Department of Microbiological Diagnostics and Virology, Statens Serum Institut, Copenhagen.
APMIS. 2013 Nov;121(11):1097-108. doi: 10.1111/apm.12089. Epub 2013 May 18.
Our aim was to determine the frequency of 12 common respiratory viruses in patients admitted to intensive care units with respiratory symptoms, evaluate the clinical characteristics and to compare the results to routine microbiological diagnostics. Throat swabs from 122 intensive care-patients >18 years with acute respiratory symptoms were collected upon admission and analysed with multiplex real-time polymerase chain reaction, for 12 community respiratory viruses. Blood and respiratory tract specimens were analysed for bacteria and fungi upon clinicians' request. Clinical and paraclinical data were collected. Viruses were detected in 19 (16%) of the 122 study patients. Five virus-positive patients (26%) had possible clinically relevant bacteria or fungi co-detected. Patients with exacerbation in COPD were associated with a viral infection (p = 0.02). Other comorbidities, clinical and paraclinical parameters, and death were independent of a viral infection or co-detection of bacteria/fungi. In conclusion, respiratory viruses were frequently detected in the patients. The investigated clinical and paraclinical parameters were not different in viral infections compared to other agents, thus respiratory viruses likely have similar impact on the clinical course as other agents. In 25% of the virus-positive patients, polymicrobial aetiology was identified. Comprehensive and sensitive diagnostic methods should be emphasized to enhance respiratory diagnostics.
我们的目的是确定 12 种常见呼吸道病毒在因呼吸道症状入住重症监护病房的患者中的频率,评估临床特征,并将结果与常规微生物学诊断进行比较。对 122 例年龄>18 岁、有急性呼吸道症状的重症监护患者入院时采集咽喉拭子,采用多重实时聚合酶链反应检测 12 种社区呼吸道病毒。根据临床医生的要求,对血液和呼吸道标本进行细菌和真菌分析。收集临床和辅助检查数据。在 122 例研究患者中,19 例(16%)检测到病毒。5 例病毒阳性患者(26%)可能同时检测到临床相关细菌或真菌。COPD 加重患者与病毒感染相关(p = 0.02)。其他合并症、临床和辅助检查参数以及死亡与病毒感染或细菌/真菌的共同检测无关。总之,在患者中经常检测到呼吸道病毒。与其他病原体相比,调查的临床和辅助检查参数在病毒感染中无差异,因此呼吸道病毒对临床病程的影响可能与其他病原体相似。在 25%的病毒阳性患者中,确定了混合病原体病因。应强调综合和敏感的诊断方法,以提高呼吸道诊断。