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Davido B, Lemarie B, Gault E, Dumoulin J, D'anglejan E, Beaune S, De Truchis P. Interest of Absolute Eosinopenia as a Marker of Influenza in Outpatients during the Fall-Winter Seasons 2016-2018 in the Greater Paris Area: The SUPERFLUOUS Study. Diagnostics (Basel) 2023; 13:2115. [PMID: 37371009 DOI: 10.3390/diagnostics13122115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/24/2023] [Accepted: 06/17/2023] [Indexed: 06/29/2023] Open
Abstract
INTRODUCTION Prior to the emergence of COVID-19, when influenza was the predominant cause of viral respiratory tract infections (VRTIs), this study aimed to analyze the distinct biological abnormalities associated with influenza in outpatient settings. METHODS A multicenter retrospective study was conducted among outpatients, with the majority seeking consultation at the emergency department, who tested positive for VRTIs using RT-PCR between 2016 and 2018. Patient characteristics were compared between influenza (A and B types) and non-influenza viruses, and predictors of influenza were identified using two different models focusing on absolute eosinopenia (0/mm3) and lymphocyte count <800/mm3. RESULTS Among 590 VRTIs, 116 (19.7%) were identified as outpatients, including 88 cases of influenza. Multivariable logistic regression analysis revealed the following predictors of influenza: in the first model, winter season (adjusted odds ratio [aOR] 7.1, 95% confidence interval [CI] 1.12-45.08) and absolute eosinopenia (aOR 6.16, 95% CI 1.14-33.24); in the second model, winter season (aOR 9.08, 95% CI 1.49-55.40) and lymphocyte count <800/mm3 (aOR 7.37, 95% CI 1.86-29.20). Absolute eosinopenia exhibited the highest specificity and positive predictive value (92% and 92.3%, respectively). CONCLUSION During the winter season, specific biological abnormalities can aid physicians in identifying influenza cases and guide the appropriate use of antiviral therapy when rapid molecular tests are not readily available.
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Affiliation(s)
- Benjamin Davido
- Maladies Infectieuses, Hôpital Raymond Poincaré, Assistance Publique des Hôpitaux de Paris (AP-HP), 92380 Garches, France
- UMR1173, Université Versailles St-Quentin, Université Paris-Saclay, 78180 Montigny-Le-Bretonneux, France
| | - Benoit Lemarie
- Maladies Infectieuses, Hôpital Raymond Poincaré, Assistance Publique des Hôpitaux de Paris (AP-HP), 92380 Garches, France
| | - Elyanne Gault
- UMR1173, Université Versailles St-Quentin, Université Paris-Saclay, 78180 Montigny-Le-Bretonneux, France
- Virologie, Hôpital Ambroise-Paré, Assistance Publique des Hôpitaux de Paris (AP-HP), 92100 Boulogne-Billancourt, France
| | - Jennifer Dumoulin
- Pneumologie, Hôpital Ambroise Paré, Assistance Publique des Hôpitaux de Paris (AP-HP), 92100 Boulogne-Billancourt, France
| | - Emma D'anglejan
- Maladies Infectieuses, Hôpital Raymond Poincaré, Assistance Publique des Hôpitaux de Paris (AP-HP), 92380 Garches, France
| | - Sebastien Beaune
- Service d'Accueil des Urgences, Hôpital Ambroise Paré, Assistance Publique des Hôpitaux de Paris (AP-HP), 92100 Boulogne-Billancourt, France
| | - Pierre De Truchis
- Maladies Infectieuses, Hôpital Raymond Poincaré, Assistance Publique des Hôpitaux de Paris (AP-HP), 92380 Garches, France
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Guzmán-Rodríguez M, Acosta-Ñañez HF, Mantilla JC, Bonelo A. Dengue Virus and Influenza A Virus Co-Infection in Pregnancy: A Case Report. Trop Med Infect Dis 2019; 4:tropicalmed4020084. [PMID: 31117316 PMCID: PMC6631397 DOI: 10.3390/tropicalmed4020084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 04/25/2019] [Accepted: 04/26/2019] [Indexed: 01/11/2023] Open
Abstract
Dengue is still an important cause of disease and mortality in tropical countries, as is influenza A virus, which is also a cause of epidemics all over the globe. In this article, we present the case of a 31-year-old woman who was in her second trimester of pregnancy and presented with severe dengue with hematological and neurological complications, and premature labor. She was misdiagnosed with bacterial infection and received antibiotic treatment with no improvement of the clinical manifestations and previous to death, she was diagnosed with dengue infection. She died from cardiorespiratory arrest. In the postmortem evaluation, influenza A co-infection was confirmed and characterization of the tissue damage and immune response in lung, liver, kidney, heart, spleen, and brain was determined, finding a severe inflammatory response in lung with T cells and macrophages infiltrating the tissue. This case report highlights the risks of accepting a single diagnosis, especially in endemic countries to multiple tropical diseases, which can lead to delay in appropriate treatment that could reduce morbidity and mortality.
