Pneumonia Complicating Asian Influenza

Pneumonia Caused by Methicillin‐ResistantStaphylococcus aureus

“…In addition, Staphylococcus aureus was recognized as an important but infrequent cause of nosocomial pneumonia, occurring especially in elderly persons [2,3]. However, in the past 2 decades, there have been important changes in S. aureus pulmonary infection.…”

Bacterial Infection and Hospital Infection of Patients with Influenza

“…Public Health Laboratory Service, I958), but those who are admitted commonly acquire hospital strains of staphylococci. Oswald and his colleagues (I958) (Table i) found a much higher proportion of staphylococci of hospital type resistant to penicillin and tetracycline in the sputum of influenzal pneumonia patients after they had been in the ward for several days than in their first days after admission; a relative increase of hospital phage types was shown in a similar comparison by Oswald, Shooter and Curwen (1958). (Shooter, Griffiths, Cook and Williams, I957; Mitchell, Shaw Dunn, Lees and Hedges, I96I).…”

“…For instance, the Public Health Laboratory Service (1958) described the isolation of staphylococci from the lungs or sputum of 62% of 477 patients who died from pneumonia during the epidemic; the staphylococcus was held responsible for most of the deaths in young, healthy patients. Oswald, Shooter and Curwen (1958) reported a mortality of 28% in 155 cases of staphylococcal pneumonia complicating influenza, compared with a mortality of i2% in 145 patients with non-staphylococcal pneumonia; the high mortality of the staphylococcal cases appeared in all age-groups, whereas the mortality of the non-staphylococcal pneumonia was highest (26%) in patients of 55 years of age or more, and low (o to 3%) in the lower age groups. In most reports Staphylococcus aureus appeared to be the worst bacterial invader, though not necessarily the commonest; indeed Forbes (1958) found Staphylococcus aureus in only five out of 34 fatal cases with bacterial complications, both pneumococci and Streptococcus pyogenes being commoner.…”

Insights from unusual aspects of the 1918 influenza pandemic

“…The lack of effective medical interventions in 1918 meant it was often better to be managed at home by one's family than to be admitted to a chaotic emergency hospital ward full of many other sick influenza patients as hospitals increased exposure to many respiratory pathogens besides influenza virus. Certainly secondary bacterial pneumonia is observed following influenza infection today but even accounting for the near universal use of antibiotics in current intensive care units, bacterial pneumonia was remarkably common in 1918 for as yet unclear reasons [6,35,36].…”