Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Apr:50:59-65.
doi: 10.1016/j.jcrc.2018.11.013. Epub 2018 Nov 15.

Influenza virus and factors that are associated with ICU admission, pulmonary co-infections and ICU mortality

M C Beumer  1 , R M Koch  2 , D van Beuningen  1 , A M OudeLashof  3 , F L van de Veerdonk  4 , E Kolwijck  5 , J G van der Hoeven  1 , D C Bergmans  6 , C W E Hoedemaekers  1
Affiliations

Influenza virus and factors that are associated with ICU admission, pulmonary co-infections and ICU mortality

M C Beumer et al. J Crit Care. 2019 Apr.

Abstract

Purpose: While most influenza patients have a self-limited respiratory illness, 5-10% of hospitalized patients develop severe disease requiring ICU admission. The aim of this study was to identify influenza-specific factors associated with ICU admission and mortality. Furthermore, influenza-specific pulmonary bacterial, fungal and viral co-infections were investigated.

Methods: 199 influenza patients, admitted to two academic hospitals in the Netherlands between 01-10-2015 and 01-04-2016 were investigated of which 45/199 were admitted to the ICU.

Results: A history of Obstructive/Central Sleep Apnea Syndrome, myocardial infarction, dyspnea, influenza type A, BMI > 30, the development of renal failure and bacterial and fungal co-infections, were observed more frequently in patients who were admitted to the ICU, compared with patients at the normal ward. Co-infections were evident in 55.6% of ICU-admitted patients, compared with 20.1% of patients at the normal ward, mainly caused by Staphylococcus aureus, Streptococcus pneumoniae, and Aspergillus fumigatus. Non-survivors suffered from diabetes mellitus and (pre-existent) renal failure more often.

Conclusions: The current study indicates that a history of OSAS/CSAS, myocardial infarction and BMI > 30 might be related to ICU admission in influenza patients. Second, ICU patients develop more pulmonary co-infections. Last, (pre-existent) renal failure and diabetes mellitus are more often observed in non-survivors.

Keywords: Bacterial; Co-infections; Fungal; ICU admission; ICU mortality; Influenza virus; Risk factors; Viral.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. McCullers J.A. Insights into the interaction between influenza virus and pneumococcus. Clin Microbiol Rev. 2006;19(3):571–582. - PMC - PubMed
    1. Metersky M.L., Masterton R.G., Lode H., File T.M., Jr., Babinchak T. Epidemiology, microbiology, and treatment considerations for bacterial pneumonia complicating influenza. Int. J. Infect. Dis. 2012;16(5):e321–e331. - PubMed
    1. Lee K.Y., Rhim J.W., Kang J.H. Hyperactive immune cells (T cells) may be responsible for acute lung injury in influenza virus infections: a need for early immune-modulators for severe cases. Med Hypotheses. 2011;76(1):64–69. - PMC - PubMed
    1. Martin-Loeches I., M J.S., Vincent J.L., Alvarez-Lerma F., Bos L.D., Sole-Violan J. Increased incidence of co-infection in critically ill patients with influenza. Intensive Care Med. 2017;43(1):48–58. doi: 10.1007/s00134-016-4578-y. Epub 2016 Oct 5. - DOI - PubMed
    1. Koch RM, Kox M, de Jonge MI, van der Hoeven JG, Ferwerda G, Pickkers P: Patterns in bacterial- and viral-induced immunosuppression and secondary infections in the ICU. Shock 2016. - PubMed