Bacterial complications of respiratory tract viral illness: a comprehensive evaluation.
Bacterial complications of respiratory tract viral illness: a comprehensive evaluation.
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DOI：
10.1093/infdis/jit190
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发表时间：
2013-08-01
期刊：
影响因子：
--
通讯作者：
Walsh EE
中科院分区：
文献类型：
--
作者：
Falsey AR;Becker KL;Swinburne AJ;Nylen ES;Formica MA;Hennessey PA;Criddle MM;Peterson DR;Baran A;Walsh EE
背景：呼吸道感染是成人住院治疗的最常见原因之一，最近的证据表明，许多这类疾病与病毒有关。 虽然已知细菌感染会使病毒感染复杂化，但病毒-细菌混合感染的频率和影响尚未得到充分研究。 方法：对3个冬季因呼吸道疾病住院的成人进行全面的病毒和细菌检测。 通过测量血清降钙素原（PCT）水平作为细菌感染的标志物来增强该评估。病毒-细菌混合感染定义为入院时或住院第2天病毒检测结果阳性加上细菌检测结果阳性或血清PCT水平≥ 0.25 ng/mL。 结果：在842例住院患者（771例）中，348例（41%）有病毒感染的证据。 共有212例住院（61%）患者仅涉及病毒感染。在其余136例涉及病毒感染的住院治疗（39%）中，64例（18%）的细菌检测结果为阳性，PCT分析确定了另外72例（21%）的细菌感染。因病毒-细菌混合感染住院的受试者年龄较大，更常被诊断为肺炎。两组中超过90%的住院患者接受了抗生素治疗。值得注意的是，在仅因病毒感染住院的受试者中，10例死亡中有4例继发于艰难梭菌结肠炎并发症。 结论：约40%需要住院治疗的病毒性呼吸道感染与细菌合并感染有关。 对于病毒检测结果阳性的患者，应仔细评估是否存在合并细菌感染。早期经验性抗生素治疗对病情不稳定的患者是合适的，但并非没有风险。
Background. Respiratory tract infection is one of the most common reasons for hospitalization among adults, and recent evidence suggests that many of these illnesses are associated with viruses. Although bacterial infection is known to complicate viral infections, the frequency and impact of mixed viral-bacterial infections has not been well studied. Methods. Adults hospitalized with respiratory illness during 3 winters underwent comprehensive viral and bacterial testing. This assessment was augmented by measuring the serum level of procalcitonin (PCT) as a marker of bacterial infection. Mixed viral-bacterial infection was defined as a positive viral test result plus a positive bacterial assay result or a serum PCT level of ≥ 0.25 ng/mL on admission or day 2 of hospitalization. Results. Of 842 hospitalizations (771 patients) evaluated, 348 (41%) had evidence of viral infection. A total of 212 hospitalizations (61%) involved patients with viral infection alone. Of the remaining 136 hospitalizations (39%) involving viral infection, results of bacterial tests were positive in 64 (18%), and PCT analysis identified bacterial infection in an additional 72 (21%). Subjects hospitalized with mixed viral-bacterial infections were older and more commonly received a diagnosis of pneumonia. Over 90% of hospitalizations in both groups involved subjects who received antibiotics. Notably, 4 of 10 deaths among subjects hospitalized with viral infection alone were secondary to complications of Clostridium difficile colitis. Conclusions. Bacterial coinfection is associated with approximately 40% of viral respiratory tract infections requiring hospitalization. Patients with positive results of viral tests should be carefully evaluated for concomitant bacterial infection. Early empirical antibiotic therapy for patients with an unstable condition is appropriate but is not without risk.
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DOI：
10.1016/s1473-3099(06)70466-2
发表时间：
2006-05
期刊：
The Lancet. Infectious diseases
影响因子：
--
作者：
Brundage JF
通讯作者：
Brundage JF
影响因子：
3.7
作者：
Miggins, Makesha;Hasan, Anjum;Ang, Darwin
通讯作者：
Ang, Darwin
影响因子：
4.8
作者：
Dhanoa A;Fang NC;Hassan SS;Kaniappan P;Rajasekaram G
通讯作者：
Rajasekaram G
DOI：
10.1111/j.2517-6161.1995.tb02031.x
发表时间：
1995-01-01
影响因子：
5.8
作者：
BENJAMINI, Y;HOCHBERG, Y
通讯作者：
HOCHBERG, Y
影响因子：
9.4
作者：
Rand, Kenneth H.;Rampersaud, Howard;Houck, Herbert J.
通讯作者：
Houck, Herbert J.