Prevalence of respiratory viruses among adults, by season, age, respiratory tract region and type of medical unit in Paris, France, from 2011 to 2016

Background Multiplex PCR tests have improved our understanding of respiratory viruses’ epidemiology by allowing their wide range detection. We describe here the burden of these viruses in hospital settings over a five-year period. Methods All respiratory samples from adult patients (>20 years old) tested by multiplex-PCR at the request of physicians, from May 1 2011 to April 30 2016, were included retrospectively. Viral findings are reported by season, patient age group, respiratory tract region (upper or lower) and type of clinical unit (intensive care unit, pneumology unit, lung transplantation unit and other medical units). Results In total, 7196 samples (4958 patients) were included; 29.2% tested positive, with viral co-infections detected in 1.6% of samples. Overall, two viral groups accounted for 60.2% of all viruses identified: picornaviruses (rhinovirus or enterovirus, 34.3%) and influenza (26.6%). Influenza viruses constituted the group most frequently identified in winter (34.4%), in the upper respiratory tract (32%) and in patients over the age of 70 years (36.4%). Picornavirus was the second most frequently identified viral group in these populations and in all other groups, including lower respiratory tract infections (41.3%) or patients in intensive care units (37.6%). Conclusion This study, the largest to date in Europe, provides a broad picture of the distribution of viruses over seasons, age groups, types of clinical unit and respiratory tract regions in the hospital setting. It highlights the burden associated with the neglected picornavirus group. These data have important implications for the future development of vaccines and antiviral drugs.

[1]  C. Yip,et al.  Rhinovirus - From bench to bedside. , 2017, Journal of the Formosan Medical Association = Taiwan yi zhi.

[2]  Y. Yazdanpanah,et al.  Impact of respiratory viruses in hospital-acquired pneumonia in the intensive care unit: A single-center retrospective study , 2017, Journal of Clinical Virology.

[3]  D. Eibach,et al.  Performance of influenza case definitions for influenza community surveillance: based on the French influenza surveillance network GROG, 2009-2014 , 2017, Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin.

[4]  M. Schwehm,et al.  Assessment of Public Health and Economic Impact of Intranasal Live-Attenuated Influenza Vaccination of Children in France Using a Dynamic Transmission Model , 2017, Applied Health Economics and Health Policy.

[5]  C. Charpentier,et al.  Usefulness of multiplex PCR methods and respiratory viruses’ distribution in children below 15 years old according to age, seasons and clinical units in France: A 3 years retrospective study , 2017, PloS one.

[6]  Y. Yazdanpanah,et al.  Viral-bacterial coinfection affects the presentation and alters the prognosis of severe community-acquired pneumonia , 2016, Critical Care.

[7]  M. Bonten,et al.  Clinical practice of respiratory virus diagnostics in critically ill patients with a suspected pneumonia: A prospective observational study , 2016, Journal of Clinical Virology.

[8]  Martin T. Wells,et al.  Impact of Early Detection of Respiratory Viruses by Multiplex PCR Assay on Clinical Outcomes in Adult Patients , 2016, Journal of Clinical Microbiology.

[9]  K. To,et al.  Pulmonary and extrapulmonary complications of human rhinovirus infection in critically ill patients. , 2016, Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology.

[10]  T. Pumarola,et al.  Virological surveillance of influenza and other respiratory viruses during six consecutive seasons from 2006 to 2012 in Catalonia, Spain , 2016, Clinical Microbiology and Infection.

[11]  E. Larson,et al.  Community ‐and hospital laboratory‐based surveillance for respiratory viruses , 2016, Influenza and other respiratory viruses.

[12]  H. Niesters,et al.  Enterovirus D68 Infection , 2015, Viruses.

[13]  Z. Bi,et al.  Viral Etiology of acute respiratory tract infections in hospitalized children and adults in Shandong Province, China , 2015, Virology Journal.

[14]  B. Lina,et al.  Clinical Characteristics Are Similar across Type A and B Influenza Virus Infections , 2015, PloS one.

[15]  R. Lutter,et al.  Changes in microbiota during experimental human Rhinovirus infection , 2015, BMC Infectious Diseases.

[16]  W. Self,et al.  Respiratory Viral Detection in Children and Adults: Comparing Asymptomatic Controls and Patients With Community-Acquired Pneumonia , 2015, The Journal of infectious diseases.

[17]  A. Lindstrand,et al.  Respiratory viruses associated with community-acquired pneumonia in children: matched case–control study , 2015, Thorax.

[18]  S. Esposito,et al.  Prospective evaluation of rhinovirus infection in healthy young children. , 2015, Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology.

[19]  Prabhu R. Shankar,et al.  Impact of a rapid respiratory panel test on patient outcomes. , 2015, Archives of pathology & laboratory medicine.

[20]  E. Walsh,et al.  Serum Procalcitonin Measurement and Viral Testing to Guide Antibiotic Use for Respiratory Infections in Hospitalized Adults: A Randomized Controlled Trial , 2015, The Journal of infectious diseases.

[21]  J. Gamieldien,et al.  Identification of New Respiratory Viruses in the New Millennium , 2015, Viruses.

[22]  C. Leport,et al.  Viruses detected by systematic multiplex polymerase chain reaction in adults with suspected community-acquired pneumonia attending emergency departments in France , 2015, Clinical Microbiology and Infection.

[23]  M. Girard Campagne de vaccination contre la grippe saisonnière , 2014 .

[24]  S. Choi,et al.  Viral Infection Is Not Uncommon in Adult Patients with Severe Hospital-Acquired Pneumonia , 2014, PloS one.

[25]  J. Chan,et al.  The emergence of influenza A H7N9 in human beings 16 years after influenza A H5N1: a tale of two cities , 2013, The Lancet Infectious Diseases.

[26]  Christian Drosten,et al.  Commentary: Middle East Respiratory Syndrome Coronavirus (MERS-CoV): Announcement of the Coronavirus Study Group , 2013, Journal of Virology.

[27]  V. Gant,et al.  Respiratory tract infections in the immunocompromised , 2013, Current opinion in pulmonary medicine.

[28]  F. Baldanti,et al.  Viral outbreaks in neonatal intensive care units: What we do not know , 2013, American Journal of Infection Control.

[29]  H. Sung,et al.  Comparison of Anyplex II RV16 with the xTAG Respiratory Viral Panel and Seeplex RV15 for Detection of Respiratory Viruses , 2013, Journal of Clinical Microbiology.

[30]  H. Park,et al.  Viral infection in patients with severe pneumonia requiring intensive care unit admission. , 2012, American journal of respiratory and critical care medicine.

[31]  Wai-ming Lee,et al.  Human rhinovirus species and season of infection determine illness severity. , 2012, American journal of respiratory and critical care medicine.

[32]  Arnab Sengupta,et al.  Detecting Respiratory Viruses in Asymptomatic Children , 2012, The Pediatric infectious disease journal.

[33]  M. Kretzschmar,et al.  Mortality attributable to 9 common infections: significant effect of influenza A, respiratory syncytial virus, influenza B, norovirus, and parainfluenza in elderly persons. , 2012, The Journal of infectious diseases.

[34]  C. Knabbe,et al.  Comparison of three multiplex PCR assays for the detection of respiratory viral infections: evaluation of xTAG respiratory virus panel fast assay, RespiFinder 19 assay and RespiFinder SMART 22 assay , 2012, BMC Infectious Diseases.

[35]  R. Gelman,et al.  Respiratory Virus Detection in Immunocompromised Patients with FilmArray Respiratory Panel Compared to Conventional Methods , 2012, Journal of Clinical Microbiology.

[36]  H. Rosenberg,et al.  Unrecognized Viral Respiratory Tract Infections in Premature Infants during their Birth Hospitalization: A Prospective Surveillance Study in Two Neonatal Intensive Care Units , 2012, The Journal of Pediatrics.

[37]  T. Perl,et al.  Epidemiology of respiratory viruses in children admitted to an infant/toddler unit. , 2012, American journal of infection control.

[38]  Mini Kamboj,et al.  Comparison of the Luminex xTAG RVP Fast Assay and the Idaho Technology FilmArray RP Assay for Detection of Respiratory Viruses in Pediatric Patients at a Cancer Hospital , 2012, Journal of Clinical Microbiology.

[39]  R. Champlin,et al.  The characteristics and outcomes of parainfluenza virus infections in 200 patients with leukemia or recipients of hematopoietic stem cell transplantation. , 2012, Blood.

[40]  R. Lu,et al.  Etiology and Clinical Characterization of Respiratory Virus Infections in Adult Patients Attending an Emergency Department in Beijing , 2012, PloS one.

[41]  E. Lautenbach,et al.  The Use of Antimicrobial Agents after Diagnosis of Viral Respiratory Tract Infections in Hospitalized Adults: Antibiotics or Anxiolytics? , 2010, Infection Control & Hospital Epidemiology.

[42]  M. Kieny,et al.  The 2009 A (H1N1) influenza virus pandemic: A review. , 2010, Vaccine.

[43]  Dena L. Schanzer,et al.  Role of influenza and other respiratory viruses in admissions of adults to Canadian hospitals , 2008, Influenza and other respiratory viruses.

[44]  G. Storch,et al.  MultiCode-PLx System for Multiplexed Detection of Seventeen Respiratory Viruses , 2007, Journal of Clinical Microbiology.

[45]  D. Schanzer,et al.  Hospitalization Attributable to Influenza and Other Viral Respiratory Illnesses in Canadian Children , 2006, The Pediatric infectious disease journal.

[46]  A. Danchin,et al.  The Severe Acute Respiratory Syndrome , 2003 .

[47]  N. Papadopoulos,et al.  Rhinoviruses infect the lower airways. , 2000, The Journal of infectious diseases.

[48]  D. Musher,et al.  Community-acquired pneumonia. , 1995, The New England journal of medicine.

[49]  D. Chung,et al.  Community-acquired pneumonia requiring hospitalization among U . S . adults , 2016 .

[50]  H. Niesters,et al.  Enterovirus D68 Infection , 2015, Viruses.