The importance of diagnostic testing in the management of community-acquired respiratory infection during influenza season

Excerpt

In a recent issue of Critical Care, Kuster and colleagues [1] reported an observational study of patients admitted to critical care during periods of high influenza activity. A diagnosis of respiratory infection and being febrile (>38°C) were predictive of influenza among 126 confirmed subjects and had a higher predictive value for pandemic 2009 influenza A H1N1 (pH1N1) than seasonal influenza. A previous study identified that obesity, pregnancy, asthma, cardiac disease, immunosuppression, and diabetes are all risk factors for pH1N1 [2]. Such findings are important for focusing early optimal empiric therapy in addition to infection control measures during peaks of influenza activity. Nevertheless, it is important to investigate alternative differential diagnoses and pursue a definitive microbiological diagnosis when possible, particularly as bacterial co-infection occurs in almost a fifth of pH1N1 respiratory infections [3]. …