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Published on: February 23, 2014
Incidence and characteristics of viral community-acquired pneumonia in adults
L C Jennings1, T P Anderson, K A Beynon
1Canterbury Health Laboratories, P O Box 151, Christchurch, New Zealand. lance.jennings@cdhb.govt.nz
Background:
In adults, viral causes of community-acquired pneumonia (CAP) are poorly characterised. The aims of this study were to characterise the viral aetiology of CAP in adults by using an extensive array of viral diagnostic tests and to compare the characteristics of viral pneumonia with those of pneumococcal pneumonia.
Methods:
Adults admitted to Christchurch Hospital over a 1-year period with CAP were included in the study. Microbiological testing methods included blood and sputum cultures, urinary antigen testing for Streptococcus pneumoniae and Legionella pneumophila, antibody detection in paired sera and detection of respiratory viruses in nasopharyngeal swabs by immunofluorescence, culture and PCR.
Results:
Of 304 patients with CAP, a viral diagnosis was made in 88 (29%), with rhinoviruses and influenza A being the most common. Two or more pathogens were detected in 49 (16%) patients, 45 of whom had mixed viral and bacterial infections. There were no reliable clinical predictors of viral pneumonia, although several variables were independently associated with some aetiologies. The presence of myalgia was associated with pneumonia caused by any respiratory virus (OR 3.62, 95% CI 1.29 to 10.12) and influenza pneumonia (OR 190.72, 95% CI 3.68 to 9891.91). Mixed rhinovirus/pneumococcal infection was associated with severe disease.
Conclusions:
Virus-associated CAP is common in adults. Polymicrobial infections involving bacterial and viral pathogens are frequent and may be associated with severe pneumonia.
Insights
Viral community-acquired pneumonia (CAP) is common in adults, often involving multiple pathogens. Mixed viral and bacterial infections can lead to severe pneumonia, highlighting the need for comprehensive diagnostics.
Area of Science:
- Infectious Diseases
- Respiratory Medicine
- Virology
Background:
- Viral causes of community-acquired pneumonia (CAP) in adults are not well understood.
- This study aimed to characterize the viral etiology of CAP in adults and compare it with pneumococcal pneumonia.
Purpose of the Study:
- To determine the prevalence and characteristics of viral CAP in adults.
- To compare viral pneumonia with pneumococcal pneumonia.
- To identify potential predictors of viral pneumonia.
Main Methods:
- Adult CAP patients admitted to Christchurch Hospital were studied over one year.
- Extensive microbiological testing included cultures, antigen tests, serology, and respiratory virus detection (immunofluorescence, culture, PCR).
Main Results:
- A viral diagnosis was made in 29% of 304 CAP patients; rhinoviruses and influenza A were most common.
- Mixed viral and bacterial infections occurred in 16% of patients.
- Myalgia was associated with viral pneumonia, and mixed rhinovirus/pneumococcal infection with severe disease.
Conclusions:
- Virus-associated CAP is a frequent occurrence in adult populations.
- Polymicrobial infections involving both bacteria and viruses are common and may indicate severe pneumonia.
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The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed.