Which patients should be tested for viruses on bronchoalveolar lavage fluid?
Bronchoalveolar lavage (BAL) is a major diagnostic tool in lung diseases, including viral respiratory infections. We aimed to better define the situations where viral tests should be performed on BAL fluid (BALF). We retrospectively studied all cases where viral tests [immunofluorescence, immunocyto...
Gespeichert in:
| Veröffentlicht in: | European journal of clinical microbiology & infectious diseases 2013-05, Vol.32 (5), p.671-677 |
|---|---|
| Hauptverfasser: | , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 677 |
|---|---|
| container_issue | 5 |
| container_start_page | 671 |
| container_title | European journal of clinical microbiology & infectious diseases |
| container_volume | 32 |
| creator | Jouneau, S. Poineuf, J.-S. Minjolle, S. Tattevin, P. Uhel, F. Kerjouan, M. Le Hô, H. Desrues, B. |
| description | Bronchoalveolar lavage (BAL) is a major diagnostic tool in lung diseases, including viral respiratory infections. We aimed to better define the situations where viral tests should be performed on BAL fluid (BALF). We retrospectively studied all cases where viral tests [immunofluorescence, immunocytochemistry, viral culture, and/or polymerase chain reaction (PCR)] were performed on BALF during a period of 1 year (2008) in our institution. We compared the characteristics of patients with virus-positive versus virus-negative BALF. Of the 636 BALF samples sent to the microbiology laboratory, 232 underwent viral tests. Of these, 70 (30 %) were positive and identified 85 viruses: herpes simplex virus (HSV)-1 (
n
= 27), cytomegalovirus (CMV,
n
= 23), Epstein–Barr virus (EBV,
n
= 18), human herpesvirus (HHV)-6 (
n
= 12), respiratory syncytial virus (RSV,
n
= 3), rhinovirus (
n
= 1), and adenovirus (
n
= 1). The variables associated with positive viral tests on univariate analysis were immunosuppression [human immunodeficiency virus (HIV), corticosteroids >10 mg/day for ≥3 weeks, or other immunosuppressive therapy], ground-glass attenuations on computed tomography (CT) scanning, late-onset ventilator-associated pneumonia (VAP), and durations of (i) hospital stay, (ii) intensive care unit (ICU) stay, and (iii) mechanical ventilation before BAL (
p
|
| doi_str_mv | 10.1007/s10096-012-1791-7 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7101843</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2942889661</sourcerecordid><originalsourceid>FETCH-LOGICAL-c567t-c69066222ebcc01bdff54290ebe06c791229e9dd5f636a5715b871ef5ad7cc1b3</originalsourceid><addsrcrecordid>eNqNkl9rFDEUxYModlv9AL5IQIT6MJqbTP69VEpRKyz4ovgYMpnMzpTsZE12Bvz2ZjtrrQXBlwSS37n35OYg9ALIWyBEvstl1aIiQCuQGir5CK2gZryqmWSP0YpoVldaUnaCTnO-IUWjpHyKTiijTAnFV2j9vR9cj3d2P_hxn3Hu4xRa3Hi893nvW9zFhOchTdlnHEfcpDi6Ptow-xhswsHOduNxF6ahff8MPelsyP75cT9D3z5--Hp1Xa2_fPp8dbmuHBdyXzmhiRCUUt84R6Bpu47XVBPfeCJceQil2uu25Z1gwnIJvFESfMdtK52Dhp2hi6Xubmq2vnXFebLB7NKwtemniXYwf9-MQ282cTYSCKialQJvlgL9A9n15doczghRkgFXMxT2_NgsxR9TGYrZDtn5EOzo45QNMCFrxblg_4FSUcrKWwevHqA3cUpjmdotxYDW4tAbFsqlmHPy3Z1ZIOYQAbNEwJQImEMEjCyal_eHc6f4_ecFeH0EbHY2dMmObsh_OMmVAq0LRxcul6tx49M9i__s_gsJ3cge</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1326312461</pqid></control><display><type>article</type><title>Which patients should be tested for viruses on bronchoalveolar lavage fluid?</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Jouneau, S. ; Poineuf, J.-S. ; Minjolle, S. ; Tattevin, P. ; Uhel, F. ; Kerjouan, M. ; Le Hô, H. ; Desrues, B.</creator><creatorcontrib>Jouneau, S. ; Poineuf, J.