Estimating the prevalence of coinfection with influenza virus and the atypical bacteria Bordetella pertussis, Chlamydophila pneumoniae, and Mycoplasma pneumoniae

Abstract

Coinfections with common bacterial respiratory pathogens and influenza viruses are well-known causes of disease, often via synergistic interactions between the influenza virus, the bacteria, and the human host. However, relatively little is known about interactions between atypical bacteria and influenza viruses. A recent report by Reinton et al. explored this issue by analyzing data from 3,661 patients seeking medical assistance for the presence of Mycoplasma pneumoniae, Chlamydophila pneumoniae, and Bordetella pertussis, as well as influenza A or B virus in nasal swab specimens. The report, however, did not accurately assess the epidemiologic interactions of these pathogens. We aimed to describe the interactions between these bacterial species and influenza infections. Strong and highly statistically significant antagonistic interspecies interactions were detected between C. pneumoniae and influenza virus [odds ratio (OR): 0.09; p<0.0001) and M. pneumoniae and influenza virus infections (OR: 0.29; p=0.003). No association was detected between B. pertussis and influenza infection (p=0.34), contrary to the initial report, and coinfection was not detected at a higher-than-by-chance frequency within the population. Further support of these results is supplied by the analysis of two earlier investigations reporting data on influenza virus and these atypical bacteria. Our results supplement the large body of literature regarding interactions between influenza virus and typical respiratory pathogens, providing a fuller picture of the spectrum of interactions between influenza viruses and respiratory bacteria. Further, we demonstrate the importance of choosing the most appropriate reference populations for the analysis being performed and describe the pitfalls that may occur when care is not taken in this regard.

Salmonella typhimurium Infection Reduces Schistosoma japonicum Worm Burden in Mice

“…typhimurium , Staphylococcus aureus ) 38 or helminths ( Plasmodium falciparum , S. japonicum ) 39 . Many of these pathogens could be present in the same host concurrently, thereby affecting severity of the infection and disrupting normal metabolism of the host.…”

The role of influenza in the severity and transmission of respiratory bacterial disease

“…Indeed, elucidation of antagonistic interactions that exist between influenza viruses and bacteria, as have been recently shown for the atypical bacteria Mycoplasma pneumoniae and Chlamydophila pneumoniae , 89 could prove useful in the discovery of mechanisms or development of improved therapeutics to combat co-infections.…”

Identfication of viral and bacterial etiologic agents of the pertussis-like syndrome in children under 5 years old hospitalized

“…Another common coinfection was B. pertussis and Flu-B present in 9 patients. Although viral-bacterial coinfections are commonly associated with worse clinical courses and longer hospitalizations [17,19,20]. Recent investigations have reported similar clinical outcomes in infants hospitalized with B. pertussis and another respiratory virus coinfection [20].…”

“…Simultaneous infections with virus and bacteria species have become an obstacle for clinicians, their prevalence has significantly increased, with studies discovering co-infections in more than 45% of cases [11,[17][18][19]. Additionally, these coinfections have been associated with longer hospitalization periods, worse clinical outcomes and increased mortality, again highlighting the importance of molecular etiological confirmation [17,19,20].…”