期刊
JOURNAL OF INFECTION
卷 67, 期 3, 页码 185-193出版社
W B SAUNDERS CO LTD
DOI: 10.1016/j.jinf.2013.05.006
关键词
Clinical features; Community-acquired pneumonia; Influenza A (H1N1) pdm09; Mortality; Post-pandemic period
资金
- Ministerio de Ciencia e Innovacion, Instituto de Salud Carlos III, Programa de Investigacion sobre gripe A/H1N1 [GR09/0014]
- Ministerio de Economia y Competitividad
- Instituto de Salud Carlos III
- European Development Regional Fund A way to achieve Europe ERDF
- Spanish Network for the Research in Infectious Diseases [REIPI RD12/0015]
- REIPI
Objectives: To determine the aetiology, clinical features and prognosis of CAP during the first post-pandemic influenza season. We also assessed the factors associated with severe disease and tested the ability of a scoring system for identifying influenza A (H1N1) pdm09-related pneumonia. Methods: Prospective cohort study carried out at 10 tertiary hospitals of Spain. All adults hospitalised with CAP from December 01, 2010 to March 31, 2011 were analysed. Results: A total of 747 adults with CAP required hospitalisation. The aetiology was determined in 315 (42.2%) patients, in whom 154 (21.9%) were due to bacteria, 125 (16.7%) were due to viruses and 36 (4.8%) were mixed (due to viruses and bacteria). The most frequently isolated bacteria were Streptococccus pneumoniae. Among patients with viral pneumonia, the most common organism identified were influenza A (H1N1) pdm09. Independent factors associated with severe disease were impaired consciousness, septic shock, tachypnea, hyponatremia, hypoxemia, influenza B, and influenza A (H1N1) pdm09. The scoring system evaluated did not differentiate reliably between patients with influenza A (H1N1) pdm09-related pneumonia and those with other aetiologies. Conclusions: The frequency of bacterial and viral pneumonia during the first post-pandemic influenza season was similar. The main identified virus was influenza A(H1N1) pdm09, which was associated with severe disease. Although certain presenting clinical features may allow recognition of influenza A (H1N1) pdm09-related pneumonia, it is difficult to express them in a reliable scoring system. (C) 2013 The British Infection Association. Published by Elsevier Ltd. All rights reserved.
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