-S. ; Minjolle, S. ; Tattevin, P. ; Uhel, F. ; Kerjouan, M. ; Le Hô, H. ; Desrues, B.</creatorcontrib><description>Bronchoalveolar lavage (BAL) is a major diagnostic tool in lung diseases, including viral respiratory infections. We aimed to better define the situations where viral tests should be performed on BAL fluid (BALF). We retrospectively studied all cases where viral tests [immunofluorescence, immunocytochemistry, viral culture, and/or polymerase chain reaction (PCR)] were performed on BALF during a period of 1 year (2008) in our institution. We compared the characteristics of patients with virus-positive versus virus-negative BALF. Of the 636 BALF samples sent to the microbiology laboratory, 232 underwent viral tests. Of these, 70 (30 %) were positive and identified 85 viruses: herpes simplex virus (HSV)-1 (
n
= 27), cytomegalovirus (CMV,
n
= 23), Epstein–Barr virus (EBV,
n
= 18), human herpesvirus (HHV)-6 (
n
= 12), respiratory syncytial virus (RSV,
n
= 3), rhinovirus (
n
= 1), and adenovirus (
n
= 1). The variables associated with positive viral tests on univariate analysis were immunosuppression [human immunodeficiency virus (HIV), corticosteroids >10 mg/day for ≥3 weeks, or other immunosuppressive therapy], ground-glass attenuations on computed tomography (CT) scanning, late-onset ventilator-associated pneumonia (VAP), and durations of (i) hospital stay, (ii) intensive care unit (ICU) stay, and (iii) mechanical ventilation before BAL (
p
< 0.01 for each comparison). On multivariate analysis, only immunosuppression [odds ratio (OR) 6.4, 95 % confidence interval (CI) [2.8–14.3],
p
< 0.0001] and ground-glass attenuations (OR 3.7, 95 % CI [1.8–7.7],
p
= 0.0004) remained associated with virus-positive BAL. None of the viral tests performed on BALF for the initial assessment of diffuse infiltrative lung disease (
n
= 15) was positive. PCR improved the diagnostic yield of viral tests on BALF by 50 %. Testing for viruses on BALF should be mostly restricted to immunocompromised patients with acute respiratory diseases and/or patients with unexplained ground-glass attenuations on CT scanning.</description><identifier>ISSN: 0934-9723</identifier><identifier>EISSN: 1435-4373</identifier><identifier>DOI: 10.1007/s10096-012-1791-7</identifier><identifier>PMID: 23238685</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer-Verlag</publisher><subject>Adenovirus ; Adenoviruses ; Adult ; Aged ; Aged, 80 and over ; Analysis of Variance ; Biological and medical sciences ; Biomedical and Life Sciences ; Biomedicine ; Bronchoalveolar Lavage Fluid - virology ; Chronic obstructive pulmonary disease ; Computed tomography ; Corticoids ; Cytomegalovirus ; Diagnosis, Differential ; Epstein-Barr virus ; Female ; France - epidemiology ; Herpes simplex virus ; Herpes viruses ; HIV ; Hospitals ; Human cytomegalovirus ; Human health and pathology ; Human herpesvirus ; Human immunodeficiency virus ; Humans ; Immune system ; Immunocompromised Host ; Infectious diseases ; Intensive care ; Internal Medicine ; Laboratories ; Lavage ; Life Sciences ; Lung diseases ; Male ; Medical Microbiology ; Medical sciences ; Microbiological Techniques - statistics & numerical data ; Microbiology ; Middle Aged ; Multivariate Analysis ; Pneumonia ; Polymerase chain reaction ; Respiratory diseases ; Respiratory syncytial virus ; Retrospective Studies ; Rhinovirus ; Steroids ; Ventilators ; Virology - methods ; Virus Diseases - diagnosis ; Virus Diseases - epidemiology ; Virus Diseases - pathology</subject><ispartof>European journal of clinical microbiology & infectious diseases, 2013-05, Vol.32 (5), p.671-677</ispartof><rights>Springer-Verlag Berlin Heidelberg 2012</rights><rights>2014 INIST-CNRS</rights><rights>Springer-Verlag Berlin Heidelberg 2013</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c567t-c69066222ebcc01bdff54290ebe06c791229e9dd5f636a5715b871ef5ad7cc1b3</citedby><cites>FETCH-LOGICAL-c567t-c69066222ebcc01bdff54290ebe06c791229e9dd5f636a5715b871ef5ad7cc1b3</cites><orcidid>0000-0003-4946-8184</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10096-012-1791-7$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10096-012-1791-7$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=27588199$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23238685$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.science/hal-00873158$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Jouneau, S.</creatorcontrib><creatorcontrib>Poineuf, J.-S.</creatorcontrib><creatorcontrib>Minjolle, S.</creatorcontrib><creatorcontrib>Tattevin, P.</creatorcontrib><creatorcontrib>Uhel, F.</creatorcontrib><creatorcontrib>Kerjouan, M.</creatorcontrib><creatorcontrib>Le Hô, H.</creatorcontrib><creatorcontrib>Desrues, B.</creatorcontrib><title>Which patients should be tested for viruses on bronchoalveolar lavage fluid?</title><title>European journal of clinical microbiology & infectious diseases</title><addtitle>Eur J Clin Microbiol Infect Dis</addtitle><addtitle>Eur J Clin Microbiol Infect Dis</addtitle><description>Bronchoalveolar lavage (BAL) is a major diagnostic tool in lung diseases, including viral respiratory infections. We aimed to better define the situations where viral tests should be performed on BAL fluid (BALF). We retrospectively studied all cases where viral tests [immunofluorescence, immunocytochemistry, viral culture, and/or polymerase chain reaction (PCR)] were performed on BALF during a period of 1 year (2008) in our institution. We compared the characteristics of patients with virus-positive versus virus-negative BALF. Of the 636 BALF samples sent to the microbiology laboratory, 232 underwent viral tests. Of these, 70 (30 %) were positive and identified 85 viruses: herpes simplex virus (HSV)-1 (
n
= 27), cytomegalovirus (CMV,
n
= 23), Epstein–Barr virus (EBV,
n
= 18), human herpesvirus (HHV)-6 (
n
= 12), respiratory syncytial virus (RSV,
n
= 3), rhinovirus (
n
= 1), and adenovirus (
n
= 1). The variables associated with positive viral tests on univariate analysis were immunosuppression [human immunodeficiency virus (HIV), corticosteroids >10 mg/day for ≥3 weeks, or other immunosuppressive therapy], ground-glass attenuations on computed tomography (CT) scanning, late-onset ventilator-associated pneumonia (VAP), and durations of (i) hospital stay, (ii) intensive care unit (ICU) stay, and (iii) mechanical ventilation before BAL (
p
< 0.01 for each comparison). On multivariate analysis, only immunosuppression [odds ratio (OR) 6.4, 95 % confidence interval (CI) [2.8–14.3],
p
< 0.0001] and ground-glass attenuations (OR 3.7, 95 % CI [1.8–7.7],
p
= 0.0004) remained associated with virus-positive BAL. None of the viral tests performed on BALF for the initial assessment of diffuse infiltrative lung disease (
n
