Pneumonia in Military Trainees: A Comparison Study Based on Adenovirus Serotype 14 Infection

• Published in: The Journal of infectious diseases Vol. 203; no. 10; pp. 1388 - 1395
• Main Authors: Vento, Todd J., Prakash, Vidhya, Murray, Clinton K., Brosch, Lorie C., Tchandja, Juste B., Cogburn, Cynthia, Yun, Heather C.
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 15-05-2011
• Subjects: Adenoviridae - classification; Adenoviridae Infections - epidemiology; Adenoviridae Infections - pathology; Adenoviridae Infections - virology; Adenoviruses; Adolescent; Biological and medical sciences; Disease Outbreaks; Diseases; Epidemiology; Female; Fundamental and applied biological sciences. Psychology; Humans; Infections; Infectious diseases; Intensive care units; Major and Brief Reports; Male; Medical sciences; Microbiology; Military Personnel; Military training; Miscellaneous; Pneumonia; Pneumonia, Viral - epidemiology; Pneumonia, Viral - pathology; Pneumonia, Viral - virology; Respiratory diseases; Retrospective Studies; United States - epidemiology; Virology; VIRUSES; Young Adult; United States; Virus; Infection; Lung disease; Pneumonia; Adenoviridae; Respiratory disease; Serotype
• ISSN: 0022-1899; 1537-6613; 1537-6613; 0022-1899
• DOI: 10.1093/infdis/jir040

Background. Adenovirus serotype 14 (Ad-14) recently emerged as a respiratory pathogen in the United States, with studies suggesting higher morbidity and mortality. This study was conducted to determine whether Ad-14 is associated with clinical outcomes in otherwise healthy patients with pneumonia. Methods. Medical records of military trainees hospitalized with pneumonia during an outbreak of Ad-14 infection were reviewed. Clinical, radiographie, and laboratory parameters were compared on the basis of Ad-14 infection. Results. Two hundred thirty-four trainees received a diagnosis of pneumonia, and 83(35%) were hospitalized. Sixty-one percent of patients with pneumonia were Ad-14 positive; 43% of patients with Ad-14 pneumonia were hospitalized (83% of female patients and 40% of male patients; P = .04), compared with 40% of patients with Ad-14 negative cases. Ad-14 infection was associated with higher admission temperature (38.3°C [interquartile range, (IQR) 37.7, 39.4] vs 37.3°C [IQR (36.7, 38.5)]; P<.01) and lower white blood cell count (8.3 X 1000 cellsμL [IQR, 5.7,12.4] vs 13 X 1000 cells/μL [IQR, 7.5,12.9]; P = .01), neutrophil count (6.7 X 1000 cells/μL [IQR, 2.8, 9.7] vs 9.7 X 1000 cells/μL [IQR, 5.6, 12.1]; P = .02), lymphocyte count (0.9 X 1000 cells/μL [IQR, 0.8,1.1] vs 1.3 X 1000 cells/μL [IQR, 1, 1.9]; P = .001), and platelet count (210 X 1000 cells/μL [IQR, 145, 285] vs 261 X 1000 cells/μL [IQR, 238, 343]; P < .01). Ad-14 pneumonia was not associated with specific radiographie findings, pneumonia severity score, intensive care unit admission, longer hospitalization, or 30-day mortality. Conclusions. During an outbreak of Ad-14 infection, Ad-14 infection was not associated with excess overall morbidity or mortality. Ad-14 infection was associated with specific laboratory and clinical parameters and higher hospitalization rates in female trainees. These data provide new insight to the epidemiology of Ad-14 infection.