Healthcare-Associated Pneumonia: Don't Forget About Respiratory Viruses!

Frontiers in Pediatrics

article

Margarita Torres-García¹  Daniela de la Rosa-Zamboni¹  Brenda Berenice Pérez Méndez²  José Luis Sánchez Huerta³  Mónica Villa Guillén⁴  Virydiana Rementería Vazquez⁵  Arturo Daniel Castro Diaz⁴  Briceida López Martinez⁶  Almudena Laris González¹  Rodolfo Norberto Jiménez-Juárez² 

[1] Epidemiology Department, Federico Gómez Children's Hospital of Mexico;Infectious Diseases Department, Federico Gómez Children's Hospital of Mexico;Molecular Biology Department, Federico Gómez Children's Hospital of Mexico;Federico Gomez Children's Hospital of Mexico;Education Department, Federico Gomez Children's Hospital of Mexico;Diagnostic Auxiliary Services, Federico Gomez Children's Hospital of Mexico;Department of Pediatrics, National Medical Center La Raza, Infectious Diseases Hospital, Mexican Institute of Social Security

关键词: hospital-acquired pneumonia;    viral pneumonia;    respiratory viruses;    nosocomial infections;    healthcare-associated infections;   

DOI  :  10.3389/fped.2019.00168

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Introduction: Healthcare-associated infections are an important cause of morbidity and mortality, are among the most common adverse events in healthcare, and of them, pneumonia is the most commonly reported. Our objective was to evaluate the incidence and clinical outcome of respiratory viruses in hospital-acquired pneumonia (HAP). Methods: This was a prospective cohort study, include patients aged between 0 and 18 who fulfilled Centers for Diseases Control and Prevention (CDC) criteria for HAP. Demographic and clinical data were obtained, and a nasopharyngeal swab specimen was taken for the detection of respiratory viruses. All included patients were monitored until discharge to collect data on the need for mechanical ventilation, intensive care unit (ICU) admission, and mortality. All-cause 30-day mortality was also ascertained. Results: Four thousand three hundred twenty-seven patients were followed for 42,658 patient-days and 5,150 ventilator-days. Eighty-eight patients (2.03%) met the CDC criteria for HAP, 63 patients were included, and clinical and epidemiological characteristics showed no statistically significant differences between patients with virus associated healthcare-associated pneumonia (VAHAP) and those with non-viral healthcare-associated pneumonia (NVHAP). At least one respiratory virus was detected in 65% [95% CI (53–77)] of episodes of HAP, with a single viral pathogen observed in 53.9% and coinfection with 2 viruses in 11.1% of cases. The outcome in terms of ICU admission, mechanical ventilation and the 30-day mortality did not show a significant difference between groups. Conclusions: In two-thirds of the patients a respiratory virus was identified. There was no difference in mortality or the rest of the clinical outcome variables. About half of the patients required mechanical ventilation and 10% died, which emphasizes the importance of considering these pathogens in nosocomial infections, since their identification can influence the decrease in hospital costs and be taken into account in infection control policies.

【 授权许可】

CC BY