Erschienen in:
01.11.2012 | Editorial
Overtreating or underdiagnosing invasive pulmonary aspergillosis (IPA) in critically ill H1N1 patients: who is right?
verfasst von:
Ignacio Martin-Loeches, Jordi Valles
Erschienen in:
Intensive Care Medicine
|
Ausgabe 11/2012
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Excerpt
Bacterial co-infection has been found in ≈25 % of all influenza-related deaths [
1,
2]. However, information regarding the impact of bacterial co-infection in critically ill H1N1 patients shows conflicting results. Based on previous reports [
3,
4], the presence of bacterial co-infection was not associated with increased mortality rates, but was an independent risk factor for severe presentation [
5] and showed higher morbidity defined by longer ICU stay. In the pre-antibiotic era, during the 1918–1919 pandemic, the bacteria most often recovered from the sputum, lungs, and blood of pneumonia patients, alive or dead, were common colonizers of the upper respiratory tracts of healthy persons, i.e.,
H. influenzae,
S. pneumoniae,
S. pyogenes, and
S. aureus [
6], In this issue of
Intensive Care Medicine, Wauters and colleagues [
7] present a retrospective analysis of a cohort of 40 adult patients with confirmed H1N1 infection admitted to the ICUs of two tertiary care hospitals. The major finding was that almost 25 % of the patients developed invasive pulmonary aspergillosis (IPA); all of them received corticosteroids (CS) either before or during ICU admission. …
