Influenza infection in the intensive care unit: Four years after the 2009 pandemic

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• 作者：Marcos Pé ; rez-Carrasco^a ; ^{marperez@vhebron.net" class="auth_mail" title="E-mail the corresponding author} ; Leonel Lagunes^a ; André ; s Antó ; n^b ; Simone Gattarello^a ; Cé ; sar Laborda^a ; Tomá ; s Pumarola^b ; Jordi Rello^a ; ^c ; CRIPS investigators^a
• 关键词：Influenza A virus ; A(H1N1)pdm09 ; Influenza-like illness ; Severe acute respiratory infection ; Acute respiratory failure
• 刊名：Enfermedades Infecciosas y Microbiología Clínica
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：34
• 期：3
• 页码：177-183
• 全文大小：623 K

文摘

The role of influenza viruses in severe acute respiratory infection (SARI) in Intensive Care Units (ICU) remains unknown. The post-pandemic influenza A(H1N1)pdm09 period, in particular, has been poorly studied.

Objective

To identify influenza SARI patients in ICU, to assess the usefulness of the symptoms of influenza-like illness (ILI), and to compare the features of pandemic vs. post-pandemic influenza A(H1N1) pdm09 infection.

Methods

A prospective observational study with SARI patients admitted to ICU during the first three post-pandemic seasons. Patient demographics, characteristics and outcomes were recorded. An influenza epidemic period (IEP) was defined as >100 cases/100,000 inhabitants per week.

Results

One hundred sixty-three patients were diagnosed with SARI. ILI was present in 65 (39.9%) patients. Influenza infection was documented in 41 patients, 27 (41.5%) ILI patients, and 14 (14.3%) non-ILI patients, 27 of them during an IEP. Influenza A viruses were mainly responsible. Only five patients had influenza B virus infection, which were non-ILI during an IEP. SARI overall mortality was 22.1%, and 15% in influenza infection patients. Pandemic and post-pandemic influenza infection patients shared similar clinical features.

Conclusions

During influenza epidemic periods, influenza infection screening should be considered in all SARI patients. Influenza SARI was mainly caused by subtype A(H1N1)pdm09 and A(H3N2) in post-pandemic seasons, and no differences were observed in ILI and mortality rate compared with a pandemic season.