Influenza-induced acute respiratory distress syndrome during the 2010-2016 seasons: bacterial co-infections and outcomes by virus type and subtype.
Adult
Aged
Bacterial Infections
/ epidemiology
Bronchoalveolar Lavage Fluid
/ microbiology
Coinfection
/ epidemiology
Extracorporeal Membrane Oxygenation
Female
Humans
Influenza A Virus, H1N1 Subtype
/ isolation & purification
Influenza A Virus, H3N2 Subtype
/ isolation & purification
Influenza B virus
/ isolation & purification
Influenza, Human
/ complications
Alphainfluenzavirus
Male
Middle Aged
Respiratory Care Units
Respiratory Distress Syndrome
/ complications
Retrospective Studies
A(H1N1)pdm09
Acute respiratory distress syndrome
Bacterial co-infections
Influenza
Syndromic testing
Journal
Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
ISSN: 1469-0691
Titre abrégé: Clin Microbiol Infect
Pays: England
ID NLM: 9516420
Informations de publication
Date de publication:
Jul 2020
Jul 2020
Historique:
received:
21
11
2019
revised:
22
02
2020
accepted:
07
03
2020
pubmed:
25
3
2020
medline:
29
1
2021
entrez:
25
3
2020
Statut:
ppublish
Résumé
We aimed to describe bacterial co-infections and acute respiratory distress (ARDS) outcomes according to influenza type and subtype. A retrospective observational study was conducted from 2012 to 2016 in patients admitted to the respiratory intensive care unit (ICU) of Marseille university hospital for influenza-induced ARDS. Microbiological investigations, including multiplex molecular respiratory panel testing and conventional bacteriological cultures, were performed as part of the routine ICU care on the bronchoalveloar lavage collected at admission. Bacterial co-infections, ICU mortality and respiratory function were investigated according to virus type and subtype. Among the 45 ARDS patients included, A(H1N1)pdm09 was the most frequent influenza virus identified (28/45 A(H1N1)pdm09, eight out of 45 A(H3N2) and nine out of 45 influenza B). Bacterial co-infections involving a total of 23 bacteria were diagnosed in 16/45 patients (36%). A(H1N1)pdm09 patients presented fewer bacterial co-infections (17.9% vs. 50.0% for A(H3N2) patients and 77.8% for B patients; p < 0.01). Overall, mortality at 90 days post admission was 33.3% (15/45), and there was no significant difference between influenza type and subtype. The need for extracorporeal membrane oxygenation was more frequent for A(H1N1)pdm2009 (20/28, 71.4%) and B patients (7/9, 77.8%) than the A(H3N2) subtype (1/8, 12.5%; p < 0.01). A(H1N1)pdm09-ARDS patients were associated with fewer ventilation-free days at day 28 (median (IQR): 0 (0-8) days) compared with other influenza-ARDS patients (15 (0-25) days, p < 0.05). In a population of influenza-induced ARDS, A(H1N1)pdm09 was associated with fewer bacterial co-infections but poorer respiratory outcomes. These data underline the major role of A(H1N1)pdm09 subtype on influenza disease severity.
Identifiants
pubmed: 32205296
pii: S1198-743X(20)30152-X
doi: 10.1016/j.cmi.2020.03.010
pii:
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
947.e1-947.e4Informations de copyright
Copyright © 2020 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.