= 15) was positive. PCR improved the diagnostic yield of viral tests on BALF by 50 %. Testing for viruses on BALF should be mostly restricted to immunocompromised patients with acute respiratory diseases and/or patients with unexplained ground-glass attenuations on CT scanning.</description><subject>Adenovirus</subject><subject>Adenoviruses</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Analysis of Variance</subject><subject>Biological and medical sciences</subject><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Bronchoalveolar Lavage Fluid - virology</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Computed tomography</subject><subject>Corticoids</subject><subject>Cytomegalovirus</subject><subject>Diagnosis, Differential</subject><subject>Epstein-Barr virus</subject><subject>Female</subject><subject>France - epidemiology</subject><subject>Herpes simplex virus</subject><subject>Herpes viruses</subject><subject>HIV</subject><subject>Hospitals</subject><subject>Human cytomegalovirus</subject><subject>Human health and pathology</subject><subject>Human herpesvirus</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Immune system</subject><subject>Immunocompromised Host</subject><subject>Infectious diseases</subject><subject>Intensive care</subject><subject>Internal Medicine</subject><subject>Laboratories</subject><subject>Lavage</subject><subject>Life Sciences</subject><subject>Lung diseases</subject><subject>Male</subject><subject>Medical Microbiology</subject><subject>Medical sciences</subject><subject>Microbiological Techniques - statistics & numerical data</subject><subject>Microbiology</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Pneumonia</subject><subject>Polymerase chain reaction</subject><subject>Respiratory diseases</subject><subject>Respiratory syncytial virus</subject><subject>Retrospective Studies</subject><subject>Rhinovirus</subject><subject>Steroids</subject><subject>Ventilators</subject><subject>Virology - methods</subject><subject>Virus Diseases - diagnosis</subject><subject>Virus Diseases - epidemiology</subject><subject>Virus Diseases - pathology</subject><issn>0934-9723</issn><issn>1435-4373</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqNkl9rFDEUxYModlv9AL5IQIT6MJqbTP69VEpRKyz4ovgYMpnMzpTsZE12Bvz2ZjtrrQXBlwSS37n35OYg9ALIWyBEvstl1aIiQCuQGir5CK2gZryqmWSP0YpoVldaUnaCTnO-IUWjpHyKTiijTAnFV2j9vR9cj3d2P_hxn3Hu4xRa3Hi893nvW9zFhOchTdlnHEfcpDi6Ptow-xhswsHOduNxF6ahff8MPelsyP75cT9D3z5--Hp1Xa2_fPp8dbmuHBdyXzmhiRCUUt84R6Bpu47XVBPfeCJceQil2uu25Z1gwnIJvFESfMdtK52Dhp2hi6Xubmq2vnXFebLB7NKwtemniXYwf9-MQ282cTYSCKialQJvlgL9A9n15doczghRkgFXMxT2_NgsxR9TGYrZDtn5EOzo45QNMCFrxblg_4FSUcrKWwevHqA3cUpjmdotxYDW4tAbFsqlmHPy3Z1ZIOYQAbNEwJQImEMEjCyal_eHc6f4_ecFeH0EbHY2dMmObsh_OMmVAq0LRxcul6tx49M9i__s_gsJ3cge</recordid><startdate>20130501</startdate><enddate>20130501</enddate><creator>Jouneau, S.</creator><creator>Poineuf, J.-S.</creator><creator>Minjolle, S.</creator><creator>Tattevin, P.</creator><creator>Uhel, F.</creator><creator>Kerjouan, M.</creator><creator>Le Hô, H.</creator><creator>Desrues, B.</creator><general>Springer-Verlag</general><general>Springer</general><general>Springer Nature B.V</general><general>Springer Verlag</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QL</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88A</scope><scope>88E</scope><scope>8AO</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>1XC</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-4946-8184</orcidid></search><sort><creationdate>20130501</creationdate><title>Which patients should be tested for viruses on bronchoalveolar lavage fluid?</title><author>Jouneau, S. ; Poineuf, J.-S. ; Minjolle, S. ; Tattevin, P. ; Uhel, F. ; Kerjouan, M. ; Le Hô, H. ; Desrues, B.