1744. Prevalence of Respiratory Viral Pathogen Testing and Co-Detections among Patients Hospitalized with Influenza, 2012-2015
Session: Oral Abstract Session: Influenza - Impact on Healthcare and Healthcare Providers
Saturday, October 29, 2016: 9:45 AM
Room: 388-390

Background: The clinical significance of respiratory viral pathogen co-detections is not well described. We determined the prevalence of co-detections among patients hospitalized with influenza and described characteristics of patients with and without co-detections.

Methods: We included adults and children (<18 years old) hospitalized with laboratory-confirmed influenza and enrolled in the Influenza Surveillance Network (FluSurv-NET) during the 2012–2015 influenza seasons (October 1–April 30). We abstracted data from medical records on clinician-directed testing for at least one other respiratory viral pathogen (respiratory syncytial virus [RSV], adenovirus [AdV], parainfluenzas 1-4 [hPIV], human metapneumovirus [hMPV], rhinovirus/enterovirus [hRV] and coronavirus [hCoV]). We used Stepwise logistic regression to examine factors associated with co-detections compared to influenza alone.

Results: In total, 4939 children and 34837 adults were hospitalized with influenza; 3796 (77%) children and 9863 (28%) adults were tested for at least one additional pathogen. RSV was the most commonly tested pathogen among children (76%) and adults (28%). Among those tested, 687 (18%) children (Figure 1) and 279 (3%) adults (Figure 2) tested positive for ≥1 additional pathogen; the most common pathogen co-detected among children was RSV (11%). Children with co-detections were more likely than those with influenza alone to be <2 years old (aOR 2.8; 95% confidence interval (CI) 2.2-3.6), have bronchiolitis (aOR 5.5; CI 4.4-6.9) or pneumonia (aOR 1.4; CI 1.1-1.7) and be admitted to an ICU (aOR 1.4; CI 1.1-1.7) and less likely to be born prematurely (aOR 0.7; CI 0.5-0.9). Adults with co-detections were more likely than those with influenza alone to be <65 years old (aOR 1.8; CI 1.4-2.3) and immunocompromised (aOR 1.5; CI 1.2-1.9).

Conclusion: Over 75% of children and 25% of adults hospitalized with influenza were tested for additional viral respiratory pathogens. While RSV co-detection was common among children, viral co-detections were uncommonly tested for and detected among adults. Children with influenza plus other virus co-detections were more likely to have bronchiolitis, pneumonia and be admitted to an ICU compared to those with influenza alone.        


Figure 1:



Figure 2:

Jessica Cohen, MPH1,2, Evan J. Anderson, MD3, Mary Lou Lindegren, MD, MPH4, Pam Daily Kirley, MPH5, Shelley M. Zansky, PhD6, Ann Thomas, MD, MPH7, Ruth Lynfield, MD, FIDSA8, Lisa Miller, MD, MSPH9, Marisa Bargsten, MPH10, James I. Meek, MPH11, Nancy M. Bennett, MD12, James Collins, MPH, RS13, Maya Monroe, MPH14, Gregg M. Reed, MPH15, Lilith Tatham, DVM, MPH16, Alicia M. Fry, MD, MPH17 and Shikha Garg, MD, MPH2, (1)Atlanta Research and Education Foundation, Atlanta, GA, (2)Centers for Disease Control and Prevention, Atlanta, GA, (3)Pediatrics and Medicine, Emory University School of Medicine, Atlanta, GA, (4)Vanderbilt University School of Medicine, Nashville, TN, (5)California Emerging Infections Program, Oakland, CA, (6)New York State Department of Health, Albany, NY, (7)Department of Human Services, Health Services, Portland, OR, (8)Minnesota Department of Health, St. Paul, MN, (9)Colorado Department of Public Health and Environment, Denver, CO, (10)New Mexico Department of Health, Santa Fe, NM, (11)Connecticut Emerging Infections Program, Yale School of Public Health, New Haven, CT, (12)University of Rochester Medical Center, Rochester, NY, (13)Michigan Department of Health and Human Services, Lansing, MI, (14)Maryland Department of Health and Mental Hygiene, Baltimore, MD, (15)Bureau of Epidemiology, Utah Department of Health, Salt Lake City, UT, (16)Ohio Department of Health, Columbus, OH, (17)Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA


J. Cohen, None

E. J. Anderson, MedImmune: Editorial assistance for a manuscript and Investigator , Research grant
AbbVie: Consultant , Consulting fee
Regeneron: Investigator , Research grant

M. L. Lindegren, None

P. Daily Kirley, None

S. M. Zansky, None

A. Thomas, None

R. Lynfield, None

L. Miller, None

M. Bargsten, None

J. I. Meek, None

N. M. Bennett, None

J. Collins, None

M. Monroe, None

G. M. Reed, None

L. Tatham, None

A. M. Fry, None

S. Garg, None

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