Prevalence and clinical impact of VIral Respiratory tract infections in patients hospitalized for Community-Acquired Pneumonia: the VIRCAP study

Abstract Background Viral respiratory tract infections (VRTI) accounts for a significant proportion of hospitalized children and contributes to a substantial use of health care resources and costs. American Academy of Pediatrics (AAP) recommends against using antibiotics in uncomplicated viral respiratory infections in children. Overuse of antibiotics ranges between 29–80%. The goal of an Antibiotic stewardship programs (ASP) is to decrease antibiotic misuse, lower costs, and prevent emergence of antibiotic resistance in the community. Proportion of children with Viral respiratory tract infections on antibiotics Methods Our smart aim was to reduce antibiotic use by 25% in admitted children with VRTI between October 2019-March 2020. Our outcome measure was to reduce inappropriate antibiotic use during the 2019–20 season by 25%. Process measures included percentage of antibiotic used in viral RTI, antibiotic days of therapy and appropriate audit-feedback from the ASP team to facilitate discontinuation or de-escalation of antibiotics based on culture data. Our balance measure included readmission rates in patients in whom antibiotics were discontinued or de-escalated. Several PDSA cycles implemented with predominant emphasis on communication between ASP team and primary providers. Results No differences were noted in patient demographics including sex, age, ethnicity between the viral season in 2018–19 and 2019–2020. In our previous study in 2018–2019 RSV season, there was 40.7% antibiotic use in patients admitted with RSV bronchiolitis. In 2019–2020 season we included all patients admitted with viral RTI. Of the 213 patients evaluated between October 2019 through Dec 2020, 40% of the patients received antibiotics. 100% of the antibiotics were justified, based on independent review of antibiotic data by the team. Most common cause of antibiotics were community acquired pneumonia, rule out sepsis and otitis media. Antibiotic discontinuation and de-escalation were achieved in over 90% of the justified antibiotics. Conclusion Though antibiotic usage was still at 40% at our institution, 100% of antibiotic use was deemed appropriate and significant proportion were discontinued or deescalated by the ASP team. The ASP team played a crucial role in communicating with the primary providers to advocate for appropriate antibiotic use in the children. Disclosures All Authors: No reported disclosures

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Respiratory viruses in adults with acute respiratory tract infections

10.21203/rs.2.9421/v1 ◽

2019 ◽

Author(s):

JING CHEN ◽

Xiaoguang Li ◽

Wei Wang ◽

Ying Jia ◽

Jie Xu

Keyword(s):

Respiratory Tract ◽

Respiratory Tract Infections ◽

Respiratory Infections ◽

Throat Swab ◽

Community Acquired Pneumonia ◽

Respiratory Pathogens ◽

Upper Respiratory Tract ◽

Upper Respiratory ◽

Tract Infections ◽

Viral Respiratory

Abstract Background: Respiratory viruses are the main pathogens of acute respiratory infections. Viral respiratory pathogens in children are well studied, but the study on adults are limited. So we design this subject to determine viral respiratory pathogens in patients with acute respiratory tract infections of adults. Methods: We conducted a retrospective study for the patients with acute respiratory infections from June, 2017 through July, 2018 at Fever Clinic in Peking University Third Hospital. We collected throat swab from the patients diagnosed with acute upper respiratory tract infections and sputum or throat swab diagnosed with community-acquired pneumonia. RT-PCRs were performed to detect infection with the following virus: human rhinovirus, influenza A virus, influenza B virus, human coronavirus 229E/HKU1，Coronavirus OC43/NL63、ADV, RSV, PIV1-4, hMPV and EV. Results：185 throat swabs and sputum were collected from outpatients. Overall, 23.8% (44/185) were found to be positive for at least one respiratory virus. The virus detection rate for AURTIs and CAP was 23.3% (14/60) and 24.0 % (30/125), respectively. The most prevalent viruses detected were IFVs (13.5%, 25/185), PIVs (3.24%, 6/185) and HRVs (2.70%, 5/185). In the Influenza Virus, the highest positive detection rate is 21.4%（6/28）in the group >60 years old, while 11.0%( 14/127) in the group <40 years old and 13.3% (4/30) (P<0.05). Conclusion: In one-year study, IFVs were the dominant pathogens both in acute upper respiratory tract infections and community-acquired pneumonia, followed by PIVs and HRVs. The patients in the group >60 years old had a higher rate of influenza infection

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