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Affiliation(s)
- Mónica Guzmán-Rodríguez
- Magister in Biomedical Sciences, Universidad del Valle, Cali 760001, Colombia.
- Emergent Viruses and Disease-VIREM, Universidad del Valle, Cali 760001, Colombia.
| | | | - Julio César Mantilla
- Department of Pathology, Universidad Industrial de Santander, Bucaramanga 680001, Colombia.
| | - Anilza Bonelo
- Emergent Viruses and Disease-VIREM, Universidad del Valle, Cali 760001, Colombia.
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Chandler DP, Griesemer SB, Knickerbocker C, Golova JB, Lambarqui A, Perov AN, Zimmerman C, Wiles C, Rudy GB, St George K. Development and clinical testing of a simple, low-density gel element array for influenza identification, subtyping, and H275Y detection. J Virol Methods 2014; 208:152-9. [PMID: 25066276 PMCID: PMC4175443 DOI: 10.1016/j.jviromet.2014.07.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Revised: 07/09/2014] [Accepted: 07/15/2014] [Indexed: 11/22/2022]
Abstract
The objectives of this study were to develop a user-friendly, gel element microarray test for influenza virus detection, subtyping, and neuraminidase inhibitor resistance detection, assess the performance characteristics of the assay, and perform a clinical evaluation on retrospective nasopharyngeal swab specimens. A streamlined microarray workflow enabled a single user to run up to 24 tests in an 8h shift. The most sensitive components of the test were the primers and probes targeting the A/H1 pdm09 HA gene with an analytical limit of detection (LoD) <100 gene copies (gc) per reaction. LoDs for all targets in nasopharyngeal swab samples were ≤1000 gc, with the exception of one target in the seasonal A/H1N1 subtype. Seasonal H275Y variants were detectable in a mixed population when present at >5% with wild type virus, while the 2009 pandemic H1N1 H275Y variant was detectable at ≤1% in a mixture with pandemic wild type virus. Influenza typing and subtyping results concurred with those obtained with real-time RT-PCR assays on more than 97% of the samples tested. The results demonstrate that a large panel of single-plex, real-time RT-PCR tests can be translated to an easy-to-use, sensitive, and specific microarray test for potential diagnostic use.
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Affiliation(s)
- Darrell P Chandler
- Akonni Biosystems, Inc., 400 Sagner Avenue, Suite 300, Frederick, MD 21701, United States.
