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


Autoria(s): Garbino J.; Soccal P.M.; Aubert J.D.; Rochat T.; Meylan P.; Thomas Y.; Tapparel C.; Bridevaux P.O.; Kaiser L.
Data(s)

2009

Resumo

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.

Identificador

https://serval.unil.ch/?id=serval:BIB_DB7AEED640D8

isbn:1468-3296[electronic]

pmid:19174425

doi:10.1136/thx.2008.105155

isiid:000265579900010

Idioma(s)

en

Fonte

Thorax, vol. 64, no. 5, pp. 399-404

Palavras-Chave #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
Tipo

info:eu-repo/semantics/article

article