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Respiratory viral infections are underdiagnosed in patients with suspected sepsis

Ljungström, Lars R. (author)
Gothenburg University,Göteborgs universitet,CARe - Centrum för antibiotikaresistensforskning,Institutionen för biomedicin, avdelningen för infektionssjukdomar,Centre for antibiotic resistance research, CARe,Institute of Biomedicine, Department of Infectious Medicine,Department of Infectious Diseases, Skaraborg Hospital / CARe (Center for Antibiotic Resistance Research), Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, Gothenburg
Jacobsson, Gunnar, 1960 (author)
Gothenburg University,Göteborgs universitet,Institutionen för biomedicin, avdelningen för infektionssjukdomar,CARe - Centrum för antibiotikaresistensforskning,Institute of Biomedicine, Department of Infectious Medicine,Centre for antibiotic resistance research, CARe,Department of Infectious Diseases, Skaraborg Hospital, Skövde / CARe (Center for Antibiotic Resistance Research), Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, Gothenburg
Claesson, B. E. B. (author)
Department of Clinical Microbiology, Unilabs, Skaraborg Hospital, Skövde
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Andersson, R. (author)
CARe (Center for Antibiotic Resistance Research), Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
Enroth, Helena (author)
Högskolan i Skövde,Institutionen för biovetenskap,Forskningscentrum för Systembiologi,Department of Clinical Molecular Microbiology, Unilabs, Skaraborg Hospital, Skövde,Infektionsbiologi, Infection Biology
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 (creator_code:org_t)
2017-05-17
2017
English.
In: European Journal of Clinical Microbiology & Infectious Diseases. - : Springer Science and Business Media LLC. - 0934-9723 .- 1435-4373. ; 36:10, s. 1767-1776
  • Journal article (peer-reviewed)
Abstract Subject headings
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  • The study aim was to investigate the prevalence and clinical relevance of viral findings by multiplex PCR from the nasopharynx of clinically septic patients during a winter season. During 11 weeks of the influenza epidemic period in January-March 2012, consecutive adult patients suspected to be septic (n = 432) were analyzed with cultures from blood and nasopharynx plus multiplex PCR for respiratory viruses on the nasopharyngeal specimen. The results were compared with those from microbiology analyses ordered as part of standard care. During the winter season, viral respiratory pathogens, mainly influenza A virus, human metapneumovirus, coronavirus, and respiratory syncytial virus were clinically underdiagnosed in 70% of patients positive by the multiplex PCR assay. During the first four weeks of the influenza epidemic, few tests for influenza were ordered by clinicians, indicating low awareness that the epidemic had started. Nasopharyngeal findings of Streptococcus pneumoniae and Haemophilus influenzae by culture correlated to pneumonia diagnosis, and in those patients laboratory signs of viral co-infections were common but rarely suspected by clinicians. The role of respiratory viral infections in patients presenting with a clinical picture of sepsis is underestimated. Specific antiviral treatment might be beneficial in some cases and may reduce spread in a hospital setting. Diagnosing viral infections may promote reduction of unnecessary antibiotic use. It can also be a tool for decisions concerning patient logistics, in order to minimize exposure of susceptible patients and personnel.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Medicinska och farmaceutiska grundvetenskaper -- Mikrobiologi inom det medicinska området (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Basic Medicine -- Microbiology in the medical area (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Infektionsmedicin (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Infectious Medicine (hsv//eng)

Keyword

community-acquired pneumonia
tract-infections
streptococcus-pneumoniae
bacterial pneumonia
influenza-virus
septic
shock
assay
pcr
coinfection
diagnosis
Infection Biology
INF000

Publication and Content Type

ref (subject category)
art (subject category)

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