| | - Sara B Griesemer
- Laboratory of Viral Diseases, Wadsworth Center, New York State Department of Health, 120 New Scotland Avenue, Albany, NY 12208, United States
| | | | - Julia B Golova
- Akonni Biosystems, Inc., 400 Sagner Avenue, Suite 300, Frederick, MD 21701, United States
| | - Amine Lambarqui
- Akonni Biosystems, Inc., 400 Sagner Avenue, Suite 300, Frederick, MD 21701, United States
| | - Alexander N Perov
- Akonni Biosystems, Inc., 400 Sagner Avenue, Suite 300, Frederick, MD 21701, United States
| | - Cynthia Zimmerman
- Akonni Biosystems, Inc., 400 Sagner Avenue, Suite 300, Frederick, MD 21701, United States
| | - Cory Wiles
- Akonni Biosystems, Inc., 400 Sagner Avenue, Suite 300, Frederick, MD 21701, United States
| | - George B Rudy
- Akonni Biosystems, Inc., 400 Sagner Avenue, Suite 300, Frederick, MD 21701, United States
| | - Kirsten St George
- Laboratory of Viral Diseases, Wadsworth Center, New York State Department of Health, 120 New Scotland Avenue, Albany, NY 12208, United States
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4
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Evaluation of two commercial real-time PCR kits for detection of pandemic (H1N1) 2009 virus in Beijing. J Virol Methods 2013; 188:25-8. [DOI: 10.1016/j.jviromet.2012.11.042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2012] [Revised: 11/21/2012] [Accepted: 11/27/2012] [Indexed: 11/17/2022]
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5
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Yang Z, Mao G, Liu Y, Chen YC, Liu C, Luo J, Li X, Zen K, Pang Y, Wu J, Liu F. Detection of the pandemic H1N1/2009 influenza A virus by a highly sensitive quantitative real-time reverse-transcription polymerase chain reaction assay. Virol Sin 2013; 28:24-35. [PMID: 23385352 DOI: 10.1007/s12250-013-3290-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Accepted: 01/23/2013] [Indexed: 11/29/2022] Open
Abstract
A quantitative real time reverse-transcription polymerase chain reaction (qRT-PCR) assay with specific primers recommended by the World Health Organization (WHO) has been widely used successfully for detection and monitoring of the pandemic H1N1/2009 influenza A virus. In this study, we report the design and characterization of a novel set of primers to be used in a qRT-PCR assay for detecting the pandemic H1N1/2009 virus. The newly designed primers target three regions that are highly conserved among the hemagglutinin (HA) genes of the pandemic H1N1/2009 viruses and are different from those targeted by the WHO-recommended primers. The qRT-PCR assays with the newly designed primers are highly specific, and as specific as the WHO-recommended primers for detecting pandemic H1N1/2009 viruses and other influenza viruses including influenza B viruses and influenza A viruses of human, swine, and raccoon dog origin. Furthermore, the qRT-PCR assays with the newly designed primers appeared to be at least 10-fold more sensitive than those with the WHO-recommended primers as the detection limits of the assays with our primers and the WHO-recommended primers were 2.5 and 25 copies of target RNA per reaction, respectively. When tested with 83 clinical samples, 32 were detected to be positive using the qRT-PCR assays with our designed primers, while only 25 were positive by the assays with the WHO-recommended primers. These results suggest that the qRT-PCR system with the newly designed primers represent a highly sensitive assay for diagnosis of the pandemic H1N1/2009 virus infection.
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Affiliation(s)
- Zhu Yang
- Institute of Virology, School of Life Sciences, Nanjing University, Nanjing 210093, Jiangsu, China
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Marzoratti L, Iannella HA, Gómez VF, Figueroa SB. Recent advances in the diagnosis and treatment of influenza pneumonia. Curr Infect Dis Rep 2012; 14:275-83. [PMID: 22477036 PMCID: PMC3342505 DOI: 10.1007/s11908-012-0257-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
A potentially fatal complication of influenza infection is the development of pneumonia, caused either directly by the influenza virus, or by secondary bacterial infection. Pneumonia related to the 2009 influenza A pandemic was found to be underestimated by commonly used pneumonia severity scores in many cases, and to be rapidly progressive, leading to respiratory failure. Confirmation of etiology by laboratory testing is warranted in such cases. Rapid antigen and immunofluorescence testing are useful screening tests, but have limited sensitivity. Confirmation of pandemic H1N1 influenza A infection can only be made by real-time reverse-transcriptase polymerase chain reaction (rRT-PCR) or viral culture. The most effective preventive measure is annual influenza vaccination in selected individuals. Decisions to administer antiviral medications for influenza treatment or chemoprophylaxis should be based upon clinical and epidemiological factors, and should not be delayed by confirmatory laboratory testing results. Neuraminidase inhibitors (NI) are the agents of choice.
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Affiliation(s)
- Lucia Marzoratti
- CEMIT (Centro Médico Investigadores Tucumán), San Miguel de Tucumán, Tucumán Argentina
| | - Hernán A. Iannella
- Pulmonary Medicine Division, Hospital de Clínicas, Universidad de Buenos Aires, Buenos Aires, Argentina
| | | | - Sandra B. Figueroa
- CEMIT (Centro Médico Investigadores Tucumán), San Miguel de Tucumán, Tucumán Argentina
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Evaluation of real-time reverse transcriptase PCR assays for detection of pandemic influenza A/H1N1 2009 virus. J Clin Microbiol 2011; 49:3444-5. [PMID: 21878586 DOI: 10.1128/jcm.00974-11] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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