The problem of bacterial complications post respiratory viral infections

Abstract

Every person over the course of their lifetime is repeatedly infected by a variety of respiratory viruses that represent risk factors for the development of bacterial complications. The most dangerous among the etiological factors of acute respiratory viral diseases is the influenza A virus. This virus is capable of causing catastrophic pandemics with high mortality mainly due to secondary bacterial pneumonia. As has been shown in numerous recent studies, the main mechanism of provoking bacterial infections irrespective of the type of respiratory virus is the imbalanced response of the antiviral innate immunity -excessive interferon response and uncontrolled inflammation. The probability of severe bacterial complications in the course of acute respiratory viral infections is determined by both the virulence of the virus itself and by the composition of the respiratory microbiota at the time of the viral infection as well as by the genetic characteristics of the organism. The occurrence of severe bacterial complications is also affected by the chronic diseases that have an impact on the regulation of the innate immune response. This review summarizes the current concept of the mechanisms of the development of post viral bacterial complications as well as the potential prevention strategies for these complications.

Outcomes of respiratory viral-bacterial co-infection in adult hospitalized patients

“…The rate of laboratory-confirmed viral-bacterial co-infection in this cohort of patients was in the lower range of the previously reported (2–77%) [ 31 , [40] , [41] , [42] , [43] , [44] , [45] ]. This is likely due to heterogeneity of our study population [46] , type of respiratory virus [ [47] , [48] , [49] ], viral detection methods [20] , case definition, community-acquired or nosocomial co-infection, seasonal variation and pandemics [ 50 , 51 ]. Moreover, we showed that laboratory-confirmed co-infection is associated with increased mortality, which is consistent with the findings from a recent meta-analysis on 31 studies consisting of 10, 762 patients with community-acquired pneumonia.…”

siRNA Therapeutics against Respiratory Viral Infections—What Have We Learned for Potential COVID‐19 Therapies?

“…While most respiratory viruses cause pathology directly by a cytopathic effect or by triggering immune responses, a main complication of ARVIs is furthermore their ability to facilitate secondary bacterial infections, thereby provoking pneumonia, otitis, meningitis, and other acute inflammatory pathologies. In fact, ARVIs are estimated to be the primary reason for about half of the community‐acquired pneumonia cases, [ 4 ] thus also impacting on antibiotic use and occurrence of multidrug resistant bacteria.…”