Should lower respiratory tract secretions from intensive care patients be systematically screened for influenza virus during the influenza season?

Ref ID: 17700

Author:

M. Giannella*, B. Rodriguez-Sanchez, P. Lopez Roa, P. Catalan,
P. Muñoz, D. Garcia de Viedma, E. Bouza

Author address:

on behalf of the Gregorio
Marañón Task Force for Pneumonia GANG

Full conference title:

22nd European Congress of Clinical Microbiology and Infectious Diseases

Abstract:

Objective: To assess the burden of influenza in adult intensive care
units (ICUs) and the rate of overlooked and nosocomial cases during
the influenza season.
Methods: Prospective study of adult patients admitted to three ICUs of
our hospital from December 2010 to February 2011. All tracheal
aspirates (TA) sent for suspicion of lower respiratory tract (LRT)
infection were systematically tested for influenza. We defined influenza
as unsuspected if testing was not requested and patient was not on
empirical antiviral therapy after sample collection. Influenza was
classified as nosocomial if symptoms started after the first 72 hours of
hospital admission.
Results: We received TA from 100 patients with suspected LRT
infection. Bacteria, viruses, and Aspergillus spp. were identified in 37,
30, and three patients, respectively. No significant microorganisms were
found in the remaining 30 patients. Influenza was detected in 28 of the
30 patients with viral infection. Influenza was classified as unsuspected
in 15 (53.6%) and as nosocomial in 11 (39.3%) patients. Compared to
patients with suspected influenza, those with unsuspected influenza
were more commonly admitted to the surgical ICU (40% vs. 0%,
p = 0.001), were classified as having nosocomial influenza (33.3% vs.
7.7%, p = 0.002), and received antiviral treatment later after symptom
onset (median 9 vs. 2.5 days, p = 0.001). Overall, in-hospital mortality
of patients with influenza was 60.7%. We could not demonstrate higher
mortality among patients with unsuspected or nosocomial influenza.
Conclusions: During the influenza season, almost one-third of critical
patients with suspected LRT infection had influenza; in 53.6% of them
the influenza was unsuspected. Microbiology departments should
consider including systematic influenza testing in LRT secretions
from adult ICUs during influenza seasons.

Abstract Number: P1972

Conference Year: 2012

Link to conference website: NULL

New link: NULL

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