BACKGROUND/AIMS: Respiratory viruses (RVs) are considered to be important respiratory pathogens in adult patients, and the multiplex reverse transcription-polymerase chain reaction (RT-PCR) test is used frequently in adult patients with respiratory infections. However, clinical data regarding utilization of the multiplex RT-PCR test for RVs are lacking. METHODS: We investigated the utilization of the multiplex RT-PCR test for RVs at Chung-Ang University Hospital in Seoul, Korea, between January 2012 and April 2013. RESULTS: During the study period, the multiplex RT-PCR test was performed for 291 adult patients. The test frequency was 4.9% of rapid influenza antigen detection tests and 0.8% of respiratory bacterial culture studies. A turnaround time of < 48 hours was observed in 25.9% of positive tests. Most of the tests were performed for admitted patients (97.9%) with a community-acquired infection (84.2%) during the flu season (82.5%). RVs were detected in 81 of 291 cases (27.8%). The RV positivity rates for community- and hospital-acquired infections did not differ (28.6% vs. 23.9%, p = 0.52). Of 166 patients with pneumonia, 44 (26.5%) had a viral infection. Among the patients with RV-associated pneumonia, an RV other than influenza was detected in 20 patients (45.4%). CONCLUSIONS: The multiplex RT-PCR test for RVs was infrequently performed at a tertiary care center, and the test results were often reported late. The test was most often performed for admitted adult patients with community-acquired infections during the flu season. The utilization of multiplex RT-PCR testing for RVs in current clinical practice should be improved.
Adult ; Aged ; Community-Acquired Infections/*diagnosis/virology ; DNA, Viral/*genetics ; Female ; Hospitals, University ; Humans ; Influenza, Human/*diagnosis/virology ; Male ; Middle Aged ; Multiplex Polymerase Chain Reaction/*utilization ; Pneumonia, Viral/*diagnosis/virology ; Predictive Value of Tests ; Republic of Korea ; Reverse Transcriptase Polymerase Chain Reaction/*utilization ; *Tertiary Care Centers

A prospective multicenter observational study was performed to investigate the epidemiology and outcomes of community-acquired severe sepsis and septic shock. Subjects included 1,192 adult patients admitted to the 22 participating intensive care units (ICUs) of 12 university hospitals in the Korean Sepsis Registry System from April, 2005 through February, 2009. Male accounted for 656 (55%) patients. Mean age was 65.0 +/- 14.2 yr. Septic shock developed in 740 (62.1%) patients. Bacteremia was present in 422 (35.4%) patients. The 28-day and in-hospital mortality rates were 23.0% and 28.0%, respectively. Men were more likely to have comorbid illnesses and acute organ dysfunctions, and had higher mortality and clinical severity compared to women. While respiratory sources of sepsis were common in men, urinary sources were predominant in women. In the multivariate logistic regression analysis, cancer (odds ratio 1.89; 95% confidence interval 1.13-3.17), urinary tract infection (0.25; 0.13-0.46), APACHE II score (1.05; 1.02-1.09), SOFA score on day 1 (1.13; 1.06-1.21) and metabolic dysfunction (2.24, 1.45-3.45) were independent clinical factors for gender-related in-hospital mortality. This study provided epidemiological and clinical characteristics of community-acquired severe sepsis and septic shock in ICUs in Korea, and demonstrated the impact of clinical factors on gender difference in mortality.
APACHE ; Adult ; Aged ; Aged, 80 and over ; Bacteremia/epidemiology/microbiology ; Community-Acquired Infections/epidemiology/microbiology/virology ; Comorbidity ; Female ; Hospital Mortality ; Hospitals, University ; Humans ; Intensive Care Units ; Logistic Models ; Lung Diseases/epidemiology ; Male ; Metabolic Diseases/epidemiology ; Middle Aged ; Neoplasms/epidemiology ; Odds Ratio ; Prospective Studies ; Republic of Korea ; Risk Factors ; Sepsis/diagnosis/*epidemiology/mortality ; Severity of Illness Index ; Sex Factors ; Shock, Septic/diagnosis/*epidemiology/mortality ; Urinary Tract Infections/epidemiology

A prospective multicenter observational study was performed to investigate the epidemiology and outcomes of community-acquired severe sepsis and septic shock. Subjects included 1,192 adult patients admitted to the 22 participating intensive care units (ICUs) of 12 university hospitals in the Korean Sepsis Registry System from April, 2005 through February, 2009. Male accounted for 656 (55%) patients. Mean age was 65.0 +/- 14.2 yr. Septic shock developed in 740 (62.1%) patients. Bacteremia was present in 422 (35.4%) patients. The 28-day and in-hospital mortality rates were 23.0% and 28.0%, respectively. Men were more likely to have comorbid illnesses and acute organ dysfunctions, and had higher mortality and clinical severity compared to women. While respiratory sources of sepsis were common in men, urinary sources were predominant in women. In the multivariate logistic regression analysis, cancer (odds ratio 1.89; 95% confidence interval 1.13-3.17), urinary tract infection (0.25; 0.13-0.46), APACHE II score (1.05; 1.02-1.09), SOFA score on day 1 (1.13; 1.06-1.21) and metabolic dysfunction (2.24, 1.45-3.45) were independent clinical factors for gender-related in-hospital mortality. This study provided epidemiological and clinical characteristics of community-acquired severe sepsis and septic shock in ICUs in Korea, and demonstrated the impact of clinical factors on gender difference in mortality.
APACHE ; Adult ; Aged ; Aged, 80 and over ; Bacteremia/epidemiology/microbiology ; Community-Acquired Infections/epidemiology/microbiology/virology ; Comorbidity ; Female ; Hospital Mortality ; Hospitals, University ; Humans ; Intensive Care Units ; Logistic Models ; Lung Diseases/epidemiology ; Male ; Metabolic Diseases/epidemiology ; Middle Aged ; Neoplasms/epidemiology ; Odds Ratio ; Prospective Studies ; Republic of Korea ; Risk Factors ; Sepsis/diagnosis/*epidemiology/mortality ; Severity of Illness Index ; Sex Factors ; Shock, Septic/diagnosis/*epidemiology/mortality ; Urinary Tract Infections/epidemiology