RESUMEN
BACKGROUND: Coronavirus OC43 infection causes severe pneumonia in patients presenting with comorbidities, but clinical signs alone do not allow for viral identification. OBJECTIVES: To analyze acute manifestations of Coronavirus OC43 infections and outcomes of patients admitted to an intensive care unit (ICU). PATIENTS AND METHODS: Retrospective and monocentric study performed during a Coronavirus OC43 outbreak. We used multiplex PCR to detect an OC43 outbreak in Reunion Island during the 2016 Southern Hemisphere's winter: seven admissions to the ICU. RESULTS: Mean age of patients was 71 [67;76] years, SAPS II was 42 [28;53], pneumonia severity index 159 [139;182] vs 73 [40.5;107] for patients in medical wards, and 43% required mechanical ventilation. Comorbidities were diabetes mellitus (87%), chronic respiratory failure (57%), and chronic renal failure (29%). One patient died from Haemophilus influenzae co-infection. CONCLUSION: As for MERS Co-V infections, underlying comorbidities impacted the clinical outcomes of OC43 infections.
Asunto(s)
Infecciones por Coronavirus/diagnóstico , Coronavirus Humano OC43 , Cuidados Críticos , Infecciones del Sistema Respiratorio/diagnóstico , Infecciones del Sistema Respiratorio/virología , Anciano , Infecciones por Coronavirus/terapia , Femenino , Humanos , Masculino , Admisión del Paciente , Infecciones del Sistema Respiratorio/terapia , Estudios RetrospectivosAsunto(s)
Coinfección/complicaciones , Síndromes Compartimentales/etiología , Subtipo H1N1 del Virus de la Influenza A , Gripe Humana/complicaciones , Leptospirosis/complicaciones , Rabdomiólisis/etiología , Infecciones Estafilocócicas/complicaciones , Adulto , Animales , Urgencias Médicas , Resultado Fatal , Femenino , Erizos/microbiología , Humanos , Gripe Humana/virología , Masculino , Persona de Mediana Edad , Insuficiencia Multiorgánica/etiología , Exposición Profesional , Síndrome de Dificultad Respiratoria/etiologíaRESUMEN
We report two cases of septic shocks due to Salmonella non typhi infection on sickle cell patients admitted to an intensive care unit. Such patients should enforce food hygiene measures, especially under tropical settings, to avoid potentially deadly severe infections.
Asunto(s)
Anemia de Células Falciformes/complicaciones , Infecciones por Salmonella/complicaciones , Salmonella enteritidis/aislamiento & purificación , Salmonella typhimurium/aislamiento & purificación , Choque Séptico/etiología , Adolescente , Anemia de Células Falciformes/epidemiología , Colecistectomía , Colecistitis/complicaciones , Colecistitis/cirugía , Infecciones por Clostridium/complicaciones , Terapia Combinada , Comorbilidad , Cuidados Críticos/métodos , Infecciones por Citomegalovirus/complicaciones , Susceptibilidad a Enfermedades , Femenino , Humanos , Unidades de Cuidados Intensivos , Masculino , Osteomielitis/etiología , Complicaciones Posoperatorias/microbiología , Reunión/epidemiología , Intoxicación Alimentaria por Salmonella/prevención & control , Infecciones por Salmonella/epidemiología , Infecciones por Salmonella/microbiología , Infecciones por Salmonella/prevención & control , Choque Séptico/epidemiología , Choque Séptico/microbiología , Choque Séptico/terapia , Hemorragia Subaracnoidea/etiología , Adulto Joven , Talasemia beta/complicacionesAsunto(s)
Oxigenación por Membrana Extracorpórea , Sistemas de Manutención de la Vida , Aviación , Femenino , Humanos , Organización y Administración , Periodo Posparto , Síndrome de Dificultad Respiratoria/terapia , Navíos , Choque Cardiogénico/terapia , Transporte de Pacientes/métodos , Adulto JovenRESUMEN
In the Southern hemisphere, Réunion Island acts as a sentinel for infections preferentially occurring during the austral winter that are likely to reach the Northern hemisphere a few months later. We relate the main features concerning patients that were admitted during years 2009 and 2010 in our intensive care unit with an A(H1N1)v2009 infection, mainly for acute respiratory distress. Demographic, clinical, and biological data as well as given medications and outcome were prospectively collected among all PCR-confirmed influenza-infected patients. In 2009 and 2010, 25 patients met the criteria. Patients' median age was 40.4 (±17.4) years. Most of them (22/25) had comorbidities such as: chronic diseases, overweight, obesity, pregnancy, and Down syndrome. Maximum bed-occupation rate was 10 days per million inhabitants. Main diagnosis for ICU admission was virus-related pneumonia. Twenty-two out of 25 patients needed mechanical ventilation, some required rescue therapies such as extracorporeal membranous oxygenation (ECMO) or hi-frequency oscillation ventilation (HFOV), both only available in few French hospitals. Within the study period, 12 patients died (48%) mainly of multi-organ failure. Through 2009 and 2010 autumn and winter periods, for several weeks, the A(H1N1)v2009 virus infection resulted in a significant increase of workload in Réunion Island ICUs. In 2010, the failure of the mass immunization campaign, particularly among the at-risk groups, led to severe cases of A(H1N1)v2009 infections, particularly among patients with comorbidities. Our data may contribute toward better management of influenza virus pandemics in the future.