Clinical relevance of and risk factors for HSV-related tracheobronchitis or pneumonia: results of an outbreak investigation View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2007-12

AUTHORS

Ilka Engelmann, Jens Gottlieb, Astrid Meier, Dorit Sohr, Arjang Ruhparwar, Cornelia Henke-Gendo, Petra Gastmeier, Tobias Welte, Thomas Friedrich Schulz, Frauke Mattner

ABSTRACT

INTRODUCTION: Herpes simplex virus (HSV) type 1 was identified in respiratory specimens from a cluster of eight patients on a surgical intensive care unit within 8 weeks. Six of these patients suffered from HSV-related tracheobronchitis and one from HSV-related pneumonia only. Our outbreak investigation aimed to determine the clinical relevance of and risk factors associated with HSV-related tracheobronchitis or pneumonia in critically ill patients, and to investigate whether the cluster was caused by nosocomial transmission. METHODS: A retrospective cohort study was performed to identify risk factors for the outcomes of HSV-related tracheobronchitis or pneumonia and death using univariable analysis as well as logistic regression analysis. Viruses were typed by molecular analysis of a fragment of the HSV type 1 glycoprotein G. RESULTS: The cohort of patients covering the outbreak period comprised 53 patients, including six patients with HSV-related tracheobronchitis and one patient with pneumonia only. HSV-related tracheobronchitis or pneumonia was associated with increased mortality (100% in patients with versus 17.8% in patients without HSV-related tracheobronchitis or pneumonia; P < 0.0001). The interaction of longer duration of ventilation and tracheotomy was associated with HSV-related tracheobronchitis or pneumonia in multivariable analysis. Identical HSV type 1 glycoprotein G sequences were found in three patients and in two patients. The group of three identical viral sequences belonged to a widely circulating strain. The two identical viral sequences were recovered from bronchoalveolar lavages of one patient with HSV-related tracheobronchitis and of one patient without clinical symptoms. These viral sequences showed unique polymorphisms, indicating probable nosocomial transmission. CONCLUSION: HSV-related tracheobronchitis or pneumonia is associated with increased mortality in critically ill patients. Care should be taken to avoid nosocomial transmission and early diagnosis should be attempted. More... »

PAGES

r119

References to SciGraph publications

  • 2002-10. Clinical Significance of Herpes Simplex Virus in the Lower Respiratory Tract of Critically Ill Patients in EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES
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    http://scigraph.springernature.com/pub.10.1186/cc6175

    DOI

    http://dx.doi.org/10.1186/cc6175

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1045728545

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/17996032


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