Spiridon Topoulos1, Christian Giesa1, Sören Gatermann2, Rene Fussen3, Sebastian Lemmen3, Santiago Ewig4. 1. Kliniken für Pneumologie und Infektiologie, EVK Herne und Augusta-Kranken-Anstalt Bochum, Thoraxzentrum Ruhrgebiet, Bergstrasse 26, 44791, Bochum, Germany. 2. Ruhr-Universität Bochum, Institut für Mikrobiologie (IML), Bochum, Germany. 3. Zentralbereich für Krankenhaushygiene und Infektiologie, Universitätsklinikum Aachen, Aachen, Germany. 4. Kliniken für Pneumologie und Infektiologie, EVK Herne und Augusta-Kranken-Anstalt Bochum, Thoraxzentrum Ruhrgebiet, Bergstrasse 26, 44791, Bochum, Germany. ewig@augusta-bochum.de.
Abstract
PURPOSE: We studied the incidence, morbidity and mortality of all patients presenting in our teaching hospital with proven influenza virus and/or respiratory syncytial virus (RSV) infection during the influenza epidemic season 2018 which was characterized by a predominant incidence of influenza virus B type B of the Yamagata line. METHODS: In the fall of 2017, specific precaution measures in addition to standard measures were implemented, including standardized testing for influenza virus A,B and RSV by multiplex PCR of pharyngeal swabsData from all consecutive patients were analyzed retrospectively. RESULTS: Overall 651 patients were examined for the presence of influenza virus and RSV; 214 patients had influenza virus A (n = 36), B (n = 152), and/or RSV (n = 30), including four patients with dual infection. 86% of cases had influenza virus (80% B), and 14% RSV infection. N = 23 cases were treated as outpatients. The rate of acute viral respiratory infections (influenza virus and RSV) was 191 of 2776 (6.9%) admissions to medical wards. Of n = 191 hospitalized cases, n = 44 cases (20.6%) had nosocomial infection. Viral infections were associated with a high morbidity (pneumonia 28.5%, mortality 4.7%). Independent predictors of prolonged hospitalization were the presence of pneumonia, NIV and renal complications, and independent predictors of pneumonia were age ≥ 65 years, bedridden status and CRP ≥ 2.9 mg/dL. CONCLUSIONS: The rate of nosocomial cases was high despite established precaution measures. RSV was associated with morbidity and mortality comparable to influenza. Pneumonia remains the main complication of acute viral respiratory infections, and antimicrobial treatment should include both antiviral as well as antibacterial agents.
PURPOSE: We studied the incidence, morbidity and mortality of all patients presenting in our teaching hospital with proven influenza virus and/or respiratory syncytial virus (RSV) infection during the influenza epidemic season 2018 which was characterized by a predominant incidence of influenza virus B type B of the Yamagata line. METHODS: In the fall of 2017, specific precaution measures in addition to standard measures were implemented, including standardized testing for influenza virus A,B and RSV by multiplex PCR of pharyngeal swabsData from all consecutive patients were analyzed retrospectively. RESULTS: Overall 651 patients were examined for the presence of influenza virus and RSV; 214 patients had influenza virus A (n = 36), B (n = 152), and/or RSV (n = 30), including four patients with dual infection. 86% of cases had influenza virus (80% B), and 14% RSV infection. N = 23 cases were treated as outpatients. The rate of acute viral respiratory infections (influenza virus and RSV) was 191 of 2776 (6.9%) admissions to medical wards. Of n = 191 hospitalized cases, n = 44 cases (20.6%) had nosocomial infection. Viral infections were associated with a high morbidity (pneumonia 28.5%, mortality 4.7%). Independent predictors of prolonged hospitalization were the presence of pneumonia, NIV and renal complications, and independent predictors of pneumonia were age ≥ 65 years, bedridden status and CRP ≥ 2.9 mg/dL. CONCLUSIONS: The rate of nosocomial cases was high despite established precaution measures. RSV was associated with morbidity and mortality comparable to influenza. Pneumonia remains the main complication of acute viral respiratory infections, and antimicrobial treatment should include both antiviral as well as antibacterial agents.
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Authors: Holger Flick; Britt-Madelaine Arns; Josef Bolitschek; Brigitte Bucher; Katharina Cima; Elisabeth Gingrich; Sabin Handzhiev; Maximilian Hochmair; Fritz Horak; Marco Idzko; Peter Jaksch; Gabor Kovacs; Roland Kropfmüller; Bernd Lamprecht; Judith Löffler-Ragg; Michael Meilinger; Horst Olschewski; Andreas Pfleger; Bernhard Puchner; Christoph Puelacher; Christian Prior; Patricia Rodriguez; Helmut Salzer; Peter Schenk; Otmar Schindler; Ingrid Stelzmüller; Volker Strenger; Helmut Täubl; Matthias Urban; Marlies Wagner; Franz Wimberger; Angela Zacharasiewicz; Ralf Harun Zwick; Ernst Eber Journal: Wien Klin Wochenschr Date: 2020-07 Impact factor: 1.704
Authors: H Flick; B M Arns; J Bolitschek; B Bucher; K Cima; E Gingrich; S Handzhiev; M Hochmair; F Horak; M Idzko; P Jaksch; G Kovacs; R Kropfmüller; B Lamprecht; J Löffler-Ragg; M Meilinger; H Olschewski; A Pfleger; B Puchner; C Puelacher; C Prior; P Rodriguez; H Salzer; P Schenk; O Schindler; I Stelzmüller; V Strenger; H Täubl; M Urban; M Wagner; F Wimberger; A Zacharasiewicz; R H Zwick; E Eber Journal: Wien Klin Mag Date: 2020-05-18