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Immunosuppressed patients with pandemic influenza A 2009 (H1N1) virus infection.

机译:免疫抑制的2009年甲型大流行性流感(H1N1)病毒感染患者。

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摘要

The purpose of this paper was to prospectively characterize the clinical manifestations and outcomes of confirmed influenza A 2009 (H1N1) virus infection in immunosuppressed patients with hospital admission and compare them with those of a general population. A multicenter prospective cohort study was carried out. All adult patients admitted to 13 hospitals in Spain with confirmed influenza A 2009 (H1N1) virus infection from June 12, 2009 to November 11, 2009 were included. Risk factors for complicated influenza infection were studied in immunosuppressed patients. Overall, 559 patients were included, of which 56 were immunosuppressed, nine with solid or hematological malignancies, 18 with solid-organ transplant recipients, 13 with corticosteroid therapy, and six with other types of immunosuppression. Clinical findings at diagnosis were similar in both groups. Nineteen immunosuppressed patients had pneumonia (33.9%). Immunosuppressed patients with pandemic influenza had bacterial co-infection more frequently (17.9% vs. 6.4%, p?=?0.02), specifically, gram-negative bacilli and Staphylococcus aureus infections. Mortality was higher in immunosuppressed patients (7.1% vs. 1.8%, p?
机译:本文的目的是前瞻性地描述在医院接受免疫抑制的患者中确诊的2009年甲型H1N1流感病毒感染的临床表现和结果,并将其与普通人群进行比较。进行了多中心前瞻性队列研究。纳入了2009年6月12日至2009年11月11日在西班牙13所医院确诊的2009年甲型H1N1流感病毒感染的所有成年患者。在免疫抑制患者中研究了复杂流感感染的危险因素。总共纳入559例患者,其中免疫抑制56例,实体或血液恶性肿瘤9例,实体器官移植受者18例,皮质类固醇激素治疗13例,其他类型的免疫抑制6例。两组在诊断时的临床发现相似。免疫抑制的19例患者患有肺炎(33.9%)。免疫抑制的大流行性流感患者发生细菌合并感染的频率更高(17.9%比6.4%,p?=?0.02),尤其是革兰氏阴性杆菌和金黄色葡萄球菌感染。免疫抑制患者的死亡率较高(7.1%比1.8%,p <0.05)。复杂的2009年甲型流感(H1N1)唯一可改变的危险因素是延迟抗病毒治疗。在免疫抑制患者中,2009年甲型H1N1流感病毒感染的死亡率高于非免疫抑制患者。细菌合并感染在复杂病例中很常见。

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