title: Respiratory virology and microbiology in intensive care units: a prospective cohort study.
abstract: Our aim was to determine the frequency of 12 common respiratory viruses in patients admitted to intensive care units with respiratory symptoms, evaluate the clinical characteristics and to compare the results to routine microbiological diagnostics. Throat swabs from 122 intensive care-patients >18 years with acute respiratory symptoms were collected upon admission and analysed with multiplex real-time polymerase chain reaction, for 12 community respiratory viruses. Blood and respiratory tract specimens were analysed for bacteria and fungi upon clinicians' request. Clinical and paraclinical data were collected. Viruses were detected in 19 (16%) of the 122 study patients. Five virus-positive patients (26%) had possible clinically relevant bacteria or fungi co-detected. Patients with exacerbation in COPD were associated with a viral infection (p = 0.02). Other comorbidities, clinical and paraclinical parameters, and death were independent of a viral infection or co-detection of bacteria/fungi. In conclusion, respiratory viruses were frequently detected in the patients. The investigated clinical and paraclinical parameters were not different in viral infections compared to other agents, thus respiratory viruses likely have similar impact on the clinical course as other agents. In 25% of the virus-positive patients, polymicrobial aetiology was identified. Comprehensive and sensitive diagnostic methods should be emphasized to enhance respiratory diagnostics.
authors.affiliation: Department of Microbiological Diagnostics and Virology, Statens Serum Institut, Copenhagen.
authors.forename: Anne-Cathrine
authors.initials: AC
authors.lastname: Østby
authors.forename: Sophie
authors.initials: S
authors.lastname: Gubbels
authors.forename: Gerben
authors.initials: G
authors.lastname: Baake
authors.forename: Lars Peter
authors.initials: LP
authors.lastname: Nielsen
authors.forename: Casper
authors.initials: C
authors.lastname: Riedel
authors.forename: Magnus
authors.initials: M
authors.lastname: Arpi
mesh_terms: D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010614:Pharynx / Q000382:microbiology / Q000821:virology; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000382:microbiology* / Q000401:mortality / Q000821:virology*
keywords: PCR; Respiratory viruses; acute respiratory disease; influenza; intensive care