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c567t-c69066222ebcc01bdff54290ebe06c791229e9dd5f636a5715b871ef5ad7cc1b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adenovirus</topic><topic>Adenoviruses</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Analysis of Variance</topic><topic>Biological and medical sciences</topic><topic>Biomedical and Life Sciences</topic><topic>Biomedicine</topic><topic>Bronchoalveolar Lavage Fluid - virology</topic><topic>Chronic obstructive pulmonary disease</topic><topic>Computed tomography</topic><topic>Corticoids</topic><topic>Cytomegalovirus</topic><topic>Diagnosis, Differential</topic><topic>Epstein-Barr virus</topic><topic>Female</topic><topic>France - epidemiology</topic><topic>Herpes simplex virus</topic><topic>Herpes viruses</topic><topic>HIV</topic><topic>Hospitals</topic><topic>Human cytomegalovirus</topic><topic>Human health and pathology</topic><topic>Human herpesvirus</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Immune system</topic><topic>Immunocompromised Host</topic><topic>Infectious diseases</topic><topic>Intensive care</topic><topic>Internal Medicine</topic><topic>Laboratories</topic><topic>Lavage</topic><topic>Life Sciences</topic><topic>Lung diseases</topic><topic>Male</topic><topic>Medical Microbiology</topic><topic>Medical sciences</topic><topic>Microbiological Techniques - statistics & numerical data</topic><topic>Microbiology</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Pneumonia</topic><topic>Polymerase chain reaction</topic><topic>Respiratory diseases</topic><topic>Respiratory syncytial virus</topic><topic>Retrospective Studies</topic><topic>Rhinovirus</topic><topic>Steroids</topic><topic>Ventilators</topic><topic>Virology - methods</topic><topic>Virus Diseases - diagnosis</topic><topic>Virus Diseases - epidemiology</topic><topic>Virus Diseases - pathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jouneau, S.</creatorcontrib><creatorcontrib>Poineuf, J.-S.</creatorcontrib><creatorcontrib>Minjolle, S.</creatorcontrib><creatorcontrib>Tattevin, P.</creatorcontrib><creatorcontrib>Uhel, F.</creatorcontrib><creatorcontrib>Kerjouan, M.</creatorcontrib><creatorcontrib>Le Hô, H.</creatorcontrib><creatorcontrib>Desrues, B.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Biology Database (Alumni Edition)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>European journal of clinical microbiology & infectious diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jouneau, S.</au><au>Poineuf, J.-S.</au><au>Minjolle, S.</au><au>Tattevin, P.</au><au>Uhel, F.</au><au>Kerjouan, M.</au><au>Le Hô, H.</au><au>Desrues, B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Which patients should be tested for viruses on bronchoalveolar lavage fluid?</atitle><jtitle>European journal of clinical microbiology & infectious diseases</jtitle><stitle>Eur J Clin Microbiol Infect Dis</stitle><addtitle>Eur J Clin Microbiol Infect Dis</addtitle><date>2013-05-01</date><risdate>2013</risdate><volume>32</volume><issue>5</issue><spage>671</spage><epage>677</epage><pages>671-677</pages><issn>0934-9723</issn><eissn>1435-4373</eissn><abstract>Bronchoalveolar lavage (BAL) is a major diagnostic tool in lung diseases, including viral respiratory infections. We aimed to better define the situations where viral tests should be performed on BAL fluid (BALF). We retrospectively studied all cases where viral tests [immunofluorescence, immunocytochemistry, viral culture, and/or polymerase chain reaction (PCR)] were performed on BALF during a period of 1 year (2008) in our institution. We compared the characteristics of patients with virus-positive versus virus-negative BALF. Of the 636 BALF samples sent to the microbiology laboratory, 232 underwent viral tests. Of these, 70 (30 %) were positive and identified 85 viruses: herpes simplex virus (HSV)-1 (
