Predictive factors of 2009 H1N1 virus infection in patients with influenza syndrome
A. SUPERVÍA, F. DEL BAÑO, G. MALDONADO, O. PALLÀS, A. AGUIRRE, C. VILAPLANA, J. P. HORCAJADA, M. T. MARTÍNEZ-IZQUIERDO
Introduction: Polymerase chain reaction (PCR) testing isone of the better techniques for viral detection in nasopharyngeal swabs. The objective of this study was to assess the percentage of positive swabs and to determine whether there were differences according to PCR positivity. Material and Methods: A retrospective study of 362 patients with flu syndrome attended at the Emergency Department between July 15 and December 15, 2009, in whom PCR of nasopharyngeal swabs for the detection of H1N1 2009 influenza virus was performed. Those cases in which swab testing was adequately requested were identified, and patients were divided into two groups according to positive or negative results for H1N1 2009 influenza virus. Results: Nasopharyngeal swab was inadequately ordered in 87. In the remaining 275 patients, PCR was positive in 141. Patients with positive nasopharyngeal swabs were younger (mean [SD] age 36.1  vs42.3  years, P= 0.002), had lower white blood cell, neutrophil and lymphocyte counts, lower serum concentrations of C-reactive protein (5.15  vs 10.5 mg/dL, P= 0.036) and lower incidence of radiological infiltrates (20.5% vs 33%, P= 0.036). In the logistic regression analysis, age, serum C-reactive protein levels, and lymphocyte count were independently associated with a positive nasopharyngeal swab. Conclusions: About 50% of patients with flu syndrome had positive nasopharyngeal swabs for H1N1 2009 influenza virus. Age, C-reactive protein, and lymphocyte count were independent predictors of positivity.
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