Kliniken für Pneumologie und Infektiologie, EVK Herne und Augusta-Kranken-Anstalt Bochum, Thoraxzentrum Ruhrgebiet, Bergstrasse 26, 44791, Bochum, Germany.
Ruhr-Universität Bochum, Institut für Mikrobiologie (IML), Bochum, Germany.
Infection. 2019 Jun;47(3):425-433. doi: 10.1007/s15010-018-1262-x. Epub 2019 Jan 16.
We studied the incidence, morbidity and mortality of all patients presenting in our teaching hospital with proven influenza virus and/or respiratory syncytial virus (RSV) infection during the influenza epidemic season 2018 which was characterized by a predominant incidence of influenza virus B type B of the Yamagata line.
In the fall of 2017, specific precaution measures in addition to standard measures were implemented, including standardized testing for influenza virus A,B and RSV by multiplex PCR of pharyngeal swabsData from all consecutive patients were analyzed retrospectively.
Overall 651 patients were examined for the presence of influenza virus and RSV; 214 patients had influenza virus A (n = 36), B (n = 152), and/or RSV (n = 30), including four patients with dual infection. 86% of cases had influenza virus (80% B), and 14% RSV infection. N = 23 cases were treated as outpatients. The rate of acute viral respiratory infections (influenza virus and RSV) was 191 of 2776 (6.9%) admissions to medical wards. Of n = 191 hospitalized cases, n = 44 cases (20.6%) had nosocomial infection. Viral infections were associated with a high morbidity (pneumonia 28.5%, mortality 4.7%). Independent predictors of prolonged hospitalization were the presence of pneumonia, NIV and renal complications, and independent predictors of pneumonia were age ≥ 65 years, bedridden status and CRP ≥ 2.9 mg/dL.
The rate of nosocomial cases was high despite established precaution measures. RSV was associated with morbidity and mortality comparable to influenza. Pneumonia remains the main complication of acute viral respiratory infections, and antimicrobial treatment should include both antiviral as well as antibacterial agents.
我们研究了在 2018 年流感流行季节期间，我院确诊流感病毒和/或呼吸道合胞病毒（RSV）感染的所有患者的发病率、患病率和死亡率。该流感流行季节的特点是乙型流感病毒 Yamagata 系占主导地位。
2017 年秋季，除了标准措施外，还实施了特定的预防措施，包括通过咽拭子多重 PCR 对流感病毒 A、B 和 RSV 进行标准化检测。对所有连续患者的数据进行回顾性分析。
共有 651 例患者接受了流感病毒和 RSV 的检测；214 例患者感染了流感病毒 A（n=36）、B（n=152）和/或 RSV（n=30），包括 4 例双重感染。86%的病例为流感病毒（80%为 B 型），14%为 RSV 感染。n=23 例为门诊治疗。内科病房住院患者中急性病毒性呼吸道感染（流感病毒和 RSV）的发生率为 2776 例中的 191 例（6.9%）。191 例住院患者中，n=44 例（20.6%）发生医院感染。病毒感染与高发病率（肺炎 28.5%，死亡率 4.7%）相关。延长住院时间的独立预测因素是肺炎、NIV 和肾脏并发症的存在，肺炎的独立预测因素是年龄≥65 岁、卧床状态和 CRP≥2.9mg/dL。
尽管采取了既定的预防措施，但医院感染的发生率仍然很高。RSV 与流感相比，发病率和死亡率相当。肺炎仍然是急性病毒性呼吸道感染的主要并发症，抗菌治疗应同时包括抗病毒和抗菌药物。
