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Comparison of viral infection in healthcare-associated pneumonia (HCAP) and community-acquired pneumonia (CAP).

 Eun Sun Kim  ;  Kyoung Un Park  ;  Sang Hoon Lee  ;  Yeon Joo Lee  ;  Jong Sun Park  ;  Young-Jae Cho  ;  Ho Il Yoon  ;  Choon-Taek Lee  ;  Jae Ho Lee 
 PLOS ONE, Vol.13(2) : e0192893, 2018 
Journal Title
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Aged ; Bacterial Infections/epidemiology ; Bacterial Infections/etiology ; Bacterial Infections/virology ; Community-Acquired Infections/epidemiology* ; Community-Acquired Infections/microbiology ; Community-Acquired Infections/virology ; Cross Infection/epidemiology* ; Cross Infection/microbiology ; Cross Infection/virology ; Female ; Humans ; Length of Stay ; Male ; Pneumonia/epidemiology* ; Pneumonia/etiology* ; Pneumonia/microbiology ; Pneumonia/virology ; Prevalence ; Republic of Korea ; Seasons ; Tertiary Care Centers ; Virus Diseases/epidemiology ; Virus Diseases/etiology ; Virus Diseases/microbiology
BACKGROUND: Although viruses are known to be the second most common etiological factor in community-acquired pneumonia (CAP), the respiratory viral profile of the patients with healthcare-associated pneumonia (HCAP) has not yet been elucidated. We investigated the prevalence and the clinical impact of respiratory virus infection in adult patients with HCAP. METHODS: Patients admitted with HCAP or CAP, between January and December 2016, to a tertiary referral hospital in Korea, were prospectively enrolled, and virus identification was performed using reverse-transcription polymerase chain reaction (RT-PCR). RESULTS: Among 452 enrolled patients (224 with HCAP, 228 with CAP), samples for respiratory viruses were collected from sputum or endotracheal aspirate in 430 (95.1%) patients and from nasopharyngeal specimens in 22 (4.9%) patients. Eighty-seven (19.2%) patients had a viral infection, and the proportion of those with viral infection was significantly lower in the HCAP than in the CAP group (13.8% vs 24.6%, p = 0.004). In both the HCAP and CAP groups, influenza A was the most common respiratory virus, followed by entero-rhinovirus. The seasonal distributions of respiratory viruses were also similar in both groups. In the HCAP group, the viral infection resulted in a similar length of hospital stay and in-hospital mortality as viral-bacterial coinfection and bacterial infection, and the CAP group showed similar results. CONCLUSIONS: The prevalence of viral infection in patients with HCAP was lower than that in patients with CAP, and resulted in a similar prognosis as viral-bacterial coinfection or bacterial infection.
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Yonsei Authors
Lee, Sang Hoon(이상훈) ORCID logo https://orcid.org/0000-0002-7706-5318
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