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Cited by 96Influenza Virus Research StudiesPneumonia and Respiratory InfectionsRespiratory viral infections research

Bacterial co-infection with H1N1 infection in patients admitted with community acquired pneumonia

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Cillóniz, Catia, Ewig, Santiago, Menéndez, Rosario, Ferrer, Miquel, Polverino, Eva, Reyes, Soledad, Gabarrús, Albert, Marcos, Maria Angeles +3 more·2012·Journal of Infection
DOI 10.1016/j.jinf.2012.04.009PMC PMC7132402
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Abstract

Background Bacterial co-infection is an important contributor to morbidity and mortality during influenza pandemics .We investigated the incidence, risk factors and outcome of patients with influenza A H1N1 pneumonia and bacterial co-infection.Methods Prospective observational study of consecutive hospitalized patients with influenza A H1N1 virus and community-acquired pneumonia (CAP). We compared cases with and without bacterial co-infection.Results The incidence of influenza A H1N1 infection in CAP during the pandemic period was 19% (n, 667). We studied 128 patients; 42(33%) had bacterial co-infection. The most frequently isolated bacterial pathogens were Streptococcus pneumoniae (26, 62%) and Pseudomonas aeruginosa (6, 14%). Predictors for bacterial co-infection were chronic obstructive pulmonary disease (COPD) and increase of platelets count. The hospital mortality was 9%. Factors associated with mortality were age ≥ 65 years, presence of septic shock and the need for mechanical ventilation. Although patients with bacterial co-infection presented with higher Pneumonia Severity Index risk class, hospital mortality was similar to patients without bacterial co-infection (7% vs. 11%, respectively, p = 0.54).Conclusion Bacterial co-infection was frequent in influenza A H1N1 pneumonia, with COPD and increased platelet count as the main predictors. Although associated with higher severe scales at admission, bacterial co-infection did not influence mortality of these patients.

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  • In seasonal epidemics, influenza bacterial coinfection is associated with increases in hospital admissions, more severe symptoms, and increases in mortality.

    “In seasonal epidemics, influenza bacterial coinfection is associated with increases in hospital admissions,4, 5 more severe symptoms,6 and increases in mortality.7”

    From The frequency of influenza and bacterial coinfection: a systematic review and meta-analysis. (2016) · cites this paper as [6]

  • Bacterial co-infection was detected in ~30% of cases in the 2009 H1N1 pandemic, with high mortality rates despite administration of appropriate antibiotics.

    “Bacterial co-infection was also detected in ~30% of cases in the 2009 H1N1 pandemic, with high mortality rates despite administration of appropriate antibiotics”

    From Respiratory viral infection-induced microbiome alterations and secondary bacterial pneumonia. (2018) · cites this paper as [11]

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Authors
Cillóniz, C., Ewig, S., Menéndez, R., Ferrer, M., Polverino, E., Reyes, S., Gabarrús, A., Marcos, M. A., Cordoba, J., Mensa, J., & Torres, A.
Affiliations
  • Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (ES)
  • Augusta-Kranken-Anstalt (DE)
  • Hospital Universitari i Politècnic La Fe (ES)
  • Hospital Clínic de Barcelona (ES)
ORCID
Venue
Journal of Infection
Publisher
Elsevier BV
Published
2012-09
Volume
65
Issue
3
Pages
223-230
ISSN
0163-4453 (ISSN-L)
DOI
10.1016/j.jinf.2012.04.009
PMC
PMC7132402
OpenAlex
W2028066970
Cited by
94
References
44
Citations by year
2026: 2 · 2025: 7 · 2024: 7 · 2023: 6 · 2022: 7 · 2021: 11 · 2020: 7 · 2019: 7 · 2018: 5 · 2017: 4 · 2016: 7 · 2015: 9 · 2014: 6 · 2013: 9
FWCI
5.75
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Infection (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Epidemiology › Influenza Virus Research Studies
  • Health Sciences › Medicine › Epidemiology › Pneumonia and Respiratory Infections
  • Health Sciences › Medicine › Epidemiology › Respiratory viral infections research
Keywords
bacterial co-infection, H1N1 influenza, community-acquired pneumonia, Streptococcus pneumoniae, Pseudomonas aeruginosa, chronic obstructive pulmonary disease, platelet count, in-hospital mortality, septic shock, mechanical ventilation, Pneumonia Severity Index, risk factors
MeSH terms
Adolescent, Adult, Aged, Aged, 80 and over, Anti-Bacterial Agents, Bacterial Infections, Female, Humans, Influenza, Human, Male, Middle Aged, Prospective Studies, Risk Factors, Incidence, Logistic Models, Community-Acquired Infections, Pneumonia, Bacterial, Influenza A Virus, H1N1 Subtype, Coinfection

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