Published ahead of print on September 10, 2004, doi:10.1164/rccm.200406-781OC Am. J. Respir. Crit. Care Med., Volume 170, Number 11, December 2004, 1197-1203 A more recent version of this article appeared on December 1, 2004
Submitted on June 23, 2004 Lower Respiratory Viral Illnesses: Improved Diagnosis by Molecular Methods and Clinical ImpactJorge Garbino1,1 Division of Infectious Diseases, University Hospitals of Geneva, Geneva, Switzerland, 2 Division of Pulmonary Medicine, University Hospitals of Geneva, Geneva, Switzerland, 3 Central Laboratory of Virology, Division of Infectious Diseases, University Hospitals of Geneva, Geneva, Switzerland, 4 Central Laboratory of Bacteriology, Division of Infectious Diseases, University Hospitals of Geneva, Geneva, Switzerland, 5 Division of Pulmonary Medicine, University Hospitals of Geneva, Geneva, Switzerland; Clinic of Thoracic Surgery, University Hospitals of Geneva, Geneva, Switzerland * To whom correspondence should be addressed. E-mail: laurent.kaiser{at}hcuge.ch.
We assessed the frequency and the potential role of respiratory viruses on disease outcomes in hospitalized patients and lung transplant recipients who underwent a bronchoalveolar lavage (BAL) for an acute respiratory infection. BAL specimens (148) were analyzed by RT-PCR for the presence of eleven different viruses, as well as Mycoplasma pneumoniae, Chlamydophila pneumoniae, and Legionella pneumophila. Respiratory viruses were identified in 34 of 117 (29%) BAL specimens obtained in patients with a suspected respiratory infection and in only 2 of 31 (6%) controls (p<0.01). Mycoplasma pneumoniae was identified in 5 additional cases. Only 30% of cases that were virus positive by molecular methods were also positive by cell culture analysis. Rhinovirus was the most frequently identified virus (56% of cases) followed by RSV (27%). In lung transplant recipients, the rate of viral infections was 55% in cases with respiratory symptoms compared to only 4% in controls (p<0.001). In these cases, respiratory viral infections were associated with significant lung function abnormalities. By using RT-PCR assays, we frequently identified respiratory viruses in BAL specimens of patients hospitalized with lower respiratory tract infections. These viruses were associated with high morbidity, particularly in lung transplant recipients. Key words: Respiratory viruses, Rhinovirus, Respiratory syncytial virus, Bronchoalveolar lavage, Lung transplantation
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