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The role of pneumonia and secondary bacterial infection in fatal and serious outcomes of pandemic influenza a(H1N1)pdm09
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The role of pneumonia and secondary bacterial infection in fatal and serious outcomes of pandemic influenza a(H1N1)pdm09
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Journal Article
The role of pneumonia and secondary bacterial infection in fatal and serious outcomes of pandemic influenza a(H1N1)pdm09
2018
Overview
Background
The aim of this study was to estimate the prevalence of pneumonia and secondary bacterial infections during the pandemic of influenza A(H1N1)pdm09.
Methods
A systematic review was conducted to identify relevant literature in which clinical outcomes of pandemic influenza A(H1N1)pdm09 infection were described. Published studies (between 01/01/2009 and 05/07/2012) describing cases of fatal or hospitalised A(H1N1)pdm09 and including data on bacterial testing or co-infection.
Results
Seventy five studies met the inclusion criteria. Fatal cases with autopsy specimen testing were reported in 11 studies, in which any co-infection was identified in 23% of cases (
Streptococcus pneumoniae 29%)
. Eleven studies reported bacterial co-infection among hospitalised cases of A(H1N1)2009pdm with confirmed pneumonia, with a mean of 19% positive for bacteria (
Streptococcus pneumoniae 54%)
. Of 16 studies of intensive care unit (ICU) patients, bacterial co-infection identified in a mean of 19% of cases (
Streptococcus pneumoniae 26%)
. The mean prevalence of bacterial co-infection was 12% in studies of hospitalised patients not requiring ICU (
Streptococcus pneumoniae 33%)
and 16% in studies of paediatric patients hospitalised in general or pediatric intensive care unit (PICU) wards (
Streptococcus pneumoniae 16%)
.
Conclusion
We found that few studies of the 2009 influenza pandemic reported on bacterial complications and testing. Of studies which did report on this, secondary bacterial infection was identified in almost one in four patients, with
Streptococcus pneumoniae
the most common bacteria identified. Bacterial complications were associated with serious outcomes such as death and admission to intensive care. Prevention and treatment of bacterial secondary infection should be an integral part of pandemic planning, and improved uptake of routine pneumococcal vaccination in adults with an indication may reduce the impact of a pandemic.
Publisher
BioMed Central,Springer Nature B.V,BMC
Subject
/ Adults
/ Autopsy
/ Bacteria
/ Bacterial and fungal diseases
/ Bacterial Infections - complications
/ Bacterial Infections - epidemiology
/ Bacterial Infections - microbiology
/ Bacterial Infections - virology
/ Child
/ Humans
/ Influenza A Virus, H1N1 Subtype - isolation & purification
/ Influenza, Human - complications
/ Influenza, Human - epidemiology
/ Influenza, Human - microbiology
/ Medicine
/ Pandemics - statistics & numerical data
/ Patients
/ Respiratory infections hospitalization
/ Studies
