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Healthcare-Associated Pneumonia: Dont Forget About Respiratory Viruses!

机译:与医疗保健相关的肺炎:不要忘了呼吸道病毒!

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摘要

>Introduction: Healthcare-associated infections are an important cause of morbidity and mortality, are among the most common adverse events in healthcare, and of them, pneumonia is the most commonly reported. Our objective was to evaluate the incidence and clinical outcome of respiratory viruses in hospital-acquired pneumonia (HAP).>Methods: This was a prospective cohort study, include patients aged between 0 and 18 who fulfilled Centers for Diseases Control and Prevention (CDC) criteria for HAP. Demographic and clinical data were obtained, and a nasopharyngeal swab specimen was taken for the detection of respiratory viruses. All included patients were monitored until discharge to collect data on the need for mechanical ventilation, intensive care unit (ICU) admission, and mortality. All-cause 30-day mortality was also ascertained.>Results: Four thousand three hundred twenty-seven patients were followed for 42,658 patient-days and 5,150 ventilator-days. Eighty-eight patients (2.03%) met the CDC criteria for HAP, 63 patients were included, and clinical and epidemiological characteristics showed no statistically significant differences between patients with virus associated healthcare-associated pneumonia (VAHAP) and those with non-viral healthcare-associated pneumonia (NVHAP). At least one respiratory virus was detected in 65% [95% CI (53–77)] of episodes of HAP, with a single viral pathogen observed in 53.9% and coinfection with 2 viruses in 11.1% of cases. The outcome in terms of ICU admission, mechanical ventilation and the 30-day mortality did not show a significant difference between groups.>Conclusions: In two-thirds of the patients a respiratory virus was identified. There was no difference in mortality or the rest of the clinical outcome variables. About half of the patients required mechanical ventilation and 10% died, which emphasizes the importance of considering these pathogens in nosocomial infections, since their identification can influence the decrease in hospital costs and be taken into account in infection control policies.
机译:>简介:与医疗保健相关的感染是发病率和死亡率的重要原因,是医疗保健中最常见的不良事件之一,其中肺炎是最常见的报告。我们的目标是评估医院获得性肺炎(HAP)中呼吸道病毒的发生率和临床结局。>方法:这是一项前瞻性队列研究,对象是0至18岁且符合疾病中心的患者HAP的控制和预防(CDC)标准。获得了人口统计学和临床​​数据,并采集了鼻咽拭子样本以检测呼吸道病毒。监测所有入选患者直至出院,以收集有关机械通气,重症监护病房(ICU)入院和死亡率的数据。还确定了全天30天的死亡率。>结果:随访了4,237例患者,共42,658例患者日和5150例呼吸机日。 88名患者(2.03%)达到了HAP的CDC标准,包括63名患者,临床和流行病学特征显示,与病毒相关的医疗相关性肺炎(VAHAP)的患者和非病毒性医疗相关的肺炎患者之间无统计学差异。相关性肺炎(NVHAP)。在HAP发作的65%[95%CI(53-77)]中,至少检测到一种呼吸道病毒,在53.9%的病例中观察到单一病毒病原体,在11.1%的病例中共感染2种病毒。在ICU入院,机械通气和30天死亡率方面的结果在两组之间没有显着差异。>结论:在三分之二的患者中鉴定出呼吸道病毒。死亡率或其他临床结果变量无差异。大约一半的患者需要机械通气,10%的患者死亡,这突出了在医院感染中考虑这些病原体的重要性,因为它们的识别会影响医院成本的下降,并在感染控制政策中予以考虑。

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