Roberto Luzzati1, Pierlanfranco D'Agaro2, Annalisa Busca3, Cristina Maurel4, Fulvia Martellani5, Chiara Rosin4, Ludovica Segat2, Giuseppe Gatti6, Marta Mascarello4, Marco Confalonieri3. 1. Infectious Diseases Unit, University Hospital of Trieste, Piazza dell'Ospitale 1, 34125 Trieste, Italy. Electronic address: roberto.luzzati@asuits.sanita.fvg.it. 2. Laboratory for Hygiene and Public Health, University Hospital of Trieste, Strada di Fiume 447, 34149 Trieste, Italy. 3. Pulmonology Unit, University Hospital of Trieste, Strada di Fiume 447, 34149 Trieste, Italy. 4. Infectious Diseases Unit, University Hospital of Trieste, Piazza dell'Ospitale 1, 34125 Trieste, Italy. 5. Anatomy and Histopathology Unit, University Hospital of Trieste, Strada di Fiume 447, 34149 Trieste, Italy. 6. Cardiosurgery Unit, University Hospital of Trieste, Strada di Fiume 447, 34149 Trieste, Italy.
Abstract
OBJECTIVES: To evaluate burden and predictors of HSV pneumonia among immunocompromised patients not undergoing invasive mechanical ventilation according to a tailored diagnostic algorithm. METHODS: This prospective, observational study included immunocompromised adults with pneumonia non-responding to empirical antibiotic therapy. Bronchoalveolar lavage (BAL) specimens were cultured for bacteria, mycobacteria and fungi. Real-time PCR for Herpesviruses and other microorganisms were performed on BAL and other specimens. Cytological examination of BAL samples was carried out for identification of intranuclear inclusion bodies and immunohistochemical staining for HSV. RESULTS: We enrolled 45 patients (mean age 64.6 years) from January 2015 to June 2016. Nineteen (42.2%) cases tested positive for HSV-1 PCR on BAL. According to our definitions, 11 (24.4%) patients had HSV-1 pneumonia with viral loads ranging between 103 copies/mL and 107 copies/mL. HSV-1 positive throat swab (OR 85.2, 95% CI 5.83-1245.1, P < 0.001) and solid organ transplant (SOT) (OR 53.3, 95% CI 1.37-2072.8, P < 0.03) as underlying condition were found to be independently associated with HSV pneumonia by multivariable analysis. CONCLUSIONS: HSV pneumonia turned out to be relatively common and should be investigated especially in individuals with HSV positive throat swab and SOT. Interventional studies are needed to assess the real clinical impact of HSV pneumonia in immunocompromised patients.
OBJECTIVES: To evaluate burden and predictors of HSV pneumonia among immunocompromised patients not undergoing invasive mechanical ventilation according to a tailored diagnostic algorithm. METHODS: This prospective, observational study included immunocompromised adults with pneumonia non-responding to empirical antibiotic therapy. Bronchoalveolar lavage (BAL) specimens were cultured for bacteria, mycobacteria and fungi. Real-time PCR for Herpesviruses and other microorganisms were performed on BAL and other specimens. Cytological examination of BAL samples was carried out for identification of intranuclear inclusion bodies and immunohistochemical staining for HSV. RESULTS: We enrolled 45 patients (mean age 64.6 years) from January 2015 to June 2016. Nineteen (42.2%) cases tested positive for HSV-1 PCR on BAL. According to our definitions, 11 (24.4%) patients had HSV-1 pneumonia with viral loads ranging between 103 copies/mL and 107 copies/mL. HSV-1 positive throat swab (OR 85.2, 95% CI 5.83-1245.1, P < 0.001) and solid organ transplant (SOT) (OR 53.3, 95% CI 1.37-2072.8, P < 0.03) as underlying condition were found to be independently associated with HSV pneumonia by multivariable analysis. CONCLUSIONS:HSV pneumonia turned out to be relatively common and should be investigated especially in individuals with HSV positive throat swab and SOT. Interventional studies are needed to assess the real clinical impact of HSV pneumonia in immunocompromised patients.
Authors: María José Pérez-Pedrero Sánchez-Belmonte; Marcelino Sánchez-Casado; Francisco Javier Moran Gallego; Roman Piza Pinilla; Cesar Gomez Hernando; Irene Paredes Borrachero Journal: Med Clin (Barc) Date: 2022-06-06 Impact factor: 3.200
Authors: José Luis Piñana; Eliseo Albert; María Dolores Gómez; Ariadna Pérez; Juan Carlos Hernández-Boluda; Juan Montoro; Miguel Salavert; Eva María González; Mar Tormo; Estela Giménez; Marta Villalba; Aitana Balaguer-Roselló; Rafael Hernani; Felipe Bueno; Rafael Borrás; Jaime Sanz; Carlos Solano; David Navarro Journal: J Infect Date: 2020-01-10 Impact factor: 6.072
Authors: Daniele Roberto Giacobbe; Stefano Di Bella; Antonio Lovecchio; Lorenzo Ball; Andrea De Maria; Antonio Vena; Bianca Bruzzone; Giancarlo Icardi; Paolo Pelosi; Roberto Luzzati; Matteo Bassetti Journal: Infect Dis Ther Date: 2022-08-01