Viral isolates in pediatric ventilator-associated pneumonia

Bhawani Parihar, R. Agrawal, Vijendra Garg, Jagdish Singh, A. Goyal, Raj Gupta, S. Gothwal
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Abstract

Introduction: Although ventilator-associated pneumonia (VAP) mostly has bacterial etiology, many cases have viral etiology. The present study aimed at determining the proportion of viral VAP and any associated factors and identifying the viral isolates in pediatric VAP. Materials and Methods: A descriptive observational study was conducted at pediatric intensive care unit of tertiary referral center including 120 VAP cases aged 1–18 years. Endotracheal aspiration samples from these patients were tested for viral etiology. Results: Most VAP cases were males (66.7%). Virus was isolated in 14.2% of cases of VAP. Human adenovirus (29%), respiratory syncytial virus (29%), and herpes simplex virus (24%) were the most common viruses identified. Viral VAP was significantly associated with age, primary disease, and total leukocyte count. Neutrophil count decreased and lymphocyte count increased significantly after viral VAP. Conclusion: Viral etiology should be considered in VAP patients, especially in patients not responding to antibiotics as proper diagnosis and timely initiation of appropriate antiviral could be lifesaving. Prevalent viruses may vary geographically; hence, hospitals should try to identify the common viruses causing VAP in their settings to guide appropriate battery of tests and antiviral drugs.
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小儿呼吸机相关性肺炎的病毒分离株
引言:尽管呼吸机相关性肺炎(VAP)大多具有细菌病因,但许多病例具有病毒病因。本研究旨在确定病毒性VAP和任何相关因素的比例,并鉴定儿科VAP中的病毒分离株。材料和方法:在三级转诊中心的儿科重症监护室进行描述性观察性研究,包括120例年龄在1-18岁的VAP病例。对这些患者的气管内抽吸样本进行病毒病因检测。结果:VAP患者多为男性(66.7%),病毒分离率为14.2%。人类腺病毒(29%)、呼吸道合胞病毒(29%)和单纯疱疹病毒(24%)是最常见的病毒。病毒性VAP与年龄、原发性疾病和白细胞总数显著相关。病毒性VAP后中性粒细胞计数下降,淋巴细胞计数显著增加。结论:VAP患者应考虑病毒病因,尤其是对抗生素无反应的患者,因为正确的诊断和及时启动适当的抗病毒药物可以挽救生命。流行病毒可能因地理位置而异;因此,医院应该尝试在其环境中识别导致VAP的常见病毒,以指导适当的一组测试和抗病毒药物。
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