TY  - BOOK
AU  - Shorr, Andrew F
TI  - Viruses are prevalent in non-ventilated hospital-acquired pneumonia
SN  - 0954-6111
PY  - 2017///
KW  - *Cross Infection/vi [Virology]
KW  - *Pneumonia, Viral/vi [Virology]
KW  - *Prevalence
KW  - *Respiration, Artificial/td [Trends]
KW  - *Viruses/ip [Isolation & Purification]
KW  - Adult
KW  - Aged
KW  - Bacteria/ip [Isolation & Purification]
KW  - Cross Infection/di [Diagnosis]
KW  - Cross Infection/ep [Epidemiology]
KW  - Female
KW  - Humans
KW  - Influenza, Human/ep [Epidemiology]
KW  - Influenza, Human/vi [Virology]
KW  - Length of Stay/sn [Statistics & Numerical Data]
KW  - Male
KW  - Middle Aged
KW  - Paramyxoviridae Infections/ep [Epidemiology]
KW  - Paramyxoviridae Infections/vi [Virology]
KW  - Pneumonia, Bacterial/di [Diagnosis]
KW  - Pneumonia, Bacterial/ep [Epidemiology]
KW  - Pneumonia, Bacterial/mi [Microbiology]
KW  - Pneumonia, Viral/di [Diagnosis]
KW  - Pneumonia, Viral/ep [Epidemiology]
KW  - Respiration, Artificial/sn [Statistics & Numerical Data]
KW  - Retrospective Studies
KW  - Rhinovirus/ip [Isolation & Purification]
KW  - Treatment Outcome
KW  - Viruses/py [Pathogenicity]
KW  - MedStar Washington Hospital Center
KW  - Medicine/Pulmonary-Critical Care
KW  - Journal Article
N2  - BACKGROUND: Hospital-acquired pneumonia arising in non-ventilated patients (NVHAP) is traditionally thought to be caused by bacteria, and little is known about viral etiologies in this syndrome. We sought to describe the prevalence of viruses causing NVHAP and to determine factors independently associated with the isolation of a virus; CONCLUSIONS: Viruses represent a common cause of NVHAP. Clinicians should consider viral diagnostic testing in NVHAP, as this may represent a means to enhance antimicrobial stewardship; Copyright � 2016 Elsevier Ltd. All rights reserved; METHODS: We identified patients with NVHAP over one year and reviewed their cultures to determine etiologies. Patients with a viral process were compared to those with either negative cultures or a bacterial infection to determine variables independently associated with the recovery of a virus; RESULTS: Among 174 cases, cultures were positive in 46.0%, with viruses identified in 22.4%. Bacterial pathogens arose 23.6% of subjects. The most common viruses included rhinovirus, influenza, and parainfluenza. We noted no seasonality in the isolation of viral organisms, and most cases of viral NVHAP developed after more than a week length of stay (LOS). Outcomes in viral NVHAP were similar to those with bacterial NVHAP. Patients with viral and bacterial NVHAP were generally similar. Two variables were independently associated with isolation of a virus: a history of coronary artery disease (adjusted odds ratio: 5.16, 95% CI: 1.14-22.44) and a LOS of greater than 10 days prior to NVHAP diagnosis (adjusted odds ratio: 2.97, 95% CI: 1.35-6.51). As a screening test for a virus, neither had a good sensitivity or specificity
UR  - https://dx.doi.org/10.1016/j.rmed.2016.11.023
ER  -