Predominant role of bacterial pneumonia as a cause of death in pandemic influenza: implications for pandemic influenza preparedness.
Predominant role of bacterial pneumonia as a cause of death in pandemic influenza: implications for pandemic influenza preparedness.
复制标题
DOI：
10.1086/591708
复制
发表时间：
2008-10-01
期刊：
影响因子：
--
通讯作者：
Fauci AS
中科院分区：
文献类型：
--
作者：
Morens DM;Taubenberger JK;Fauci AS
尽管有关于过去120年发生的4次大流行的公开数据，但关于与流感大流行有关的死亡原因的现代信息很少。我们检查了最近一次流感大流行的相关信息，该大流行发生在使用抗生素之前的1918-1919年“西班牙流感”大流行期间。我们检查了58例尸检中获得的肺组织切片，并回顾了109个已发表的尸检系列中描述了8398个个体尸检的病理和细菌学数据。我们检查了1918-1919年间死于流感的人的尸检样本，一致显示出细菌性肺炎的严重变化。发表的尸检系列的细菌学和组织病理学结果清楚而一致地表明，在大多数流感死亡病例中，继发性细菌性肺炎是由常见的上呼吸道细菌引起的。1918-1919年流感大流行中的大多数死亡可能是由常见上呼吸道细菌引起的继发性细菌性肺炎直接造成的。随后的1957年和1968年大流行的较少实质性数据与这些发现一致。如果严重的大流行性流感在很大程度上是病毒-细菌共生的问题，大流行规划需要超越单独解决病毒原因的问题(例如流感疫苗和抗病毒药物)。预防、诊断、预防和治疗继发性细菌性肺炎以及储备抗生素和细菌疫苗也应是大流行规划的高度优先事项。
Despite the availability of published data on 4 pandemics that have occurred over the past 120 years, there is little modern information on the causes of death associated with influenza pandemics. We examined relevant information from the most recent influenza pandemic that occurred during the era prior to the use of antibiotics, the 1918–1919 “Spanish flu” pandemic. We examined lung tissue sections obtained during 58 autopsies and reviewed pathologic and bacteriologic data from 109 published autopsy series that described 8398 individual autopsy investigations. The postmortem samples we examined from people who died of influenza during 1918–1919 uniformly exhibited severe changes indicative of bacterial pneumonia. Bacteriologic and histopathologic results from published autopsy series clearly and consistently implicated secondary bacterial pneumonia caused by common upper respiratory–tract bacteria in most influenza fatalities. The majority of deaths in the 1918–1919 influenza pandemic likely resulted directly from secondary bacterial pneumonia caused by common upper respiratory–tract bacteria. Less substantial data from the subsequent 1957 and 1968 pandemics are consistent with these findings. If severe pandemic influenza is largely a problem of viral-bacterial copathogenesis, pandemic planning needs to go beyond addressing the viral cause alone (e.g., influenza vaccines and antiviral drugs). Prevention, diagnosis, prophylaxis, and treatment of secondary bacterial pneumonia, as well as stockpiling of antibiotics and bacterial vaccines, should also be high priorities for pandemic planning.
登录
查看更多内容
DOI：
10.1016/s1473-3099(06)70466-2
发表时间：
2006-05
期刊：
The Lancet. Infectious diseases
影响因子：
--
作者：
Brundage JF
通讯作者：
Brundage JF
影响因子：
15.3
作者：
Didierlaurent, Arnaud;Goulding, John;Patel, Seema;Snelgrove, Robert;Low, Lionel;Bebien, Magali;Lawrence, Toby;van Rijt, Leonie S.;Lambrecht, Bart N.;Sirard, Jean-Claude;Hussell, Tracy
通讯作者：
Hussell, Tracy
影响因子：
6.4
作者：
Hirsch, EF;McKinney, M
通讯作者：
McKinney, M
影响因子：
158.5
作者：
Abdel-Ghafar, Abdel-Nasser;Chotpitayasunondh, Tawee;Uyeki, Timothy M.
通讯作者：
Uyeki, Timothy M.
影响因子：
3.1
作者：
Bakwin, H
通讯作者：
Bakwin, H