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A prospective assessment of the role of respiratory viruses and atypical bacteria in patients hospitalized with severe lower respiratory tract infections

English title A prospective assessment of the role of respiratory viruses and atypical bacteria in patients hospitalized with severe lower respiratory tract infections
Applicant Kaiser Laurent
Number 101670
Funding scheme Project funding (Div. I-III)
Research institution Laboratoire central de virologie Hôpital cantonal universitaire
Institution of higher education University of Geneva - GE
Main discipline Infectious Diseases
Start/End 01.01.2004 - 31.12.2006
Approved amount 176'118.00
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All Disciplines (2)

Discipline
Infectious Diseases
Respiratory Diseases

Keywords (5)

respiratory viruses; atypical bacteria; immunocompromised hosts; pneumonia; respiratory infections

Lay Summary (English)

Lead
Lay summary
Respiratory viruses can be considered as the first cause of infections in humans. In healthy adults the disease is generally restricted to the upper respiratory tract and self-limited. However, respiratory viruses contribute also to lower respiratory tract diseases either directly by infecting the lower respiratory tract itself or indirectly by promoting complications, particularly in those with chronic lung diseases. Acute lower respiratory tract infections and community acquired pneumonia are among the most frequent causes of hospitalizations. Most of these episodes might be initially linked to a viral respiratory tract infection. The use of appropriate sensitive tools covering the largest possible number of viruses could shed a light on the respective role of each respiratory virus. This is of particular importance given the recent discovery of several new respiratory viruses like the human metapneumovirus (HMPV), the human coronaviruses (HCoV) NL63 and HKU1 and the bocavirus. Whether these viruses have any impact in transplant recipients and immunocompromised hosts has not been assessed. We screened prospectively more than 500 patients that underwent a bronchoalveolar lavage (BAL) by using sensitive nucleic acid detection assays targeting 17 different human respiratory viruses. In order to correlate the presence of symptoms to our virological findings patients were not selected based on their symptoms and all those that underwent a BAL were enrolled.We first have established that the prevalence of respiratory virus infections in the studied population is 17%. Our inclusion criteria focused our investigation on severely immunocompromised hosts and patients most at risk of complications. Thus this 17% estimate of viral respiratory tract infection is likely to represent the minimal estimate to find a viral respiratory tract infection in high-risk hospitalized patients. An important finding of our study is it ability to highlight the respective role and the distribution of the different respiratory viruses in the studied population. Consistent with previous pilot studies we confirm that the so-called common cold virus's rhinovirus (23%) and coronavirus (32%) are the most frequent.Our clinical analysis strongly suggests that these respiratory viruses played a role in the production of symptoms in most cases. We also have observed that a subgroup of individuals that were infected with rhinovirus can develop a chronic infection and that the virus is identified in lung biopsy. This could have major clinical implications in immunocompromised hosts at risk of complications.To the best of our knowledge our investigation is the first that has established in a large cohort, using standardized lower respiratory, the epidemiology of respiratory viruses. We provide data on the potential impact of respiratory viruses where it matter the most in term of clinical impact;, the highly immunocompromised patients at risk of serious complications. We also have identified new concepts concerning rhinovirus: this virus can infect the lower respiratory tract and cause chronic infections in lung transplant recipients.
Direct link to Lay Summary Last update: 21.02.2013

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Associated projects

Number Title Start Funding scheme
113426 Rhinoviruses associated with lower respiratory diseases: genetic variability and replications site 01.01.2007 Project funding (Div. I-III)

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