TY - JOUR
T1 - Pneumonia in military trainees
T2 - A comparison study based on adenovirus serotype 14 infection
AU - Vento, Todd J.
AU - Prakash, Vidhya
AU - Murray, Clinton K.
AU - Brosch, Lorie C.
AU - Tchandja, Juste B.
AU - Cogburn, Cynthia
AU - Yun, Heather C.
PY - 2011/5/15
Y1 - 2011/5/15
N2 - Background. Adenovirus serotype 14 (Ad-14) recently emerged as a respiratory pathogen in the United States, with studies suggesting higher morbidity and mortality. This study was conducted to determine whether Ad-14 is associated with clinical outcomes in otherwise healthy patients with pneumonia. Methods. Medical records of military trainees hospitalized with pneumonia during an outbreak of Ad-14 infection were reviewed. Clinical, radiographic, and laboratory parameters were compared on the basis of Ad-14 infection. Results. Two hundred thirty-four trainees received a diagnosis of pneumonia, and 83(35%) were hospitalized. Sixty-one percent of patients with pneumonia were Ad-14 positive; 43% of patients with Ad-14 pneumonia were hospitalized (83% of female patients and 40% of male patients; P5 .04), compared with 40% of patients with Ad-14 negative cases. Ad-14 infection was associated with higher admission temperature (38.3oC [interquartile range, (IQR) 37.7, 39.4] vs 37.37deg;C [IQR (36.7, 38.5)]; P < .01) and lower white blood cell count (8.3 × 1000 cells/μL [IQR, 5.7, 12.4] vs 13 × 1000 cells/μL [IQR, 7.5, 12.9]; P=.01), neutrophil count (6.7 × 1000 cells/μL [IQR, 2.8, 9.7] vs 9.7 × 1000 cells/7mu;L [IQR, 5.6, 12.1]; P=.02), lymphocyte count (0.9 × 1000 cells/μL [IQR, 0.8, 1.1] vs 1.3 × 1000 cells/μL [IQR, 1, 1.9]; P=.001), and platelet count (210 × 1000 cells/μL [IQR, 145, 285] vs 261 × 1000 cells/μL [IQR, 238, 343]; P < .01). Ad-14 pneumonia was not associated with specific radiographic findings, pneumonia severity score, intensive care unit admission, longer hospitalization, or 30-day mortality. Conclusions. During an outbreak of Ad-14 infection, Ad-14 infection was not associated with excess overall morbidity or mortality. Ad-14 infection was associated with specific laboratory and clinical parameters and higher hospitalization rates in female trainees. These data provide new insight to the epidemiology of Ad-14 infection.
AB - Background. Adenovirus serotype 14 (Ad-14) recently emerged as a respiratory pathogen in the United States, with studies suggesting higher morbidity and mortality. This study was conducted to determine whether Ad-14 is associated with clinical outcomes in otherwise healthy patients with pneumonia. Methods. Medical records of military trainees hospitalized with pneumonia during an outbreak of Ad-14 infection were reviewed. Clinical, radiographic, and laboratory parameters were compared on the basis of Ad-14 infection. Results. Two hundred thirty-four trainees received a diagnosis of pneumonia, and 83(35%) were hospitalized. Sixty-one percent of patients with pneumonia were Ad-14 positive; 43% of patients with Ad-14 pneumonia were hospitalized (83% of female patients and 40% of male patients; P5 .04), compared with 40% of patients with Ad-14 negative cases. Ad-14 infection was associated with higher admission temperature (38.3oC [interquartile range, (IQR) 37.7, 39.4] vs 37.37deg;C [IQR (36.7, 38.5)]; P < .01) and lower white blood cell count (8.3 × 1000 cells/μL [IQR, 5.7, 12.4] vs 13 × 1000 cells/μL [IQR, 7.5, 12.9]; P=.01), neutrophil count (6.7 × 1000 cells/μL [IQR, 2.8, 9.7] vs 9.7 × 1000 cells/7mu;L [IQR, 5.6, 12.1]; P=.02), lymphocyte count (0.9 × 1000 cells/μL [IQR, 0.8, 1.1] vs 1.3 × 1000 cells/μL [IQR, 1, 1.9]; P=.001), and platelet count (210 × 1000 cells/μL [IQR, 145, 285] vs 261 × 1000 cells/μL [IQR, 238, 343]; P < .01). Ad-14 pneumonia was not associated with specific radiographic findings, pneumonia severity score, intensive care unit admission, longer hospitalization, or 30-day mortality. Conclusions. During an outbreak of Ad-14 infection, Ad-14 infection was not associated with excess overall morbidity or mortality. Ad-14 infection was associated with specific laboratory and clinical parameters and higher hospitalization rates in female trainees. These data provide new insight to the epidemiology of Ad-14 infection.
UR - http://www.scopus.com/inward/record.url?scp=79955035999&partnerID=8YFLogxK
U2 - 10.1093/infdis/jir040
DO - 10.1093/infdis/jir040
M3 - Article
C2 - 21502080
AN - SCOPUS:79955035999
SN - 0022-1899
VL - 203
SP - 1388
EP - 1395
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 10
ER -