• Nicole Haber, Siham Dekimeche, Cyrille Cantet, Dominique Marquand, Carol Szekely, and Pierre Lebon.
• Service de Gériatrie, Hôpital Charles RICHET, Assistance-Publique-Hôpitaux de Paris, F-95400 Villiers Le Bel, France. nicole.haber@crc.aphp.fr
• Presse Med. 2009 Jun 1; 38 (6): 893-903.

ObjectivesTo assess the proportion of lower respiratory tract infections (LRTI) attributable to influenza virus and respiratory syncytial virus (RSV) during the 2005-2006 winter period, among hospitalized elderly in a geriatric unit of a French hospital near Paris and and describe the characteristics of these infections.MethodsIn a geriatric unit with 115 beds, distributed as 14 in acute care (ACF), 21 in rehabilitation and intermediate-care (RICF) and 80 in long-term-care-facilities (LTCF), all patients over age 65 with LRTI were enrolled during a winter. Clinical and biological parameters were recorded including paired serology for influenza virus and RSV.Results54 LRTI concerned 47 patients were recorded. 50 paired serums were analysed. Influenza virus or RSV were found in 17 cases (34%). The distribution of the cases was as follows: Influenza A in 5 cases, Influenza B in 3 cases, a co-infection with influenza A and B in 4 cases, RSV in 3 cases and co-infections with influenza and RSV in 2 cases (influenza A and RSV in one case and influenza A and B and RSV in the other case). 7 cases concerned patients in ACF, in 3 cases patients were in RICF and in 7 cases patients were in LTCF. 15 cases were nosocomial infections. 11 patients infected by influenza virus were vaccined. It was concluded as bronchitis in 8 cases, interstitial pneumonia in 6 cases and alveolar pneumonia in 3 cases. Antibiotics were prescribed in 11 cases. In one case the evolution was unfavourable with death. Patients with influenza or RSV infections had significantly more rales and rhonchi compared with patients non infected by these virus (p<0.05).ConclusionInfluenza and RSV are an important cause of LRTI in elderly during the winter months, influenza infections can occurring among vaccinated elderly. It seems necessary to achieve further clinical studies about LRTI in elderly and to study the impact of rapid diagnostic tests to improve the management of these infections.

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