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Community-acquired pneumonia during the first post-pandemic influenza season: A prospective, multicentre cohort study

  • Diego Viasus
  • , Carmen Marinescu
  • , Aroa Villoslada
  • , Elisa Cordero
  • , Juan Gálvez-Acebal
  • , María C. Fariñas
  • , Irene Gracia-Ahufinger
  • , Anabel Fernández-Navarro
  • , Jordi Niubó
  • , Lucia Ortega
  • , Elena Muñez-Rubio
  • , María P. Romero-Gómez
  • , Jordi Carratalà
  • , Melchor Riera
  • , Antoni Payeras
  • , Victoria Férnandez-Baca
  • , Antonio Gutiérrez
  • , Teresa Aydillo
  • , Agdalena Sánchez
  • , Giovana Osorio
  • Caridad Milara, Pilar Perez-Romero, Jerónimo Pachón, Felipe Fernández-Cuenca, Jesús Rodríguez-Baño, Carmen Casillas Ruiz, Celia García De la Fuente, María Victoria Sanjuán, José Antonio Parra, Julián Torre-Cisneros, Manuel Casal, Manuel Causse, Juan Gutiérrez-Aroca, Rosario Lara, Antonio Rivero, Fernando Rodríguez, Rocio Tejero, Joaquín Martínez-Montauti, Francisca Portero Azorín, Antonio Ramos Martínez, Teresa Álvarez-Espejo Montiel, Sarah Caro-Bragado, José Ramón Paño-Pardo

Research output: Contribution to journalArticlepeer-review

22 Scopus citations

Abstract

Objectives: To determine the aetiology, clinical features and prognosis of CAP during the first post-pandemic influenza season. We also assessed the factors associated with severe disease and tested the ability of a scoring system for identifying influenza A (H1N1)pdm09-related pneumonia. Methods: Prospective cohort study carried out at 10 tertiary hospitals of Spain. All adults hospitalised with CAP from December 01, 2010 to March 31, 2011 were analysed. Results: A total of 747 adults with CAP required hospitalisation. The aetiology was determined in 315 (42.2%) patients, in whom 154 (21.9%) were due to bacteria, 125 (16.7%) were due to viruses and 36 (4.8%) were mixed (due to viruses and bacteria). The most frequently isolated bacteria were Streptococccus pneumoniae. Among patients with viral pneumonia, the most common organism identified were influenza A (H1N1)pdm09. Independent factors associated with severe disease were impaired consciousness, septic shock, tachypnea, hyponatremia, hypoxemia, influenza B, and influenza A (H1N1)pdm09. The scoring system evaluated did not differentiate reliably between patients with influenza A (H1N1)pdm09-related pneumonia and those with other aetiologies. Conclusions: The frequency of bacterial and viral pneumonia during the first post-pandemic influenza season was similar. The main identified virus was influenza A (H1N1)pdm09, which was associated with severe disease. Although certain presenting clinical features may allow recognition of influenza A (H1N1)pdm09-related pneumonia, it is difficult to express them in a reliable scoring system.

Original languageEnglish
Pages (from-to)185-193
Number of pages9
JournalJournal of Infection
Volume67
Issue number3
DOIs
StatePublished - Sep 2013
Externally publishedYes

Keywords

  • Clinical features
  • Community-acquired pneumonia
  • Influenza A (H1N1)pdm09
  • Mortality
  • Post-pandemic period

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