Secondary Bacterial Infections Associated with Influenza Pandemics

Abstract

Lower and upper respiratory infections are the fourth highest cause of global mortality (Lozano et al., 2012). Epidemic and pandemic outbreaks of respiratory infection are a major medical concern, often causing considerable disease and a high death toll, typically over a relatively short period of time. Influenza is a major cause of epidemic and pandemic infection. Bacterial co/secondary infection further increases morbidity and mortality of influenza infection, with Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus reported as the most common causes. With increased antibiotic resistance and vaccine evasion it is important to monitor the epidemiology of pathogens in circulation to inform clinical treatment and development, particularly in the setting of an influenza epidemic/pandemic.

Impact of bacterial and viral coinfection in community-acquired pneumonia in adults

“…As well-known synergism exists between influenza and S. pneumoniae (Klein et al, 2016;McCullers, 2006), bacterial-viral interaction would be fatal to pneumonia patients and increase mortality dramatically. Various viral mechanisms, such as disruption of the epithelial barrier, upregulation of adhesion proteins, or dysfunction of the immune system, could facilitate the bacterial infection (Bosch et al, 2013;Morris et al, 2017), and we assume that these synergisms could play a role in worsening pneumonia. Second, most patients with CAP were treated with appropriate antimicrobial therapy; however, antiviral agents were very limited and treatment of coinfection in influenza (Chertow and Memoli, 2013;Morris et al, 2017), however, the role of antiviral agents in bacterial and viral coinfected patients with CAP has not yet been elucidated.…”

“…Various viral mechanisms, such as disruption of the epithelial barrier, upregulation of adhesion proteins, or dysfunction of the immune system, could facilitate the bacterial infection (Bosch et al, 2013;Morris et al, 2017), and we assume that these synergisms could play a role in worsening pneumonia. Second, most patients with CAP were treated with appropriate antimicrobial therapy; however, antiviral agents were very limited and treatment of coinfection in influenza (Chertow and Memoli, 2013;Morris et al, 2017), however, the role of antiviral agents in bacterial and viral coinfected patients with CAP has not yet been elucidated. Although we attempted to minimize errors, several limitations exist in the study as follows: first, because of the nature of the retrospective study, we had to rely on chart review for the patients' information.…”

An international perspective on hospitalized patients with viral community-acquired pneumonia

“…A mixed infection was defined as a CAP in which a virus was detected together with either bacteria or fungi. A coinfection, when present, was considered as a viral CAP [15][16][17][18].…”

Проблема Бактериальных Осложнений При Респираторных Вирусных Инфекциях

“…Как ни странно, не было выявлено радикальных отличий в генетической структуре вируса гриппа, вызвавшего «испанку», от вируса гриппа того же подтипа, цирку-лирующего в человеческой популяции в настоящее время [6]. При исследовании патологоанатомических материалов в более чем 90% образцов тканей легкого людей, умерших от гриппа в период пандемии, выяв-лены признаки бактериальной инфекции [7][8][9]. Ока-залось, что 95% летальных исходов были следствием бактериальной пневмонии, а не первичной вирусной пневмонии.…”

“…При доминировании S. pneumoniae в образцах легких идентифицированы также Staphylococcus aureus (S. aureus), H. influenzae и другие представители Streptococcus spp. [5,7]. Таким образом, катастрофические последствия пандемии 1918 г. могли определяться отсутствием вакцины и специфических препаратов против вируса гриппа, а также антибиотиков, способных подавить вторич-ные бактериальные осложнения.…”