marco, MA
Garcia, E
Mensa, J
Ewig, S
Lode, H
Torres, A
机构
[1] Univ Barcelona, Serv Pneumol, Barcelona, Spain
[2] Univ Barcelona, Inst Clin Pneumol Cirurgia Torac, Barcelona, Spain
[3] Univ Barcelona, Microbiol Serv, Barcelona, Spain
[4] Univ Barcelona, Serv Malaties Infecc, Barcelona, Spain
[5] Univ Barcelona, Inst Clin Immunol & Infecc, Inst Invest Biomed August Pi Sunyer Hosp Clin, Fac Med,, Barcelona, Spain
[6] Augusta Kranken Anstalt, Pneumol Klin, Bochum, Germany
[7] Zentralklin Emil Von Behring, Dept Lungenklin Heckeshorn 1, Berlin, Germany
关键词
chronic heart failure; community-acquired pneumonia; respiratory viral infection; risk factor;
D O I
10.1378/chest.125.4.1343
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Introduction: Viral community-acquired pneumonia (CAP) has been poorly studied and clinically characterized. Using strict criteria for inclusion, we studied this type of infection in a large series of hospitalized adults with CAP. Materials and methods: All nonimmunocompromised adult patients with a diagnosis of CAP having paired serology for respiratory viruses (RVs) [338 patients] were prospectively included in the study from 1996 to 2001 at our 1,000-bed university teaching hospital, and subsequently were followed up. We compared patients with pure viral (PV), mixed viral (RV + bacteria), and pneumococcal CAP. RVs (ie, influenza, parainfluenza, respiratory syncytial virus, and adenovirus) were diagnosed by means of paired serology. Results: Sixty-one of 338 patients (18%) with paired serology had an RV detected, and in 31 cases (9%) it was the only pathogen identified. Influenza was the most frequent virus detected (39 patients; 64%). Patients with chronic heart failure (CHF) had an increased risk of acquiring PV CAP (8 of 26 patients; 31%) when compared to a mixed viral/bacterial etiology (2 of 26 patients; 8%; p = 0.035) or CAP caused by Streptococcus pneumoniae (1 of 44 patients; 2%; p = 0.001). Multivariate analysis revealed that CHF (odds ratio [OR], 15.3; 95% confidence interval [CI], 1.4 to 163; p = 0.024) and the absence of expectoration (OR, 0.14; 95% CI, 0.04 to 0.6; p = 0.006) were associated with PV pneumonia compared to pneumococcal CAP. Conclusion: RVs are frequent etiologies of CAP (single or in combination with bacteria). Patients with CHF have an increased risk of acquiring a viral CAP.
引用
收藏
页码:1343 / 1351
页数:9
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