Journal
JOURNAL OF INFECTION
Volume 65, Issue 3, Pages 223-230Publisher
W B SAUNDERS CO LTD
DOI: 10.1016/j.jinf.2012.04.009
Keywords
Influenza A H1N1 pneumonia; Bacterial co-infection; Community-acquired pneumonia
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Funding
- CibeRes [CB06/06/0028]
- Programa de Investigacion en Gripe-ISCiii-McyT
- IDIBAPS
- [2009 SGR 911]
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Background: Bacterial co-infection is an important contributor to morbidity and mortality during influenza pandemics. We investigated the incidence, risk factors and outcome of patients with influenza A H1N1 pneumonia and bacterial co-infection. Methods: Prospective observational study of consecutive hospitalized patients with influenza A H1N1 virus and community-acquired pneumonia (CAP). We compared cases with and without bacterial co-infection. Results: The incidence of influenza A H1N1 infection in CAP during the pandemic period was 19% (n, 667). We studied 128 patients; 42(33%) had bacterial co-infection. The most frequently isolated bacterial pathogens were Streptococcus pneumoniae (26, 62%) and Pseudomonas aeruginosa (6, 14%). Predictors for bacterial co-infection were chronic obstructive pulmonary disease (COPD) and increase of platelets count. The hospital mortality was 9%. Factors associated with mortality were age >= 65 years, presence of septic shock and the need for mechanical ventilation. Although patients with bacterial co-infection presented with higher Pneumonia Severity Index risk class, hospital mortality was similar to patients without bacterial co-infection (7% vs. 11%, respectively, p = 0.54). Conclusion: Bacterial co-infection was frequent in influenza A H1N1 pneumonia, with COPD and increased platelet count as the main predictors. Although associated with higher severe scales at admission, bacterial co-infection did not influence mortality of these patients. (C) 2012 The British Infection Association. Published by Elsevier Ltd. All rights reserved.
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