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Molecular detection of respiratory viruses in immunocopromised ICU patients: Incidence and meaning

PURPOSE: Prospective single-center study to assess the sensitivity and clinical relevance of molecular testing for respiratory viruses in critically ill immunocompromised patients with acute respiratory failure (ARF). METHODS: 100 consecutive critically ill immunocompromised patients with ARF in 200...

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Autores principales: Schnell, David, Legoff, Jérôme, Mariotte, Eric, Seguin, Amélie, Canet, Emmanuel, Lemiale, Virginie, Darmon, Michael, Schlemmer, Benoît, Simon, François, Azoulay, Élie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier Ltd. 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7126300/
https://www.ncbi.nlm.nih.gov/pubmed/22647492
http://dx.doi.org/10.1016/j.rmed.2012.05.001
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author Schnell, David
Legoff, Jérôme
Mariotte, Eric
Seguin, Amélie
Canet, Emmanuel
Lemiale, Virginie
Darmon, Michael
Schlemmer, Benoît
Simon, François
Azoulay, Élie
author_facet Schnell, David
Legoff, Jérôme
Mariotte, Eric
Seguin, Amélie
Canet, Emmanuel
Lemiale, Virginie
Darmon, Michael
Schlemmer, Benoît
Simon, François
Azoulay, Élie
author_sort Schnell, David
collection PubMed
description PURPOSE: Prospective single-center study to assess the sensitivity and clinical relevance of molecular testing for respiratory viruses in critically ill immunocompromised patients with acute respiratory failure (ARF). METHODS: 100 consecutive critically ill immunocompromised patients with ARF in 2007–2009. Among them, 65 had hematologic malignancies (including 14 hematopoietic stem cell transplant recipients), 22 had iatrogenic immunosuppression, and 13 had solid malignancies. A multiplex molecular assay (MMA) was added to the usual battery of tests performed to look for causes of ARF. RESULTS: Nasopharyngeal aspirates and/or bronchoalveolar lavage fluid were tested for respiratory viruses using both the MMA and immunofluorescence. A virus was detected in 47 (47%) patients using the MMA and 8 (8%) patients using immunofluorescence (P = 0.006). MMA-positive and MMA-negative patients had similar clinical and radiographic presentations and were not significantly different for the use of ventilatory support (58% vs. 76%, P = 0.09), occurrence of shock (43% vs. 53%, P = 0.41), use of renal replacement therapy (26% vs. 23%, P = 0.92), SAPS II (35 [26–44] vs. 38 [27–50], P = 0.36), time spent in the ICU (6 vs. 7 days, P = 0.35), or ICU mortality (17% vs. 28%, P = 0.27). Using MMA, a virus was found in 6 of the 12 patients with no diagnosis at the end of the etiologic investigations. CONCLUSIONS: In critically ill immunocompromised patients, an MMA was far more sensitive than immunofluorescence for respiratory virus detection. Patients with RVs detected in the respiratory tract had the same clinical characteristics and outcomes as other patients.
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spelling pubmed-71263002020-04-08 Molecular detection of respiratory viruses in immunocopromised ICU patients: Incidence and meaning Schnell, David Legoff, Jérôme Mariotte, Eric Seguin, Amélie Canet, Emmanuel Lemiale, Virginie Darmon, Michael Schlemmer, Benoît Simon, François Azoulay, Élie Respir Med Article PURPOSE: Prospective single-center study to assess the sensitivity and clinical relevance of molecular testing for respiratory viruses in critically ill immunocompromised patients with acute respiratory failure (ARF). METHODS: 100 consecutive critically ill immunocompromised patients with ARF in 2007–2009. Among them, 65 had hematologic malignancies (including 14 hematopoietic stem cell transplant recipients), 22 had iatrogenic immunosuppression, and 13 had solid malignancies. A multiplex molecular assay (MMA) was added to the usual battery of tests performed to look for causes of ARF. RESULTS: Nasopharyngeal aspirates and/or bronchoalveolar lavage fluid were tested for respiratory viruses using both the MMA and immunofluorescence. A virus was detected in 47 (47%) patients using the MMA and 8 (8%) patients using immunofluorescence (P = 0.006). MMA-positive and MMA-negative patients had similar clinical and radiographic presentations and were not significantly different for the use of ventilatory support (58% vs. 76%, P = 0.09), occurrence of shock (43% vs. 53%, P = 0.41), use of renal replacement therapy (26% vs. 23%, P = 0.92), SAPS II (35 [26–44] vs. 38 [27–50], P = 0.36), time spent in the ICU (6 vs. 7 days, P = 0.35), or ICU mortality (17% vs. 28%, P = 0.27). Using MMA, a virus was found in 6 of the 12 patients with no diagnosis at the end of the etiologic investigations. CONCLUSIONS: In critically ill immunocompromised patients, an MMA was far more sensitive than immunofluorescence for respiratory virus detection. Patients with RVs detected in the respiratory tract had the same clinical characteristics and outcomes as other patients. Elsevier Ltd. 2012-08 2012-05-29 /pmc/articles/PMC7126300/ /pubmed/22647492 http://dx.doi.org/10.1016/j.rmed.2012.05.001 Text en Copyright © 2012 Elsevier Ltd. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Article
Schnell, David
Legoff, Jérôme
Mariotte, Eric
Seguin, Amélie
Canet, Emmanuel
Lemiale, Virginie
Darmon, Michael
Schlemmer, Benoît
Simon, François
Azoulay, Élie
Molecular detection of respiratory viruses in immunocopromised ICU patients: Incidence and meaning
title Molecular detection of respiratory viruses in immunocopromised ICU patients: Incidence and meaning
title_full Molecular detection of respiratory viruses in immunocopromised ICU patients: Incidence and meaning
title_fullStr Molecular detection of respiratory viruses in immunocopromised ICU patients: Incidence and meaning
title_full_unstemmed Molecular detection of respiratory viruses in immunocopromised ICU patients: Incidence and meaning
title_short Molecular detection of respiratory viruses in immunocopromised ICU patients: Incidence and meaning
title_sort molecular detection of respiratory viruses in immunocopromised icu patients: incidence and meaning
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7126300/
https://www.ncbi.nlm.nih.gov/pubmed/22647492
http://dx.doi.org/10.1016/j.rmed.2012.05.001
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