VIRAL INFECTION IN ADULTS HOSPITALIZED WITH COMMUNITY-ACQUIRED PNEUMONIA: PREVALENCE, PATHOGENS AND PRESENTATION

Community acquired pneumonia has an important role in the morbidity and mortality in any given adult population and as the potential role of respiratory viruses in the natural history of community-acquired pneumonia (CAP) in adults has not been well described since the advent of nucleic amplification tests (NATs) this study was undertaken to answer the same. From 2004 to 2006, adults with CAP who were admitted to five hospitals were prospectively enrolled in the study, and clinical data, cultures, serology, and nasopharyngeal swabs were obtained. NATs from swabs were tested for influenza, human metapneumovirus (hMPV), respiratory syncytial virus (RSV), rhinovirus, parainfluenza virus 1-4, coronaviruses, and adenoviruses. In this study a total of 193 patients were included; the median age was 71 years, of which 51% were male, and 47% of patients had severe CAP. Overall, 39% had a pathogen identified and of this, 15% were viral, 20% were bacterial, 4% were mixed, and the rest were "unknown." Influenza, hMPV, and RSV accounted for most viral infections. Streptococcus pneumoniae was the most common bacterial infection (37%). Compared with bacterial infection, patients with viral infection were older (76 vs 64 years, respectively; were more likely to have cardiac disease (66% vs 32%), and were more frail. Viral infections are common in adults with pneumonia. Easily transmissible viruses such as influenza, hMPV, and RSV were the most common, raising concerns about infection control.

Educational article provided by Solvay Pharmaceuticals.