The impact of bacterial and viral co-infection in severe influenza.
The impact of bacterial and viral co-infection in severe influenza.
复制标题
DOI：
10.1111/j.1750-2659.2012.00360.x
复制
发表时间：
2013-03
影响因子：
4.4
通讯作者：
COSI Microbiological Investigators
中科院分区：
文献类型：
--
作者：
Blyth CC;Webb SA;Kok J;Dwyer DE;van Hal SJ;Foo H;Ginn AN;Kesson AM;Seppelt I;Iredell JR;ANZIC Influenza Investigators;COSI Microbiological Investigators
请引用本文：Blyth 等人。 (2013)细菌和病毒双重感染对严重流感的影响。流感和其他呼吸道病毒 7(2) 168–176。 背景 关于入住重症监护病房 (ICU) 的大流行性流感患者的负担、危险因素以及细菌和病毒混合感染的影响，仍然存在许多问题。 目标 研究澳大利亚重症流感患者细菌和病毒双重感染的负担、危险因素和影响。 患者/方法 在 14 个 ICU 中进行了一项队列研究。 2009 年流感季节期间确诊患有甲型流感的患者有资格纳入。收集人口统计数据、危险因素、临床数据、微生物数据、并发症和结果。对储存的呼吸道样本进行了针对其他细菌和病毒呼吸道病原体的聚合酶链反应。 结果 严重甲型流感感染患者中有 23·3–26·9% 存在合并感染：病毒合并感染为 3·2–3·4%，细菌合并感染为 20·5–24·7%。金黄色葡萄球菌是最常见的细菌合并感染，其次是肺炎链球菌和流感嗜血杆菌。合并感染的患者更年轻[平均年龄差异 = 8·46 岁（95% CI：0·18–16·74 岁）]，出现显着合并症的可能性较小（32·0% vs 66·2%，P = 0·004），且肥胖率较低[体重指数平均差异 = 6·86 (95% CI: 1·77–11·96)]与没有合并感染的人相比。 结论 入住 ICU 的严重甲型流感感染患者中，有四分之一因细菌或病毒合并感染而复杂化。尽管合并感染的患者年龄较小且合并症较少，但未观察到结果存在显着差异。对于那些没有严重流感疾病其他危险因素的人来说，合并感染很可能导致需要入住 ICU。对于所有严重甲型流感感染的患者，应强烈考虑使用具有葡萄球菌活性的经验性抗生素。
Please cite this paper as: Blyth et al. (2013) The impact of bacterial and viral co‐infection in severe influenza. Influenza and Other Respiratory Viruses 7(2) 168–176. Background Many questions remain concerning the burden, risk factors and impact of bacterial and viral co‐infection in patients with pandemic influenza admitted to the intensive care unit (ICU). Objectives To examine the burden, risk factors and impact of bacterial and viral co‐infection in Australian patients with severe influenza. Patients/Methods A cohort study conducted in 14 ICUs was performed. Patients with proven influenza A during the 2009 influenza season were eligible for inclusion. Demographics, risk factors, clinical data, microbiological data, complications and outcomes were collected. Polymerase chain reaction for additional bacterial and viral respiratory pathogens was performed on stored respiratory samples. Results Co‐infection was identified in 23·3–26·9% of patients with severe influenza A infection: viral co‐infection, 3·2–3·4% and bacterial co‐infection, 20·5–24·7%. Staphylococcus aureus was the most frequent bacterial co‐infection followed by Streptococcus pneumoniae and Haemophilus influenzae. Patients with co‐infection were younger [mean difference in age = 8·46 years (95% CI: 0·18–16·74 years)], less likely to have significant co‐morbidities (32·0% versus 66·2%, P = 0·004) and less frequently obese [mean difference in body mass index = 6·86 (95% CI: 1·77–11·96)] compared to those without co‐infection. Conclusions Bacterial or viral co‐infection complicated one in four patients admitted to ICU with severe influenza A infection. Despite the co‐infected patients being younger and with fewer co‐morbidities, no significant difference in outcomes was observed. It is likely that co‐infection contributed to a need for ICU admission in those without other risk factors for severe influenza disease. Empiric antibiotics with staphylococcal activity should be strongly considered in all patients with severe influenza A infection.
登录
查看更多内容
DOI：
10.1086/591708
发表时间：
2008-10-01
期刊：
The Journal of infectious diseases
影响因子：
--
作者：
Morens DM;Taubenberger JK;Fauci AS
通讯作者：
Fauci AS
影响因子：
120.7
作者：
Thompson, WW;Shay, DK;Fukuda, K
通讯作者：
Fukuda, K
影响因子：
--
作者：
SCHWARZMANN, SW;ADLER, JL;MARINE, WM
通讯作者：
MARINE, WM
影响因子：
3
作者：
Kong, FR;Wang, WZ;Gilbert, GL
通讯作者：
Gilbert, GL
DOI：
10.1164/201001-0037oc
发表时间：
2010-07-01
影响因子：
24.7
作者：
Estenssoro, Elisa;Rios, Fernando G.;Valdez, Pascual
通讯作者：
Valdez, Pascual