Please use this identifier to cite or link to this item: http://hdl.handle.net/10553/45950
Title: Community-acquired respiratory coinfection in critically III patients with pandemic 2009 influenza A(H1N1) virus
Authors: Martín-Loeches, Ignacio
Sanchez-Corral, Ana
Diaz, Emili
Granada, Rosa María
Zaragoza, Rafael
Villavicencio, Christian
Albaya, Antonio
Cerdá, Enrique
Catalán, Rosa María
Luque, Pilar
Paredes, Amparo
Navarrete, Inés
Rello, Jordi
Rodríguez, Alejandro
Cobo, Pedro
Martins, Javier
Carbayo, Cecilia
Robles-Musso, Emilio
Cárdenas, Antonio
Fierro, Javier
Fernández, Ocaña
Sierra, Rafael
Huertos, Ma Jesús
Pozo, Juan Carlos
Guerrero, Rafael
Márquez, Enrique
Rodríguez-Carvajal, Manuel
Jareño, Antonio
Pomares, José
Ballesteros, José Luis
Fernández, Yolanda
Lobato, Francisco
Prieto, José F.
Albofedo-Sánchez, José
Martínez, Pilar
Castellanos, Miguel Angel Díaz
Sevilla, Guillermo
Garnacho-Montero, José
Hinojosa, Rafael
Fernández, Esteban
Loza, Ana
León, Cristóbal
Arenzana, Angel
Ocaña, Dolores
Avellanas, Manuel Luis
Lander, Arantxa
De Arellano, S. Garrido Ramírez
Lacueva, M. I.Marquina
González, Ignacio
Montón, Jose Ma
Díaz, Jose Ma
López-Reina, Pilar
Sáez, Sergio
Iglesias, Lisardo
González, Carmen Pascual
Quiroga
García-Rodríguez, Águeda
Socias, Lorenzo
Ibánez, Pedro
Borges-Sa, Marcío
Socias, A.
Del Castillo, A.
Marcos, Ricard Jordà
Bonell, José M.
Amestarán, Ignacio
Ruiz-Santana, Sergio 
Díaz, Juan José
Sisón
Hernández, David
Trujillo, Ana
Regalado, Luis
Lorente, Leonardo
Martín, Mar
Martínez, Sergio
Cáceres, J. J.
Suberviola, Borja
Ugarte, P.
García-López, Fernando
Alonso, Angel Álvaro
Pasilla, Antonio
Grande, Ma Luisa Gómez
Canabal, Alfonso
Marina, Luis
Messa, Juan B.López
Pueyo, Ma Jesús López
Ferreras, Zulema
Macias, Santiago
Berezo, José Ángel
Varela, Jesús Blanco
Andaluz, Ojeda A.
Terrero, Antonio Álvarez
Ezpeleta, Fabiola Tena
UNESCO Clasification: 32 Ciencias médicas
242008 Virus respiratorios
Keywords: Infection
Influenza A
H1N1
Issue Date: 2011
Journal: Chest (American College of Chest Physicians) 
Abstract: Background: Little is known about the impact of community-acquired respiratory coinfection in patients with pandemic 2009 influenza A(H1N1) virus infection. Methods: This was a prospective, observational, multicenter study conducted in 148 Spanish ICUs. Results: Severe respiratory syndrome was present in 645 ICU patients. Coinfection occurred in 113 (17.5%) of patients. Streptococcus pneumoniae (in 62 patients [54.8%]) was identified as the most prevalent bacteria. Patients with coinfection at ICU admission were older (47.5±15.7 vs 43.8±14.2 years, P<.05) and presented a higher APACHE (Acute Physiology and Chronic Health Evaluation) II score (16.1±7.3 vs 13.3±7.1, P<.05) and Sequential Organ Failure Assessment (SOFA) score (7.0±3.8 vs 5.2±3.5, P<.05). No differences in comorbidities were observed. Patients who had coinfection required vasopressors (63.7% vs 39.3%, P<.05) and invasive mechanical ventilation (69% vs 58.5%, P<.05) more frequently. ICU length of stay was 3 days longer in patients who had coinfection than in patients who did not (11 [interquartile range, 5-23] vs 8 [interquartile range 4-17], P=.01). Coinfection was associated with increased ICU mortality (26.2% vs 15.5%; OR, 1.94; 95% CI, 1.21-3.09), but Cox regression analysis adjusted by potential confounders did not confirm a significant association between coinfection and ICU mortality. Conclusions: During the 2009 pandemics, the role played by bacterial coinfection in bringing patients to the ICU was not clear, S pneumoniae being the most common pathogen. This work provides clear evidence that bacterial coinfection is a contributor to increased consumption of health resources by critical patients infected with the virus and is the virus that causes critical illness in the vast majority of cases.
URI: http://hdl.handle.net/10553/45950
ISSN: 0012-3692
DOI: 10.1378/chest.10-1396
Source: Chest [ISSN 0012-3692],v. 139, p. 555-562
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