Respiratory viruses in bronchoalveolar lavage: a hospital-based cohort study in adults

Autor: Laurent Kaiser, John-David Aubert, Caroline Tapparel, Pascal Meylan, Thierry Rochat, Pierre-Olivier Bridevaux, Yves Thomas, Jorge Garbino, Paola M. Soccal
Rok vydání: 2009
Předmět:
Male
Pulmonary and Respiratory Medicine
medicine.medical_specialty
Pathology
Opportunistic Infections/*diagnosis/virology
Population
Opportunistic Infections
Cross Infection/*virology
medicine.disease_cause
Gastroenterology
Cohort Studies
Human metapneumovirus
Respiratory Tract Infections/diagnosis/*virology
Internal medicine
Humans
Medicine
Respiratory system
Prospective cohort study
education
Respiratory Tract Infections
ddc:616
Cross Infection
education.field_of_study
Lung
medicine.diagnostic_test
biology
Reverse Transcriptase Polymerase Chain Reaction
business.industry
Viruses/*isolation & purification
Respiratory infection
Middle Aged
biology.organism_classification
Virus Diseases/diagnosis/*virology
Hospitalization
Bronchoalveolar lavage
medicine.anatomical_structure
Virus Diseases
Viruses
Female
Seasons
Rhinovirus
Bronchoalveolar Lavage Fluid/*virology
business
Bronchoalveolar Lavage Fluid
Lung Transplantation
Zdroj: Thorax, Vol. 64, No 5 (2009) pp. 399-404
ISSN: 0040-6376
DOI: 10.1136/thx.2008.105155
Popis: Background The epidemiology of respiratory viruses and their potential clinical impact when recovered in lower respiratory specimens has not been established in the hospital setting. A study was performed to investigate the association between positive viral detection and respiratory infection in an at-risk population. Methods 299 adult patients who underwent bronchoalveolar lavage (BAL) procedures were enrolled in a hospital-based prospective cohort study. Descriptive epidemiology is presented of 17 different respiratory viruses detected by reverse transcription-polymerase chain reaction assays in BAL fluid specimens. Multivariate analysis was conducted to identify the clinical characteristics independently associated with the presence of virus. Results Of 522 BAL fluid specimens analysed, 81% were collected in adult transplant recipients or other immunocompromised patients. Overall, PCR assays identified viral nucleic acid in 91 BAL fluid samples (17.4%). Similar rates of virus-positive BAL fluid were found in the different subpopulations studied (p = 0.113). Coronaviruses were the most frequent (32.3%), followed by rhinovirus (22.6%), parainfluenza (19.5%), influenza (9.7%), respiratory synctial virus (8.6%), human metapneumovirus (4.2%) and bocavirus (3.1%). Multivariate analysis using mixed models showed that respiratory viral infections were associated with a lack of antibiotic treatment response (OR 2.2, 95% CI 1.2 to 4.1) and the absence of radiological infiltrate (OR 0.3, 95% CI 0.2 to 0.8). In lung transplant recipients in whom a respiratory infection was suspected, the respiratory viral detection rate was 24.4% compared with 13.8% overall in other patients (p = 0.02). Conclusions In this cohort of hospitalised adults, respiratory viruses detected in BAL fluid specimens were associated with respiratory symptoms, absence of radiological infiltrates and a poor response to antibiotic therapy.
Databáze: OpenAIRE
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