Researchers investigated the clinical practices of testing for respiratory virus infections in intensive care unit (ICU) patients with suspected community-acquired pneumonia (CAP) or hospital-acquired pneumonia (HAP) and found that fewer than half of these patients are tested for the presence of viral pathogens, even during flu season.
The research paper, “Clinical practice of respiratory virus diagnostics in critically ill patients with a suspected pneumonia: A prospective observational study,” published in the Journal of Clinical Virology, shows there is room to improve the routine flu virus testing in patients with suspected CAP and HAP admitted to the ICU during flu season.
Current clinical guidelines recommend testing for respiratory viruses during flu season, although it remains unclear which patients in the ICU should be tested. Regarding pneumonia specifically, there are currently no specific recommendations as to whether all patients admitted to the ICU with a suspected CAP should be tested, and there are no recommendations for virus testing in patients admitted to the ICU due to HAP. As a result, the current clinical practices regarding such testing in seriously ill patients with suspected CAP or HAP remain mostly unknown.
In this study, researchers studied CAP and HAP patients that stayed at an ICU for more than 24 hours in two hospitals in the Netherlands from 2011 to December 2013, and determined the proportion of these patients who were tested for respiratory viruses.
The study included 1,452 patients, of which 712 presented with CAP and 740 with HAP. Of these, 282 of the 712 patients with suspected CAP (40 percent) were tested for respiratory viruses, and of patients admitted with a suspected HAP, 95 of 740 (13 percent) were tested.
In patients who were tested during flu season, the prevalence of influenza was 14 percent in patients with CAP and 10 percent in patients with HAP.
According to the different results, it can be concluded that “less than half of the ICU patients admitted with a suspected pneumonia, either in or outside the influenza season, are tested for the presence of viral pathogens, and that the decision to test seems primarily to depend on patient comorbidities and inflammation biomarker profile.”
In their concluding remarks, the authors wrote that it would be beneficial to improve routine flu virus testing in patients with suspected CAP and HAP admitted to the ICU during flu season.