Bacterial and viral co-infections complicating severe influenza: Incidence and impact among 507 U.S. patients, 2013–14

Shah, Nirav; Greenberg, Jared A.; McNulty, Moira; Gregg, Kevin; Riddell, James; Mangino, Julie E.; Weber, Devin; Hebert, Courtney; Marzec, Natalie S.; Barron, Michelle A.; Chaparro-Rojas, Fredy; Restrepo, Alejandro; Hemmige, Vagish; Prasidthrathsint, Kunatum; Cobb, Sandra; Herwaldt, Loreen A.; Raabe, Vanessa; Cannavino, Christopher; Hines, Andrea Green; Bares, Sara H; Antiporta, Philip B.; Scardina, Tonya; Patel, Ursula; Reid, Gail; Mohazabnia, Parvin; Kachhdiya, Suresh; Le, Binh Minh; Park, Connie J.; Ostrowsky, Belinda; Robicsek, Ari; Smith, Becky; Schied, Jeanmarie; Bhatti, Micah M.; Mayer, Stockton; Sikka, Monica K; Murphy-Aguilu, Ivette; Patwari, Priti; Abeles, Shira R.; Torriani, Francesca J.; Abbas, Zainab; Toya, Sophie P.; Doktor, Katherine; Chakrabarti, Anindita; Doblecki-Lewis, Susanne; Looney, David J.; David, Michael Z.

doi:10.1016/j.jcv.2016.04.008

Cited by 90 publications

(77 citation statements)

References 30 publications

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“…Herein, we confirmed the frequency of co-infection in severe influenza-pneumonia patients. In their recent large study on 2,901 ICU patients in Spain, Martin-Loeches et al found a 16.6% co-infection rate [9], whereas Shah et al's evaluation of 507 patients distributed in 33 American centers yielded a rate of 22.5% [15]. We report a higher co-infection rate than those cited above, which could be explained by multiple factors, e.g., that co-infection could be participating in overall disease severity, as previously advanced [16], the different criteria used to define co-infection, and its diagnosis may have been facilitated by the easier and more reliable sample collection on MV.…”

Section: Discussionmentioning

confidence: 96%

Co-infection with influenza-associated acute respiratory distress syndrome requiring extracorporeal membrane oxygenation

Rozencwajg

Bréchot

Schmidt

et al. 2018

International Journal of Antimicrobial Agents

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The co-infection frequency and impact among influenza-associated acute respiratory distress syndrome (ARDS) patients requiring extracorporeal membrane oxygenation (ECMO) are not known. This retrospective observational analysis concerned data prospectively collected from patients admitted to our medical intensive care unit (ICU) who received ECMO support for influenza-associated ARDS between 2009-2016. Co-infection was defined as occurring within 48 h following ICU admission. Among the 77 ARDS patients requiring ECMO support, 39 (51%) developed co-infections, with Staphylococcus aureus [18 (46%) of the co-infected patients] being the most prevalent pathogen. Panton-Valentin leukocidin (PVL)-producing S. aureus was isolated from 10 patients (56% of S. aureus co-infections and 26% of all co-infections). Co-infected patients were comparable with those without co-infection, except for BMI, initial disease severity and antibiotic treatment prior to admission. Co-infection was associated with higher in-ICU mortality (62% vs. 29%; P = 0.006) and with fewer ECMO-free days [median (IQR) 0 (0-19) vs. 23 (0-46); P = 0.004] and fewer mechanical ventilation-free days [0 (0-0) vs. 6 (0-35); P = 0.003] on Day 60. Multivariable analysis retained age >49 years, pre-ECMO Simplified Acute Physiology Score (SAPS) II score >70 and co-infection as independent predictors of hospital mortality. In conclusion, co-infection is frequent in ECMO-treated patients with influenza-associated ARDS, affecting ca. 50%, and is independently associated with poor outcome. Staphylococcus aureus was the most frequently identified pathogen, with a high rate of PVL-positive S. aureus. Whether specific therapy targeting PVL-producing S. aureus should be given remains to be determined.

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Section: Discussionmentioning

confidence: 96%

Co-infection with influenza-associated acute respiratory distress syndrome requiring extracorporeal membrane oxygenation

Rozencwajg

Bréchot

Schmidt

et al. 2018

International Journal of Antimicrobial Agents

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“…Influenza is still a significant health problem that results in high morbidity and mortality in the United States and worldwide (23). The therapeutic approaches used for the prevention and treatment of influenza infection include amantadine, neuraminidase inhibitors (24), and vaccines (25).…”

Section: Discussionmentioning

confidence: 99%

Anti-influenza Activity of a Bacillus subtilis Probiotic Strain

Starosila

Рыбалко

Varbanetz

et al. 2017

Antimicrob Agents Chemother

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Among Bacillus bacteria, B. subtilis is the species that produces the most antimicrobial compounds. In this study, we analyzed the activity of probiotic strain B. subtilis 3 against the influenza virus. The antiviral effect of this strain has been demonstrated in vitro and in vivo. A new peptide, P18, produced by the probiotic strain was isolated, purified, chemically synthesized, and characterized. Cytotoxicity studies demonstrated no toxic effect of P18 on Madin-Darby canine kidney (MDCK) cells, even at the highest concentration tested (100 g/ml). Complete inhibition of the influenza virus in vitro was observed at concentrations of 12.5 to 100 g/ ml. The protective effect of P18 in mice was comparable to that of oseltamivir phosphate (Tamiflu). Further study will assess the potential of peptide P18 as an antiviral compound and as a promising candidate for the development of new antiviral vaccines.

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“…Also, in almost one-third of the Simplexa™ positive samples, TAC detected Flu A and the presence of an additional pathogen. Respiratory co-infections, in particular, the association of Flu A with (an)other viral, bacterial or fungal pathogen(s), could be associated with longer hospital stay, a longer ICU stay and even higher mortality (Shah et al, 2016;Echenique et al, 2013;Crotty et al, 2015). Detecting these co-infections could have an important clinical impact.…”

Section: Discussionmentioning

confidence: 99%

Performance evaluation of direct fluorescent antibody, Focus Diagnostics Simplexa™ Flu A/B & RSV and multi-parameter customized respiratory Taqman® array card in immunocompromised patients

Steensels

Descheemaeker

Curran

et al. 2017

Journal of Virological Methods

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Bacterial and viral co-infections complicating severe influenza: Incidence and impact among 507 U.S. patients, 2013–14

Cited by 90 publications

References 30 publications

Co-infection with influenza-associated acute respiratory distress syndrome requiring extracorporeal membrane oxygenation

Co-infection with influenza-associated acute respiratory distress syndrome requiring extracorporeal membrane oxygenation

Anti-influenza Activity of a Bacillus subtilis Probiotic Strain

Performance evaluation of direct fluorescent antibody, Focus Diagnostics Simplexa™ Flu A/B & RSV and multi-parameter customized respiratory Taqman® array card in immunocompromised patients

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