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Original Research: LUNG INFECTION |

Respiratory Viruses in Adults With Community-Acquired Pneumonia

David Lieberman, MD; Avi Shimoni, MD; Yonat Shemer-Avni, PhD; Ayelet Keren-Naos, PhD; Rachel Shtainberg, PhD; Devora Lieberman, MD
Author and Funding Information

From the Pulmonary Unit (Dr David Lieberman), Division of Internal Medicine (Drs David Lieberman, Shimoni, and Devora Lieberman), Clinical Virology Laboratory (Drs Shemer-Avni, Keren-Naos, and Shtainberg), and Department of Geriatric Medicine (Dr Devora Lieberman), Soroka Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

Correspondence to: David Lieberman, MD, Pulmonary Unit, Soroka Medical Center, Beer-Sheva, Israel 84101; e-mail: Lieberma@bgu.ac.il


For editorial comment see page 767

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2010 American College of Chest Physicians


Chest. 2010;138(4):811-816. doi:10.1378/chest.09-2717
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Background:  Use of nucleic acid amplification techniques has increased the identification of respiratory viruses (RVs) in adult patients with community-acquired pneumonia (CAP). The objectives of the present study were to identify RV in patients with CAP using three different sampling methods and to compare CAP virus proportions and types with two comparison groups.

Methods:  The study population included 183 adult patients with CAP, 450 control subjects, and 201 patients with nonpneumonic lower respiratory tract infection (NPLRTI). Each participant was sampled by oropharyngeal swab, nasopharyngeal swab, and nasopharyngeal washing, and the samples were tested for detection of 12 RVs by multiplex TaqMan Hydrolysis probe-based real-time polymerase chain reaction (Integrated DNA Technology; Coralville, IA).

Results:  At least one RV was identified in 58 patients with CAP (31.7%) compared with 32 (7.1%) in control subjects and 104 (51.7%) in patients with NPLRTI (P < .01 and P < .01, respectively). Coronaviruses were identified in 24 (13.1%) patients with CAP, compared with 17 (3.8%) in control subjects, and 21 (10.4%) patients with NPLRTI. Respiratory syncytial virus was identified in 13 (7.1%), four (0.9%), and seven (3.5%); rhinovirus in nine (4.9%), nine (2.0%), and 15 (7.5%); and influenza virus in eight (4.4%), two (0.4%), and 63 (31.3%) patients with CAP, control subjects, and patients with NPLRTI, respectively.

Conclusions:  The proportion of RV involvement in CAP is higher than previously reported. The proportion of RV identified in healthy subjects is significantly lower than in CAP, but it is not zero and should be weighed when interpreting corresponding proportions among patients.


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