التفاصيل البيبلوغرافية
| العنوان: |
Clinical Significance of Upper Airway Virus Detection in Critically Ill Hematology Patients. |
| المؤلفون: |
Legoff, Jérôme, Zucman, Noémie, Lemiale, Virginie, Mokart, Djamel, Pène, Frédéric, Lambert, Jérôme, Kouatchet, Achille, Demoule, Alexandre, Vincent, François, Nyunga, Martine, Bruneel, Fabrice, Contejean, Adrien, Mercier-Delarue, Séverine, Rabbat, Antoine, Lebert, Christine, Perez, Pierre, Meert, Anne-Pascale, Benoit, Dominique, Schwebel, Carole, Jourdain, Mercé |
| المصدر: |
American Journal of Respiratory & Critical Care Medicine; 2/15/2019, Vol. 199 Issue 4, p518-528, 11p |
| مستخلص: |
Rationale: Noninvasive diagnostic multiplex molecular tests may enable the early identification and treatment of viral infections in critically ill immunocompromised patients.Objectives: To assess the association between viral detection in nasopharyngeal swabs and ICU mortality in critically ill hematology patients.Methods: This was a post hoc analysis of a prospective cohort of critically ill hematology patients admitted to 17 ICUs. Nasal swabs sampled and frozen at ICU admission were tested using a multiplex PCR assay. Predictors of ICU mortality and assay positivity were identified.Measurements and Main Results: Of the 747 patients (447 with acute respiratory failure [ARF]), 21.3% had a virus detected (56.4% rhinovirus/enterovirus and 30.7% influenza/parainfluenza/respiratory syncytial viruses). Overall ICU and hospital mortality rates were 26% and 37%, respectively. Assay positivity was associated with lymphoproliferative disorders, hematopoietic stem cell transplantation, treatment with steroids or other immunosuppressants, ARF (25.5% vs. 16.3%; P = 0.004), and death in the ICU (28.9% vs. 19.3%; P = 0.008). The association with ICU mortality was significant for all viruses and was strongest for influenza/parainfluenza/respiratory syncytial viruses. In patients with ARF, detection of any respiratory virus was independently associated with ICU mortality (odds ratio, 2.07; 95% confidence interval, 1.22-3.50).Conclusions: Respiratory virus detection in the upper airway by multiplex PCR assay is common in critically ill hematology patients. In patients with ARF, respiratory virus detection was independently associated with ICU mortality. Multiplex PCR assay may prove helpful for the risk stratification of hematology patients with ARF. Studies to understand whether respiratory tract viruses play a causal role in outcomes are warranted. [ABSTRACT FROM AUTHOR] |
|
Copyright of American Journal of Respiratory & Critical Care Medicine is the property of American Thoracic Society and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) |
| قاعدة البيانات: |
Complementary Index |
Full Text Finder