title: Immunosuppressed patients with pandemic influenza A 2009 (H1N1) virus infection.
abstract: The purpose of this paper was to prospectively characterize the clinical manifestations and outcomes of confirmed influenza A 2009 (H1N1) virus infection in immunosuppressed patients with hospital admission and compare them with those of a general population. A multicenter prospective cohort study was carried out. All adult patients admitted to 13 hospitals in Spain with confirmed influenza A 2009 (H1N1) virus infection from June 12, 2009 to November 11, 2009 were included. Risk factors for complicated influenza infection were studied in immunosuppressed patients. Overall, 559 patients were included, of which 56 were immunosuppressed, nine with solid or hematological malignancies, 18 with solid-organ transplant recipients, 13 with corticosteroid therapy, and six with other types of immunosuppression. Clinical findings at diagnosis were similar in both groups. Nineteen immunosuppressed patients had pneumonia (33.9%). Immunosuppressed patients with pandemic influenza had bacterial co-infection more frequently (17.9% vs. 6.4%, p = 0.02), specifically, gram-negative bacilli and Staphylococcus aureus infections. Mortality was higher in immunosuppressed patients (7.1% vs. 1.8%, p < 0.05). The only modifiable risk factor of complicated influenza A 2009 (H1N1) was delayed antiviral therapy. In immunosuppressed patients, influenza A 2009 (H1N1) virus infection has higher mortality than in non-immunosuppressed individuals. Bacterial co-infection is common in complicated cases.
authors.affiliation: Infectious Diseases Unit, University Hospital Virgen del Rocío, Av. Manuel Siurot s/n, 41013, Sevilla, Spain. mariae.cordero.sspa@juntadeandalucia.es
authors.forename: E
authors.initials: E
authors.lastname: Cordero
authors.forename: T
authors.initials: T
authors.lastname: Aydillo
authors.forename: M C
authors.initials: MC
authors.lastname: Fariñas
authors.forename: J R
authors.initials: JR
authors.lastname: Paño-Pardo
authors.forename: J
authors.initials: J
authors.lastname: Pachón
authors.forename: D
authors.initials: D
authors.lastname: Viasus
authors.forename: M
authors.initials: M
authors.lastname: Riera
authors.forename: F
authors.initials: F
authors.lastname: López-Medrano
authors.forename: A
authors.initials: A
authors.lastname: Payeras
authors.forename: A
authors.initials: A
authors.lastname: Moreno
authors.forename: J
authors.initials: J
authors.lastname: Rodríguez-Baño
authors.forename: J A
authors.initials: JA
authors.lastname: Oteo
authors.forename: J
authors.initials: J
authors.lastname: Martínez-Montauti
authors.forename: J
authors.initials: J
authors.lastname: Torre-Cisneros
authors.forename: F
authors.initials: F
authors.lastname: Segura
authors.forename: J
authors.initials: J
authors.lastname: Carratalá
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000008:administration & dosage; D015331:Cohort Studies; D060085:Coinfection / Q000453:epidemiology; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D053118:Influenza A Virus, H1N1 Subtype / Q000302:isolation & purification*; D007251:Influenza, Human / Q000188:drug therapy / Q000401:mortality / Q000473:pathology* / Q000821:virology*; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000453:epidemiology; D011446:Prospective Studies; D013030:Spain; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D007166:Immunosuppressive Agents