Clinical characteristics and outcome of respiratory syncytial virus infection among adults hospitalized with influenza-like illness in France

被引：76

作者：

Loubet, P. ^{[1
,2
]}

Lenzi, N. ^{[3
]}

Valette, M. ^{[4
]}

Foulongne, V. ^{[5
]}

Krivine, A. ^{[6
]}

Houhou, N. ^{[7
]}

Lagathu, G. ^{[8
]}

Rogez, S. ^{[9
]}

Alain, S. ^{[10
]}

Duval, X. ^{[1
,11
]}

Galtier, F. ^{[3
,12
]}

Postil, D. ^{[13
]}

Tattevin, P. ^{[14
]}

Vanhems, P. ^{[15
,16
]}

Carrat, F. ^{[17
,18
]}

Lina, B. ^{[4
,19
]}

Launay, O. ^{[3
,20
,21
,22
]}

机构：

[1] Univ Paris Diderot, Sorbonne Paris Cite, INSERM, IAME,UMR 1137, Paris, France

[2] Hop Bichat Claude Bernard, AP HP, Serv Malad Infectieuses & Trop, Paris, France

[3] INSERM, F CRIN, Innovat Clin Res Network Vaccinol I REIVAC, Paris, France

[4] Hosp Civils Lyon, GHN, Inst Agents Infectieux, CNR Virus Influenza, Lyon, France

[5] CHU Montpellier, Hop St Eloi, Inserm U 1058, Laboratoire Virol, Montpellier, France

[6] Hop Cochin Broca Hotel Dieu, AP HP, Lab Virol, Paris, France

[7] Hop Bichat Claude Bernard, AP HP, Lab Virol, Paris, France

[8] CHRU Pontchaillou, Lab Virol, Rennes, France

[9] CHU Dupuytren, Serv Bacteriol Virol Hyg, Limoges, France

[10] CHU Dupuytren, Lab Virol, Limoges, France

[11] Hop Bichat Claude Bernard, AP HP, Inserm CIC 1425, Paris, France

[12] CHU Montpellier, Hop Saint Eloi, Inserm CIC 1411, Montpellier, France

[13] CHU Dupuytren, CIC 1435, Limoges, France

[14] CHRU Pontchaillou, Malad Infect & Reanimat Med, CIC INSERM 1414, Rennes, France

[15] Grp Hosp Edouard Herriot, Serv Hyg Epidemiol & Prevent, Lyon, France

[16] CIRI, Inserm U1111, CNRS UMR5308, ENS Lyon,Emerging Pathogens Lab Fdn Merieux,UCBL1, Lyon, France

[17] Sorbonne Univ, UPMC Univ Paris 06, INSERM, Inst Pierre Louis Epidemiol & Sante Publ IPLESP U, Paris, France

[18] Hop Saint Antoine, AP HP, Publ Hlth Dept, Paris, France

[19] Univ Lyon, Hosp Civils Lyon, CIRI,CNRS,UMR5308,Ecole Normale Super Lyon, Virpath,Inserm U1111,Univ Claude Bernard Lyon 1, Lyon, France

[20] INSERM, CIC 1417, Paris, France

[21] Univ Paris 05, Sorbonne Paris Cite, Paris, France

[22] Cochin Broca Hotel Dieu Hosp, AP HP, Dept Infect Dis, CIC Cochin Pasteur, Paris, France

来源：

CLINICAL MICROBIOLOGY AND INFECTION | 2017年 / 23卷 / 04期

关键词：

Respiratory syncytial virus; Pneumonia; Adults; Influenza-like illness; Influenza; Elderly; OLDER-ADULTS; RISK-FACTORS;

D O I：

10.1016/j.cmi.2016.11.014

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Objectives: The aim of this study was to analyse characteristics and outcome of respiratory syncytial virus (RSV) infection in adults hospitalized with influenza-like illness (ILI). Methods: Patients hospitalized with ILI were included in this prospective, multicentre study carried out in six French hospitals during three consecutive influenza seasons (2012-2015). RSV and other respiratory viruses were detected by multiplex PCR in nasopharyngeal swabs. Risk factors for RSV infection were identified by backward stepwise logistic regression analysis. Results: A total of 1452 patients hospitalized with ILI were included, of whom 59% (861/1452) were >65 years and 83% (1211/1452) had underlying chronic illnesses. RSV was detected in 4% (59/1452), and influenza virus in 39% (566/1452). Risk factors for RSV infection were cancer (adjusted OR 2.1, 95% CI 1.1 -4.1, p 0.04), and immunosuppressive treatment (adjusted OR 2.0, 95% CI 1.1-3.8, p 0.03). Patients with RSV had a median length of stay of 9 days (6-25), and 57% of them (30/53) had complications, including pneumonia (23/53, 44%) and respiratory failure (15/53, 28%). Fifteen per cent (8/53) were admitted to an intensive care unit, and the in-hospital mortality rate was 8% (4/53). Pneumonia was more likely to occur in patients with RSV than in patients with RSV-negative ILI (44% (23/53) versus 26% (362/1393), p 0.006) or with influenza virus infection (44% versus 28% (157/560), p 0.02). Conclusion: RSV is an infrequent cause of ILI during periods of influenza virus circulation but can cause severe complications in hospitalized adults. Risk factors for RSV detection in adults hospitalized with ILI include cancer and immunosuppressive treatment. Specific immunization and antiviral therapy might benefit patients at risk. (C) 2016 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

引用

页码：253 / 259

页数：7

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