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

Détails

ID Serval
serval:BIB_DB7AEED640D8
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Respiratory viruses in bronchoalveolar lavage: a hospital-based cohort study in adults.
Périodique
Thorax
Auteur⸱e⸱s
Garbino J., Soccal P.M., Aubert J.D., Rochat T., Meylan P., Thomas Y., Tapparel C., Bridevaux P.O., Kaiser L.
ISSN
1468-3296[electronic]
Statut éditorial
Publié
Date de publication
2009
Volume
64
Numéro
5
Pages
399-404
Langue
anglais
Notes
Publication types: Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Résumé
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.
Mots-clé
Bronchoalveolar Lavage Fluid/virology, Cohort Studies, Cross Infection/virology, Female, Hospitalization, Humans, Lung Transplantation, Male, Middle Aged, Opportunistic Infections/diagnosis, Opportunistic Infections/virology, Respiratory Tract Infections/diagnosis, Respiratory Tract Infections/virology, Reverse Transcriptase Polymerase Chain Reaction, Seasons, Virus Diseases/diagnosis, Virus Diseases/virology, Viruses/isolation & purification
Pubmed
Web of science
Open Access
Oui
Création de la notice
21/01/2010 12:21
Dernière modification de la notice
20/08/2019 17:00
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