Increased Mortality Rates Associated with<i>Staphylococcus aureus</i>and Influenza Co-infection, Maryland and Iowa, USA1

McDanel, Jennifer S.; Perencevich, Eli N.; Storm, Jeremy C.; Diekema, Daniel J.; Herwaldt, Loreen A.; Johnson, J. Kristie; Winokur, Patricia L.; Schweizer, Marin L.

doi:10.3201/eid2207.151319

Cited by 35 publications

(30 citation statements)

References 10 publications

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“…A report of the 2009-2010 influenza pandemic among critically ill children revealed that nearly 5% of the patients had bacteremia within 72 h and Staphylococcus aureus was the most frequently isolated bacterium, which contributed to the death rate in the current pandemic [33]. In a study of 32 influenza-positive patients (including pediatric and adult patients), poor outcomes were found among patients who were coinfected with influenza viruses and Staphylococcus aureus [34]. Although we were unable to conclude whether or not initiating timely additional antimicrobial treatment in critically ill influenza patients led to better clinical outcomes, our findings and previous reports underscore that Staphylococcus aureus remains the most important cause of bacterial coinfection in pediatric and adult influenza patients.…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and Predictors of Mortality in Critically Ill Influenza Adult Patients

Hsu

Lee

Huang

et al. 2020

JCM

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Severe influenza is associated with high morbidity and mortality. The aim of this study was to investigate the factors affecting the clinical outcomes of critically ill influenza patients. In this retrospective study, we enrolled critically ill adult patients with influenza at the Kaohsiung Chang Gung Memorial Hospital in Taiwan. We evaluated the demographic, clinical, and laboratory findings and examined whether any of these measurements correlated with mortality. We then created an event-based algorithm as a simple predictive tool using two variables with statistically significant associations with mortality. Between 2015 and 2018, 102 critically ill influenza patients (median age, 62 years) were assessed; among them, 41 (40.1%) patients died. Of the 94 patients who received oseltamivir therapy, 68 (72.3%) began taking oseltamivir 48 h after the onset of illness. Of the 102 patients, the major influenza-associated complications were respiratory failure (97%), pneumonia (94.1%), acute kidney injury (65.7%), adult respiratory distress syndrome (ARDS) (51%), gastrointestinal bleeding (35.3%), and bacteremia (16.7%). In the multivariate regression model, high lactate levels, ARDS, acute kidney injury, and gastrointestinal bleeding were independent predictors of mortality in critically ill influenza patients. The optimal lactate level cutoff for predicting mortality was 3.7 mmol/L with an area under curve of 0.728. We constructed an event-associated algorithm that included lactate and ARDS. Fifteen (75%) of 20 patients with lactate levels 3.7 mmol/L and ARDS died, compared with only 1 (7.7%) of 13 patients with normal lactate levels and without ARDS. We identified clinical and laboratory predictors of mortality that could aid in the care of critically ill influenza patients. Identification of these prognostic markers could be improved to prioritize key examinations that might be useful in determining patient outcomes.

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Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and Predictors of Mortality in Critically Ill Influenza Adult Patients

Hsu

Lee

Huang

et al. 2020

JCM

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“…Influenza viruses are responsible for an average of 400,000 deaths per year globally (Simonsen et al, 1997 ; Bakaletz, 2004 ; King et al, 2017 ; Tansey, 2017 ). During previous influenza pandemics (H1N1, 1918; H2N2, 1957; H3N2, 1968; H1N1, 2009) and seasonal epidemics, many influenza-related deaths actually occurred due to bacterial co-infections (Guarner et al, 2006 ; Taubenberger and Morens, 2008 ; Weiser, 2010 ; Klein et al, 2016 ; McDanel et al, 2016 ; Shah et al, 2016 ). Since the 1950s, researchers have increasingly focused on concomitant infections with influenza viruses and a range of bacterial agents (Table 1 ).…”

Section: Introductionmentioning

confidence: 99%

Mechanisms of Severe Mortality-Associated Bacterial Co-infections Following Influenza Virus Infection

Jia

Xie

Zhao

et al. 2017

Front. Cell. Infect. Microbiol.

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Influenza virus infection remains one of the largest disease burdens on humans. Influenza-associated bacterial co-infections contribute to severe disease and mortality during pandemic and seasonal influenza episodes. The mechanisms of severe morbidity following influenza-bacteria co-infections mainly include failure of an antibacterial immune response and pathogen synergy. Moreover, failure to resume function and tolerance might be one of the main reasons for excessive mortality. In this review, recent advances in the study of mechanisms of severe disease, caused by bacterial co-infections following influenza virus pathogenesis, are summarized. Therefore, understanding the synergy between viruses and bacteria will facilitate the design of novel therapeutic approaches to prevent mortality associated with bacterial co-infections.

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“…Superinfections caused by bacteria during respiratory viral infections found associated with significant cause of death 23 . In a previous study an increased mortality was observed in coinfection of staphylococcus aureus with Influenza in hospitals of Iowa and Maryland, USA during 2003 -2009 24 .…”

Section: Fig 2: the Gel Image Showing Polymerase Chain Reaction Amplmentioning

confidence: 89%

Untitled

2017

IJPSR

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Background: Influenza and influenza like illness (ILI) is a common respiratory illness among HIV patients. ILI is caused by various respiratory viruses and bacteria other than influenza virus. The symptoms of ILI recover within a few days, but in HIV patients ILI with opportunistic coinfections may lead to serious complications and hospitalization. Objective: To determine the incidence of human rhinovirus (HRV) coinfection with Staphylococcus aureus among HIV patients suffering from flu like illness. Materials and Methods: In this study 92 throat swab samples of flu suspected HIV patients were collected from Department of Immunology, SGPGIMS, Lucknow and ART Centre, RMLIMS, Lucknow, during 2014-2015. Samples were cultured on mannitol salt agar (MSA) plates, Staphylococcus aureus were confirmed by the biochemical characterization. The confirmation of HRV was done by RT-PCR. HeLa cell lines were used for isolation of human rhinovirus. Results: The prevalence of HRV was found 17 (18.5%), while S. aureus were isolated from 40 (43.5%) samples. Coinfection of S. aureus was found in 11 HRV positive samples (64.7%), among them 5 (45.5%) isolates were found high colonizer. Only 2 HRV confirmed samples (11.8%) were found cell culture positive on HeLa cell lines. The significant enhancement in clinical symptoms such as coughing, sore throat and sputum was found during coinfection (P <0.05). Conclusion: The high prevalence of HRV is found in flu suspected HIV patients in this region. S. aureus coinfection is found higher during HRV infection with higher rate of colonization. Respiratory complications were observed significantly increased during coinfection. INTRODUCTION: Human immunodeficiency virus (HIV) increases susceptibility to numerous respiratory infections 1 .

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Increased Mortality Rates Associated withStaphylococcus aureusand Influenza Co-infection, Maryland and Iowa, USA1

Cited by 35 publications

References 10 publications

Clinical Characteristics and Predictors of Mortality in Critically Ill Influenza Adult Patients

Clinical Characteristics and Predictors of Mortality in Critically Ill Influenza Adult Patients

Mechanisms of Severe Mortality-Associated Bacterial Co-infections Following Influenza Virus Infection

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