There is increasing pressure on health-care professionals to identify and measure their individual impact on the outcome of patients. This study adds further insight into the complexities associated with evaluating the influence of individual contribution on patient outcome, especially when it is characterized by complex processes involving clinical judgement and decision-making.

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S23viruses were seen in 33.3% and 43.9% of WUV and KIV samples respectively. The median age range for WUV was 0−2yrs and KIV was 2−4yrs. Conclusions: This study suggests that WUV is a more likely pathogen in immunocompetent children between 0−2yrs, whereas KIV is prevalent in the immunosuppressed population, mainly children between 2−4yrs, as a coinfection with other respiratory viruses. There are a paucity of data regarding the exact clinical role of these polyomaviruses as human pathogens thus requiring prospective longitudinal and seroprevalence studies.Background: Respiratory viruses including influenza A and B viruses, parainfluenza viruses, and respiratory syncytial virus (RSV) have been recognized as causes of severe pneumonia in patients with hematologic malignancies. Adenoviruses (Ad) cause both isolated respiratory infections and infections transmitted via the faecal-oral or conjunctival routes. Increased rates of Ad-related pneumonia have been reported with malignancies of haematopoietic origin. Objectives: To evaluate the occurrence of respiratory virus infections in the inpatient settings of the hematology department, cases that developed episodes of lower respiratory tract infections (LRTI) were evaluated. Study design: Immunoflouresence search for IgM antibodies of influenza A and B, parainfluenza serotypes 1, 2, 3, RSV, and Ad (Pneumoslide IgM IFA, Vircell SL, Spain) were performed on serum samples of 91 patients with hematologic malignancies who had LRTIs. Results: We identified at least one respiratory virus in 24.2% (22 in 91) of patients. In 13 (14.3%) cases multiple viral agents were identified. Adenovirus was the most common virus found (14.3%), followed by parainfluenza virus (9.9%). Influenza A virus and RSV were found equally in 6.6% of patients. Influenza B virus, which is usually responsible for respiratory infections in the community, was the least frequently identified respiratory virus in patients with hematologic malignancies (3.3%). Conclusion: This study showed that respiratory viruses, especially Ad, are common either as a single or multiple cause of LRTIs in patients receiving chemotherapy. We conclude that diagnostic tests for respiratory viruses should be incorporated in the routine diagnostic study of patients with hematologic malignancies.

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