Journal article
Bacterial and viral co-infections complicating severe influenza: Incidence and impact among 507 U.S. patients, 2013–14
Journal of clinical virology, Vol.80, pp.12-19
07/2016
DOI: 10.1016/j.jcv.2016.04.008
PMCID: PMC7185824
PMID: 27130980
Abstract
•22.5% of adult patients with H1N1 developed bacterial co-infection.•Staphylococcus aureus was the most common cause of co-infection.•Bacterial and viral co-infections were associated with death in bivariate.•Patients with a bacterial co-infection had greater use of resources.
Influenza acts synergistically with bacterial co-pathogens. Few studies have described co-infection in a large cohort with severe influenza infection.
To describe the spectrum and clinical impact of co-infections.
Retrospective cohort study of patients with severe influenza infection from September 2013 through April 2014 in intensive care units at 33 U.S. hospitals comparing characteristics of cases with and without co-infection in bivariable and multivariable analysis.
Of 507 adult and pediatric patients, 114 (22.5%) developed bacterial co-infection and 23 (4.5%) developed viral co-infection. Staphylococcus aureus was the most common cause of co-infection, isolated in 47 (9.3%) patients. Characteristics independently associated with the development of bacterial co-infection of adult patients in a logistic regression model included the absence of cardiovascular disease (OR 0.41 [0.23–0.73], p=0.003), leukocytosis (>11K/μl, OR 3.7 [2.2–6.2], p<0.001; reference: normal WBC 3.5–11K/μl) at ICU admission and a higher ICU admission SOFA score (for each increase by 1 in SOFA score, OR 1.1 [1.0–1.2], p=0.001). Bacterial co-infections (OR 2.2 [1.4–3.6], p=0.001) and viral co-infections (OR 3.1 [1.3–7.4], p=0.010) were both associated with death in bivariable analysis. Patients with a bacterial co-infection had a longer hospital stay, a longer ICU stay and were likely to have had a greater delay in the initiation of antiviral administration than patients without co-infection (p<0.05) in bivariable analysis.
Bacterial co-infections were common, resulted in delay of antiviral therapy and were associated with increased resource allocation and higher mortality.
Details
- Title: Subtitle
- Bacterial and viral co-infections complicating severe influenza: Incidence and impact among 507 U.S. patients, 2013–14
- Creators
- Nirav S Shah - Department of Medicine, University of Chicago, Chicago, IL, United StatesJared A Greenberg - Department of Medicine, University of Chicago, Chicago, IL, United StatesMoira C McNulty - Department of Medicine, University of Chicago, Chicago, IL, United StatesKevin S Gregg - Department of Medicine, University of Michigan Medical School, Ann Arbor, MI, United StatesJames Riddell - Department of Medicine, University of Michigan Medical School, Ann Arbor, MI, United StatesJulie E Mangino - Department of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, United StatesDevin M Weber - Department of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, United StatesCourtney L Hebert - Department of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, United StatesNatalie S Marzec - Department of Family Medicine, University of Colorado Denver, Denver, CO, United StatesMichelle A Barron - Department of Medicine, University of Colorado Denver, Denver, CO, United StatesFredy Chaparro-Rojas - Department of Medicine, Vidant Medical Center, Greenville, NC, United StatesAlejandro Restrepo - Department of Medicine, Baylor College of Medicine, Houston, TX, United StatesVagish Hemmige - Department of Medicine, Baylor College of Medicine, Houston, TX, United StatesKunatum Prasidthrathsint - Department of Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, United StatesSandra Cobb - Department of Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, United StatesLoreen Herwaldt - Department of Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, United StatesVanessa Raabe - Department of Pediatrics, University of California San Diego and Rady Children’s Hospital San Diego, San Diego, CA, United StatesChristopher R Cannavino - Department of Pediatrics, University of California San Diego and Rady Children’s Hospital San Diego, San Diego, CA, United StatesAndrea Green Hines - Department of Medicine, University of Nebraska Medical Center, Omaha, NE, United StatesSara H Bares - Department of Medicine, University of Nebraska Medical Center, Omaha, NE, United StatesPhilip B Antiporta - Department of Medicine, Loyola University Medical Center, Maywood, IL, United StatesTonya Scardina - Department of Pharmacy, Loyola University Medical Center, Maywood, IL, United StatesUrsula Patel - Department of Pharmacy, Edward Hines VA Hospital, Maywood, IL, United StatesGail Reid - Department of Medicine, Loyola University Medical Center, Maywood, IL, United StatesParvin Mohazabnia - Department of Medicine, University of Texas Southwestern Medical Center, Dallas, TX, United StatesSuresh Kachhdiya - Department of Medicine, University of Texas Southwestern Medical Center, Dallas, TX, United StatesBinh-Minh Le - Department of Medicine, University of Texas Southwestern Medical Center, Dallas, TX, United StatesConnie J Park - Department of Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, United StatesBelinda Ostrowsky - Department of Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, United StatesAri Robicsek - Department of Medicine, University of Chicago, Chicago, IL, United StatesBecky A Smith - Department of Medicine, Northshore University HealthSystem, Evanston, IL, United StatesJeanmarie Schied - Department of Pediatrics, University of Chicago, Chicago, IL, United StatesMicah M Bhatti - Department of Pediatrics, University of Chicago, Chicago, IL, United StatesStockton Mayer - Department of Medicine, University of Illinois at Chicago, Chicago, IL, United StatesMonica Sikka - Department of Medicine, University of Illinois at Chicago, Chicago, IL, United StatesIvette Murphy-Aguilu - Department of Medicine, University of Illinois at Chicago, Chicago, IL, United StatesPriti Patwari - Department of Medicine, Community Care Networks, Inc., Munster, IN, United StatesShira R Abeles - Department of Medicine, University of California San Diego, San Diego, CA, United StatesFrancesca J Torriani - Department of Medicine, University of California San Diego, San Diego, CA, United StatesZainab Abbas - Department of Medicine, Methodist Hospitals, Merrillville, IN, United StatesSophie Toya - Department of Medicine, Methodist Hospitals, Merrillville, IN, United StatesKatherine Doktor - Department of Medicine, University of Miami/Jackson Health System, Miami, FL, United StatesAnindita Chakrabarti - Department of Medicine, University of Miami/Jackson Health System, Miami, FL, United StatesSusanne Doblecki-Lewis - Department of Medicine, University of Miami/Jackson Health System, Miami, FL, United StatesDavid J Looney - Department of Medicine, VA San Diego/University of California San Diego, San Diego, CA, United StatesMichael Z David - Department of Medicine, University of Chicago, Chicago, IL, United States
- Resource Type
- Journal article
- Publication Details
- Journal of clinical virology, Vol.80, pp.12-19
- DOI
- 10.1016/j.jcv.2016.04.008
- PMID
- 27130980
- PMCID
- PMC7185824
- NLM abbreviation
- J Clin Virol
- ISSN
- 1386-6532
- eISSN
- 1873-5967
- Publisher
- Elsevier B.V
- Language
- English
- Date published
- 07/2016
- Academic Unit
- Infectious Diseases; Epidemiology; Pathology; Internal Medicine
- Record Identifier
- 9984094563702771
Metrics
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