n
= 27), cytomegalovirus (CMV,
n
= 23), Epstein–Barr virus (EBV,
n
= 18), human herpesvirus (HHV)-6 (
n
= 12), respiratory syncytial virus (RSV,
n
= 3), rhinovirus (
n
= 1), and adenovirus (
n
= 1). The variables associated with positive viral tests on univariate analysis were immunosuppression [human immunodeficiency virus (HIV), corticosteroids >10 mg/day for ≥3 weeks, or other immunosuppressive therapy], ground-glass attenuations on computed tomography (CT) scanning, late-onset ventilator-associated pneumonia (VAP), and durations of (i) hospital stay, (ii) intensive care unit (ICU) stay, and (iii) mechanical ventilation before BAL (
p
< 0.01 for each comparison). On multivariate analysis, only immunosuppression [odds ratio (OR) 6.4, 95 % confidence interval (CI) [2.8–14.3],
p
< 0.0001] and ground-glass attenuations (OR 3.7, 95 % CI [1.8–7.7],
p
= 0.0004) remained associated with virus-positive BAL. None of the viral tests performed on BALF for the initial assessment of diffuse infiltrative lung disease (
n
= 15) was positive. PCR improved the diagnostic yield of viral tests on BALF by 50 %. Testing for viruses on BALF should be mostly restricted to immunocompromised patients with acute respiratory diseases and/or patients with unexplained ground-glass attenuations on CT scanning.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer-Verlag</pub><pmid>23238685</pmid><doi>10.1007/s10096-012-1791-7</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0003-4946-8184</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0934-9723 |
| ispartof | European journal of clinical microbiology & infectious diseases, 2013-05, Vol.32 (5), p.671-677 |
| issn | 0934-9723 1435-4373 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7101843 |
| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Adenovirus Adenoviruses Adult Aged Aged, 80 and over Analysis of Variance Biological and medical sciences Biomedical and Life Sciences Biomedicine Bronchoalveolar Lavage Fluid - virology Chronic obstructive pulmonary disease Computed tomography Corticoids Cytomegalovirus Diagnosis, Differential Epstein-Barr virus Female France - epidemiology Herpes simplex virus Herpes viruses HIV Hospitals Human cytomegalovirus Human health and pathology Human herpesvirus Human immunodeficiency virus Humans Immune system Immunocompromised Host Infectious diseases Intensive care Internal Medicine Laboratories Lavage Life Sciences Lung diseases Male Medical Microbiology Medical sciences Microbiological Techniques - statistics & numerical data Microbiology Middle Aged Multivariate Analysis Pneumonia Polymerase chain reaction Respiratory diseases Respiratory syncytial virus Retrospective Studies Rhinovirus Steroids Ventilators Virology - methods Virus Diseases - diagnosis Virus Diseases - epidemiology Virus Diseases - pathology |
| title | Which patients should be tested for viruses on bronchoalveolar lavage fluid? |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-05T01%3A55%3A32IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Which%20patients%20should%20be%20tested%20for%20viruses%20on%20bronchoalveolar%20lavage%20fluid?&rft.jtitle=European%20journal%20of%20clinical%20microbiology%20&%20infectious%20diseases&rft.au=Jouneau,%20S.&rft.date=2013-05-01&rft.volume=32&rft.issue=5&rft.spage=671&rft.epage=677&rft.pages=671-677&rft.issn=0934-9723&rft.eissn=1435-4373&rft_id=info:doi/10.1007/s10096-012-1791-7&rft_dat=%3Cproquest_pubme%3E2942889661%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1326312461&rft_id=info:pmid/23238685&rfr_iscdi=true |