2344. Parainfluenza in Hematologic patients – Impact of Prolonged Viral Shedding and Nosocomial Infection
Session: Poster Abstract Session: Transplant Virology
Saturday, October 29, 2016
Room: Poster Hall
Background: Parainfluenza virus (PIV) is often cause of self-limiting upper respiratory tract infection (URTI), but can result in severe and even life-threatening lower respiratory infection (LRTI) in the immunocompromised host. In contrast to seasonal influenza, PIV is transmitted all year round. Here, we describe outcome and risk factors of PIV infection in hematologic patients and report on prolonged viral shedding in this particular population.

Methods: Clinical characteristics and outcome of hematologic patients with documented PIV infection treated at our institution from July 2013 to June 2015 were retrospectively evaluated. In patients with available consecutive tests for PIV, duration of viral shedding was assessed. 

Results: 60 patients were identified, 47 with PIV 1/3, 13 with PIV 2/4. Median age was 59 years [range 26-76], 38 patients were male. 41 patients had received a stem cell transplantation (20 allogeneic, 17 autologous, 4 both). Nosocomial infection, defined as diagnosis of PIV infection ≥1 week after hospital admission, was apparent in 23 patients. In regard to outcome, 36 patients had URTI only, 24 (40%) developed a LRTI. Of the latter, 3 patients (13%) were transferred to the ICU and subsequently died. Neither type of PIV nor underlying hematologic disease had a significant impact on outcome. Leukopenia as well as nosocomial infection were significantly associated with LRTI (p=0.02 and p=0.01, resp.), a trend was seen for status post allogeneic transplantation (p=0.06). Duration of viral shedding could be evaluated in 23 patients. Median duration of viral shedding was 14 days, but shedding of up to 79 days was observed. A significant association between LRTI and prolonged shedding for >20 days was observed (p=0.01).

Conclusion: PIV infection can cause significant morbidity in hematologic patients. Nosocomial infection was frequently present and was associated with a higher rate of LRTI in our patient population. Prolonged viral shedding was observed which might facilitate nosocomial spread of PIV and should be taken into account in infection control management.

Nicola Lehners, MD, Joe Puthenparambil, MD, Martin Schiller, MD, Anthony D. Ho, MD, Paul Schnitzler, PhD and Gerlinde Egerer, MD, University Hospital of Heidelberg, Heidelberg, Germany

Disclosures:

N. Lehners, None

J. Puthenparambil, None

M. Schiller, None

A. D. Ho, None

P. Schnitzler, None

G. Egerer, None

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