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First influenza season after the 2009 pandemic influenza: characteristics of intensive care unit admissions in adults and children in Vall d'Hebron Hospital.
Clin Microbiol Infect. 2012 Apr; 18(4):374-80.CM

Abstract

To assess potential differences in epidemiology and management of patients admitted with influenza infection in the intensive care unit (ICU) during the first post-pandemic influenza period. Observational prospective study comparing September 2009-January 2010 with September 2010-January 2011. Variables captured: demographics, co-morbidities, physiological parameters, outcomes and management. Analysis was performed using SPSS v. 13.0; significance was set at p 0.5. Data from 53 patients, 38 adults (age, median 41.5 years; interquartile range (IQR) 32.8-51.3) and 15 children (age, median 2 years, IQR 0.5-9) are presented. Vaccination rates were 0% and 4.3% during the first and second periods, respectively. Differences postpandemic were: 100% of episodes developed after December compared with 16.7% in the 2009 season. Younger children were affected (median age 0.8 years (IQR 0.3-4.8) vs 7 years (IQR 1.25-11.5), p 0.05) and influenza B caused 8.7% of ICU admissions. Influenza A (H1N1) 2009 and respiratory syncytial virus epidemics occurred simultaneously (42.8% of children) and bacterial co-infections doubled (from 10% to 21.7%); the prevalence of co-infections (viral or bacterial) increased from 10% to 39.1% (OR 5.8, 95% CI 1.3-24.8). Respiratory syndromes without chest X-ray opacities reflecting exacerbation of asthma or chronic obstructive pulmonary disease, bronchitis or bronchiolitis increased (from 6.9% to 39.1%, p<0.05) and pneumonia decreased (from 83.3% to 56.5%, p <0.05). Primary viral pneumonia predominated among ICU admissions. Postpandemic ICU influenza developed later, with some cases of influenza B, more frequent bacterial and viral co-infections and more patients with severe acute respiratory infection with normal chest X-ray. Increasing vaccination rates among risk-group individuals is warranted to prevent ICU admission and death.

Authors+Show Affiliations

Department of Critical Care, Vall d'Hebron University Hospital, Barcelona, Spain.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21851487

Citation

Poulakou, G, et al. "First Influenza Season After the 2009 Pandemic Influenza: Characteristics of Intensive Care Unit Admissions in Adults and Children in Vall d'Hebron Hospital." Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases, vol. 18, no. 4, 2012, pp. 374-80.
Poulakou G, Souto J, Balcells J, et al. First influenza season after the 2009 pandemic influenza: characteristics of intensive care unit admissions in adults and children in Vall d'Hebron Hospital. Clin Microbiol Infect. 2012;18(4):374-80.
Poulakou, G., Souto, J., Balcells, J., Pérez, M., Laborda, C., Roca, O., Tórtola, T., Pujol, M., Palomar, M., & Rello, J. (2012). First influenza season after the 2009 pandemic influenza: characteristics of intensive care unit admissions in adults and children in Vall d'Hebron Hospital. Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases, 18(4), 374-80. https://doi.org/10.1111/j.1469-0691.2011.03617.x
Poulakou G, et al. First Influenza Season After the 2009 Pandemic Influenza: Characteristics of Intensive Care Unit Admissions in Adults and Children in Vall d'Hebron Hospital. Clin Microbiol Infect. 2012;18(4):374-80. PubMed PMID: 21851487.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - First influenza season after the 2009 pandemic influenza: characteristics of intensive care unit admissions in adults and children in Vall d'Hebron Hospital. AU - Poulakou,G, AU - Souto,J, AU - Balcells,J, AU - Pérez,M, AU - Laborda,C, AU - Roca,O, AU - Tórtola,T, AU - Pujol,M, AU - Palomar,M, AU - Rello,J, Y1 - 2011/08/18/ PY - 2011/8/20/entrez PY - 2011/8/20/pubmed PY - 2012/7/18/medline SP - 374 EP - 80 JF - Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases JO - Clin Microbiol Infect VL - 18 IS - 4 N2 - To assess potential differences in epidemiology and management of patients admitted with influenza infection in the intensive care unit (ICU) during the first post-pandemic influenza period. Observational prospective study comparing September 2009-January 2010 with September 2010-January 2011. Variables captured: demographics, co-morbidities, physiological parameters, outcomes and management. Analysis was performed using SPSS v. 13.0; significance was set at p 0.5. Data from 53 patients, 38 adults (age, median 41.5 years; interquartile range (IQR) 32.8-51.3) and 15 children (age, median 2 years, IQR 0.5-9) are presented. Vaccination rates were 0% and 4.3% during the first and second periods, respectively. Differences postpandemic were: 100% of episodes developed after December compared with 16.7% in the 2009 season. Younger children were affected (median age 0.8 years (IQR 0.3-4.8) vs 7 years (IQR 1.25-11.5), p 0.05) and influenza B caused 8.7% of ICU admissions. Influenza A (H1N1) 2009 and respiratory syncytial virus epidemics occurred simultaneously (42.8% of children) and bacterial co-infections doubled (from 10% to 21.7%); the prevalence of co-infections (viral or bacterial) increased from 10% to 39.1% (OR 5.8, 95% CI 1.3-24.8). Respiratory syndromes without chest X-ray opacities reflecting exacerbation of asthma or chronic obstructive pulmonary disease, bronchitis or bronchiolitis increased (from 6.9% to 39.1%, p<0.05) and pneumonia decreased (from 83.3% to 56.5%, p <0.05). Primary viral pneumonia predominated among ICU admissions. Postpandemic ICU influenza developed later, with some cases of influenza B, more frequent bacterial and viral co-infections and more patients with severe acute respiratory infection with normal chest X-ray. Increasing vaccination rates among risk-group individuals is warranted to prevent ICU admission and death. SN - 1469-0691 UR - https://www.unboundmedicine.com/medline/citation/21851487/First_influenza_season_after_the_2009_pandemic_influenza:_characteristics_of_intensive_care_unit_admissions_in_adults_and_children_in_Vall_d'Hebron_Hospital_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1198-743X(14)61450-6 DB - PRIME DP - Unbound Medicine ER -