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Analysis of acute respiratory infections due to influenza virus A, B and RSV during an influenza epidemic 2018

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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.

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Abbreviations

NIV:

Noninvasive mechanical ventilation

MV:

(Invasive) mechanical ventilation

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Authors and Affiliations

  1. Kliniken für Pneumologie und Infektiologie, EVK Herne und Augusta-Kranken-Anstalt Bochum, Thoraxzentrum Ruhrgebiet, Bergstrasse 26, 44791, Bochum, Germany

    Spiridon Topoulos, Christian Giesa & Santiago Ewig

  2. Ruhr-Universität Bochum, Institut für Mikrobiologie (IML), Bochum, Germany

    Sören Gatermann

  3. Zentralbereich für Krankenhaushygiene und Infektiologie, Universitätsklinikum Aachen, Aachen, Germany

    Rene Fussen & Sebastian Lemmen

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  1. Spiridon Topoulos
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  2. Christian Giesa
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  6. Santiago Ewig
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Correspondence to Santiago Ewig.

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Topoulos, S., Giesa, C., Gatermann, S. et al. Analysis of acute respiratory infections due to influenza virus A, B and RSV during an influenza epidemic 2018. Infection 47, 425–433 (2019). https://doi.org/10.1007/s15010-018-1262-x

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  • DOI: https://doi.org/10.1007/s15010-018-1262-x

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