Abstract
BackgroundRespiratory viral and atypical bacterial infections data in Egyptian patients are sparse. This study describes the clinical features and outcomes of patients with severe acute respiratory infections (SARI) in hospitalized patients in Egypt.MethodsSARI surveillance was implemented at Cairo University Hospital (CUH) during the period 2010–2014. All hospitalized patients meeting the WHO case definition for SARI were enrolled. Nasopharyngeal/oropharyngeal (NP/OP) swabs were collected and samples were tested using RT-PCR for influenza A, B, respiratory syncytial virus (RSV), human metapneumovirus (hMPV), parainfluenza virus (PIV 1,2,3,4), adenovirus, bocavirus, coronavirus, enterovirus, rhinovirus, and atypical bacteria. Data were analyzed to calculate positivity rates for viral pathogens and determine which pathogens related to severe outcomes or resulted in death.ResultsOverall, 1,075/3,207 (33.5%) cases had a viral etiology, with a mean age of 5.74 (±13.87) years. The highest rates were reported for RSV (485 cases, 45.2%), PIV (125, 11.6%), and adenovirus (105, 9.8%). Children had a higher viral rate (981, 91.2%) compared to 94 (8.8%) cases in adults. Patients with identified viruses had significantly lower rates for ICU admission, hospital stay, mechanical ventilation, and overall mortality than those without identified viruses. No infections were independently associated with severe outcomes.ConclusionsViral pathogens were encountered in one-third of hospitalized adult and pediatric Egyptian patients with SARI, while atypical bacteria had a minor role. Highest rates of viral infections were reported for RSV, PIV, and adenovirus. Viral infections had neither negative impacts on clinical features nor outcomes of patients with SARI in our locality.
Highlights
Respiratory viral and atypical bacterial infections data in Egyptian patients are sparse
Demographic data of the study population Out of 3,207 participants enrolled in this severe acute respiratory infections (SARI) surveillance, 1,075 (33.5%) had positive results for viral and atypical bacteria tested
We found a viral etiology in 33.5 % of hospitalized patients with SARI, which is comparable to previous studies conducted in either developing or Middle Eastern countries [9,10,11, 13]
Summary
Respiratory viral and atypical bacterial infections data in Egyptian patients are sparse. This study describes the clinical features and outcomes of patients with severe acute respiratory infections (SARI) in hospitalized patients in Egypt. Viruses are responsible for 30-70 % of ARI where respiratory syncytial virus (RSV), influenza virus, parainfluenza virus (PIV), human Bocavirus, human metapneumovirus (hMPV), adenovirus, Hatem et al Multidisciplinary Respiratory Medicine (2019) 14:11 atypical bacterial infection in causing ARI is not usually documented [10, 11]. We analyzed surveillance data from Egyptian patients with SARI, enrolled at Cairo University Hospital (CUH) from 2010 to 2014. We aimed to calculate proportions of positive samples for different viral pathogens, to determine which pathogens were related to severe outcomes, and to address the impact of SARI on the clinical outcomes of enrolled patients, in terms of morbidity and mortality
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