Program Schedule

787
Respiratory Pathogen Detection in Cases of Severe Acute Respiratory Illness (SARI) Among Hospitalized Patients at Two Metro-Area Hospitals, Minnesota, 2013-2014

Session: Poster Abstract Session: Clinical Respiratory Infections
Friday, October 10, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Background:

In the United States, surveillance of non-influenza severe acute respiratory illness (SARI) is not well established. The Minnesota Department of Health (MDH) is conducting pilot hospital-based surveillance to characterize SARI in adults and children year-round.

Methods:

SARI surveillance was implemented two hospitals (one pediatric, one general). Residual upper respiratory specimens, collected for diagnostic testing, were submitted to the MDH-Public Health Laboratory from Dec 2013 to Feb 2014. Specimens were tested for 22 viral and bacterial pathogens by real-time PCR. Admission records, including history and physical, were reviewed to identify patients meeting SARI case definition (cough, shortness of breath, or difficulty breathing, with or without fever), and medical records were reviewed to obtain demographic and clinical data on patients with submitted specimens.

Results:

Of known hospitalizations, 1,232 specimens were submitted.  Pediatrics median age was 2.9 yrs (range X – xx); adult median age was 45.3 yrs (range xx-xx). There were no detections of enterovirus, influenza B, coronavirus 229E, Bordetella,  Legionella pneumophila, or mycoplasma all other detections are presented in table 1. 204 (19%) pediatric patients had >1 pathogen detected compared to 2 (2%) adult patients (p< 0.01). The most common pediatric co-detection was RSV and rhinovirus (xx/204).

Table 1.

 

Pediatrics (n=1087)

No. (%)

Adults (n=138)

No. (%)

p-value

Any pathogen detected

780 (71)

48 (35)

<0.001

RSV

454 (42)

6 (4)

<0.001

Rhinovirus

156 (14)

2 (1)

<0.001

Adenovirus

98 (9)

2 (1)

  0.002

Influenza A

63 (6)

31 (22)

<0.001

Chlamydophila pneumonia

3 (<1)

0

NS

Coronavirus HKU1

53 (5)

0

0.008

Coronavirus NL63

38 (4)

3 (2)

NS

Coronavirus OC43

33 (3)

0

0.038

hMPV

45 (4)

2 (1)

NS

Parainfluenza 1

22 (2)

1 (1)

NS

Parainfluenza 2

13 (1)

0

NS

Parainfluenza 3

2 (<1)

0

NS

Parainfluenza 4

2 (<1)

0

NS

NS=not significant; hMPV=human metapneumovirus

Conclusion:

MDH established a pilot surveillance effort for SARI at two hospitals. Pediatric patients were more likely than adults to have a pathogen detected and to have > 1 pathogen detected.  Data are helpful to inform the development of prevention and therapeutic interventions for respiratory infections.

Hannah Friedlander, MPH and Kathryn Como-Sabetti, MPH, Minnesota Department of Health, St. Paul, MN

Disclosures:

H. Friedlander, None

K. Como-Sabetti, None

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