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Clinical relevance of and risk factors for HSV-related tracheobronchitis or pneumonia: results of an outbreak investigation

INTRODUCTION: Herpes simplex virus (HSV) type 1 was identified in respiratory specimens from a cluster of eight patients on a surgical intensive care unit within 8 weeks. Six of these patients suffered from HSV-related tracheobronchitis and one from HSV-related pneumonia only. Our outbreak investiga...

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Autores principales: Engelmann, Ilka, Gottlieb, Jens, Meier, Astrid, Sohr, Dorit, Ruhparwar, Arjang, Henke-Gendo, Cornelia, Gastmeier, Petra, Welte, Tobias, Schulz, Thomas Friedrich, Mattner, Frauke
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2007
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2246208/
https://www.ncbi.nlm.nih.gov/pubmed/17996032
http://dx.doi.org/10.1186/cc6175
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author Engelmann, Ilka
Gottlieb, Jens
Meier, Astrid
Sohr, Dorit
Ruhparwar, Arjang
Henke-Gendo, Cornelia
Gastmeier, Petra
Welte, Tobias
Schulz, Thomas Friedrich
Mattner, Frauke
author_facet Engelmann, Ilka
Gottlieb, Jens
Meier, Astrid
Sohr, Dorit
Ruhparwar, Arjang
Henke-Gendo, Cornelia
Gastmeier, Petra
Welte, Tobias
Schulz, Thomas Friedrich
Mattner, Frauke
author_sort Engelmann, Ilka
collection PubMed
description INTRODUCTION: Herpes simplex virus (HSV) type 1 was identified in respiratory specimens from a cluster of eight patients on a surgical intensive care unit within 8 weeks. Six of these patients suffered from HSV-related tracheobronchitis and one from HSV-related pneumonia only. Our outbreak investigation aimed to determine the clinical relevance of and risk factors associated with HSV-related tracheobronchitis or pneumonia in critically ill patients, and to investigate whether the cluster was caused by nosocomial transmission. METHODS: A retrospective cohort study was performed to identify risk factors for the outcomes of HSV-related tracheobronchitis or pneumonia and death using univariable analysis as well as logistic regression analysis. Viruses were typed by molecular analysis of a fragment of the HSV type 1 glycoprotein G. RESULTS: The cohort of patients covering the outbreak period comprised 53 patients, including six patients with HSV-related tracheobronchitis and one patient with pneumonia only. HSV-related tracheobronchitis or pneumonia was associated with increased mortality (100% in patients with versus 17.8% in patients without HSV-related tracheobronchitis or pneumonia; P < 0.0001). The interaction of longer duration of ventilation and tracheotomy was associated with HSV-related tracheobronchitis or pneumonia in multivariable analysis. Identical HSV type 1 glycoprotein G sequences were found in three patients and in two patients. The group of three identical viral sequences belonged to a widely circulating strain. The two identical viral sequences were recovered from bronchoalveolar lavages of one patient with HSV-related tracheobronchitis and of one patient without clinical symptoms. These viral sequences showed unique polymorphisms, indicating probable nosocomial transmission. CONCLUSION: HSV-related tracheobronchitis or pneumonia is associated with increased mortality in critically ill patients. Care should be taken to avoid nosocomial transmission and early diagnosis should be attempted.
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spelling pubmed-22462082008-02-20 Clinical relevance of and risk factors for HSV-related tracheobronchitis or pneumonia: results of an outbreak investigation Engelmann, Ilka Gottlieb, Jens Meier, Astrid Sohr, Dorit Ruhparwar, Arjang Henke-Gendo, Cornelia Gastmeier, Petra Welte, Tobias Schulz, Thomas Friedrich Mattner, Frauke Crit Care Research INTRODUCTION: Herpes simplex virus (HSV) type 1 was identified in respiratory specimens from a cluster of eight patients on a surgical intensive care unit within 8 weeks. Six of these patients suffered from HSV-related tracheobronchitis and one from HSV-related pneumonia only. Our outbreak investigation aimed to determine the clinical relevance of and risk factors associated with HSV-related tracheobronchitis or pneumonia in critically ill patients, and to investigate whether the cluster was caused by nosocomial transmission. METHODS: A retrospective cohort study was performed to identify risk factors for the outcomes of HSV-related tracheobronchitis or pneumonia and death using univariable analysis as well as logistic regression analysis. Viruses were typed by molecular analysis of a fragment of the HSV type 1 glycoprotein G. RESULTS: The cohort of patients covering the outbreak period comprised 53 patients, including six patients with HSV-related tracheobronchitis and one patient with pneumonia only. HSV-related tracheobronchitis or pneumonia was associated with increased mortality (100% in patients with versus 17.8% in patients without HSV-related tracheobronchitis or pneumonia; P < 0.0001). The interaction of longer duration of ventilation and tracheotomy was associated with HSV-related tracheobronchitis or pneumonia in multivariable analysis. Identical HSV type 1 glycoprotein G sequences were found in three patients and in two patients. The group of three identical viral sequences belonged to a widely circulating strain. The two identical viral sequences were recovered from bronchoalveolar lavages of one patient with HSV-related tracheobronchitis and of one patient without clinical symptoms. These viral sequences showed unique polymorphisms, indicating probable nosocomial transmission. CONCLUSION: HSV-related tracheobronchitis or pneumonia is associated with increased mortality in critically ill patients. Care should be taken to avoid nosocomial transmission and early diagnosis should be attempted. BioMed Central 2007 2007-11-08 /pmc/articles/PMC2246208/ /pubmed/17996032 http://dx.doi.org/10.1186/cc6175 Text en Copyright © 2007 Engelmann et al, licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Engelmann, Ilka
Gottlieb, Jens
Meier, Astrid
Sohr, Dorit
Ruhparwar, Arjang
Henke-Gendo, Cornelia
Gastmeier, Petra
Welte, Tobias
Schulz, Thomas Friedrich
Mattner, Frauke
Clinical relevance of and risk factors for HSV-related tracheobronchitis or pneumonia: results of an outbreak investigation
title Clinical relevance of and risk factors for HSV-related tracheobronchitis or pneumonia: results of an outbreak investigation
title_full Clinical relevance of and risk factors for HSV-related tracheobronchitis or pneumonia: results of an outbreak investigation
title_fullStr Clinical relevance of and risk factors for HSV-related tracheobronchitis or pneumonia: results of an outbreak investigation
title_full_unstemmed Clinical relevance of and risk factors for HSV-related tracheobronchitis or pneumonia: results of an outbreak investigation
title_short Clinical relevance of and risk factors for HSV-related tracheobronchitis or pneumonia: results of an outbreak investigation
title_sort clinical relevance of and risk factors for hsv-related tracheobronchitis or pneumonia: results of an outbreak investigation
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2246208/
https://www.ncbi.nlm.nih.gov/pubmed/17996032
http://dx.doi.org/10.1186/cc6175
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