Elsevier

Journal of Clinical Virology

Volume 83, October 2016, Pages 37-42
Journal of Clinical Virology

Clinical practice of respiratory virus diagnostics in critically ill patients with a suspected pneumonia: A prospective observational study

https://doi.org/10.1016/j.jcv.2016.08.295Get rights and content
Under a Creative Commons license
open access

Highlights

  • Guidelines are unclear which ICU patients should be tested for respiratory viruses.

  • Less than half of ICU patients with CAP or HAP are tested for viral pathogens.

  • In ICU patients who were tested, the prevalence of viral infections is 16–34%.

  • There is room for increasing routine testing of influenza virus in CAP and HAP.

Abstract

Background

Clinical guidelines suggest testing for respiratory viruses during the influenza season, but are unclear which categories of patients on the intensive care unit (ICU) should be tested.

Objective

We described the clinical practice of diagnostic testing for respiratory virus infections in patients presenting to ICU with suspected community-acquired pneumonia (CAP) or hospital-acquired pneumonia (HAP).

Study design

Prospective observational study in consecutive CAP and HAP patients with an ICU stay of more than 24 h in two tertiary care hospitals in The Netherlands, from 2011 to December 2013. The proportion of patients receiving diagnostic testing with PCR for the presence of respiratory viruses in respiratory tract specimens was determined.

Results

In total, 1452 patients were included, of which 712 patients presented with CAP and 740 with HAP. In CAP, 282 of 712 (40%) were tested for respiratory viruses (190 of 417 (46%) during the influenza season). In HAP, 95 of 740 (13%) were tested (50 of 372 (13%) during the influenza season). Regardless of the season, virus diagnostic tests were ordered significantly more often in patients with comorbidities, and in those presenting with elevated CRP and leucopenia. In patients who were tested during the influenza season, the prevalence of influenza was 14% in patients with CAP and 10% in those with HAP. Influenza was absent during the summer in both groups.

Conclusions

Less than half of patients admitted to the ICU with suspected pneumonia were tested for the presence of viral pathogens, either in or outside the influenza season.

Keywords

Respiratory tract infections
Virus diseases
Pneumonia
Routine diagnostic tests
Intensive care
Influenza

Cited by (0)

1

Both authors contributed equally to this work as co-first authors.

2

Members of the MARS Consortium are listed in the acknowledgments section.