Viruses are prevalent in non-ventilated hospital-acquired pneumonia

Shorr, Andrew F.; Zilberberg, Marya D.; Micek, Scott T.; Kollef, Marin H.

doi:10.1016/j.rmed.2016.11.023

Cited by 61 publications

(45 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Viral infections presenting concurrently with bacterial CAP are now known to occur with a frequency of 30-50% in both adult and pediatric populations [64][65][66][67]. Interestingly, it would be more intuitive to assume that CAP would be the most severe manifestation of these co-infections, but more recently there have been several studies demonstrating these viral-bacterial infections also affect 10-20% of patients with hospital-acquired pneumonia (HAP) [44,[68][69][70]. In a large cohort study with over 2,000 patients hospitalized with severe H1N1pdm09 influenza, the following risk factors were identified for developing HAP: need for mechanical ventilation, sepsis, ICU admission on the first day, lymphocytopenia, older age, and anemia.…”

Section: Role Of Viral-bacterial Co-infections and Their Effect On Oumentioning

confidence: 99%

Influenza virus-related critical illness: pathophysiology and epidemiology

2019

View full text Add to dashboard Cite

Influenza virus affects the respiratory tract by direct viral infection or by damage from the immune system response. In humans, the respiratory epithelium is the only site where the hemagglutinin (HA) molecule is effectively cleaved, generating infectious virus particles. Virus transmission occurs through a susceptible individual’s contact with aerosols or respiratory fomites from an infected individual. The inability of the lung to perform its primary function of gas exchange can result from multiple mechanisms, including obstruction of the airways, loss of alveolar structure, loss of lung epithelial integrity from direct epithelial cell killing, and degradation of the critical extracellular matrix. Approximately 30–40% of hospitalized patients with laboratory-confirmed influenza are diagnosed with acute pneumonia. These patients who develop pneumonia are more likely to be < 5 years old, > 65 years old, Caucasian, and nursing home residents; have chronic lung or heart disease and history of smoking, and are immunocompromised. Influenza can primarily cause severe pneumonia, but it can also present in conjunction with or be followed by a secondary bacterial infection, most commonly by Staphylococcus aureus and Streptococcus pneumoniae . Influenza is associated with a high predisposition to bacterial sepsis and ARDS. Viral infections presenting concurrently with bacterial pneumonia are now known to occur with a frequency of 30–50% in both adult and pediatric populations. The H3N2 subtype has been associated with unprecedented high levels of intensive care unit (ICU) admission. Influenza A is the predominant viral etiology of acute respiratory distress syndrome (ARDS) in adults. Risk factors independently associated with ARDS are age between 36 and 55 years old, pregnancy, and obesity, while protective factors are female sex, influenza vaccination, and infections with Influenza A (H3N2) or Influenza B viruses. In the ICU, particularly during the winter season, influenza should be suspected not only in patients with typical symptoms and epidemiology, but also in patients with severe pneumonia, ARDS, sepsis with or without bacterial co-infection, as well as in patients with encephalitis, myocarditis, and rhabdomyolysis.

show abstract

Section: Role Of Viral-bacterial Co-infections and Their Effect On Oumentioning

confidence: 99%

Influenza virus-related critical illness: pathophysiology and epidemiology

2019

View full text Add to dashboard Cite

show abstract

“…Also, given the multifocal nature of VAP, even mini-BAL samples obtained blindly without the use of bronchoscopy can be effective [41]. More recently, the FilmArray Respiratory Panel has been employed to demonstrate that more than 24% of HAP episodes were associated with respiratory virus infection alone or concomitant viral and bacterial infection [42]. The FilmArray Respiratory Panel has recently been extended to include 24 common respiratory pathogens (including 8 gram-positive bacteria, 11 gram-negative bacteria, and 5 Candida species) with global sensitivity of 78.6% and specificity 98.1% compared to conventional microbiologic techniques [43].…”

Section: Bacterial and Respiratory Viral Identificationmentioning

confidence: 99%

Emerging strategies for the noninvasive diagnosis of nosocomial pneumonia

Liapikou

Cillóniz

2019

Expert Review of Anti-infective Therapy

View full text Add to dashboard Cite

“…15 A recent study detected viruses in 22% of patients diagnosed with hospital-acquired pneumonia. 16 • Administration of influenza vaccine to staff and vulnerable hospital clients.…”

Section: Hospital-acquired Respiratory Tract Virusesmentioning

confidence: 99%

“…2 Table 1 summarises common HAI and outlines preventive strategies. [3][4][5][6][7][8][9][10][11][12][13][14][15][16] In this review, we have focused on the illustrative problems of carbapenem resistance and CDI, and on Infection Control and Antimicrobial Stewardship (AMS), areas where further practice change can be anticipated to reduce HAI rates.…”

Section: Introductionmentioning

confidence: 99%

Healthcare‐acquired infections: prevention strategies

Fernando

Gray

Gottlieb

2017

Internal Medicine Journal

View full text Add to dashboard Cite

Healthcare‐acquired infections (HAI) impact on patient care and have cost implications for the Australian healthcare system. The management of HAI is exacerbated by rising rates of antimicrobial resistance (AMR). Health‐care workers and a contaminated hospital environment are increasingly implicated in the transmission and persistence of multi‐resistant organisms (MRO), as well as other pathogens, such as Clostridium difficile. This has resulted in a timely focus on a range of HAI prevention actions. Core components include antimicrobial stewardship, to reduce overuse and ensure evidence‐based antimicrobial use; infection prevention strategies, to control MRO – particularly methicillin‐resistant Staphylococcus aureus (MRSA), vancomycin‐resistant Enterococcus spp. (VRE) and, more recently, multi‐resistant Gram‐negative bacteria; enhanced institutional investment in hand hygiene; hospital cleaning and disinfection; and the development of prescribing guidelines and standards of care. AMR surveillance and comparisons of prescribing are useful feedback activities once effectively communicated to end users. Successful implementation of these strategies requires cultural shifts at local hospital level and, to tackle the serious threat posed by AMR, greater co‐ordination at a national level. HAI prevention needs to be multi‐modal, requires broad healthcare collaboration, and the strong support and accountability of all medical staff.

show abstract

Viruses are prevalent in non-ventilated hospital-acquired pneumonia

Abstract: Viruses represent a common cause of NVHAP. Clinicians should consider viral diagnostic testing in NVHAP, as this may represent a means to enhance antimicrobial stewardship.

Cited by 61 publications

References 9 publications

Influenza virus-related critical illness: pathophysiology and epidemiology

Influenza virus-related critical illness: pathophysiology and epidemiology

Emerging strategies for the noninvasive diagnosis of nosocomial pneumonia

Healthcare‐acquired infections: prevention strategies

Contact Info

Product

Resources

About