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Bacterial coinfections likely played a role in almost one-third of fatal cases of 2009 pandemic influenza A(H1N1) in the United States, based on data from 77 patients published online in the Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.
“These findings confirm that bacterial lung infections are occurring among patients with fatal cases of 2009 H1N1 and underscore both the importance of pneumococcal vaccination for persons at increased risk for pneumococcal pneumonia and the need for early recognition of bacterial pneumonia in persons with influenza,” the investigators wrote (MMWR 2009;58:1–4).
The investigators found evidence of concurrent bacterial infection in lung specimens from 22 of 77 patients (29%) with fatal cases of 2009 H1N1 infection. The specimens were submitted to the CDC by medical examiners and local health departments between May 1 and Aug. 20, 2009.
A total of 10 fatal cases were coinfections with Streptococcus pneumoniae, 6 were Streptococcus pyogenes, 7 were Staphylococcus aureus, 2 were Streptococcus mitis, and 1 was Haemophilus influenzae. Four of the fatal cases involved multiple pathogens. The age of the patients ranged from 2 months to 56 years, with an average age of 31 years. The 22 patients were divided evenly by sex. The average duration of illness was 6 days, based on data from 17 of the 22 coinfection cases for whom this information was available.
Medical history was available for 21 of the coinfection patients, and 16 of these had underlying medical conditions “that were known to increase the risk for influenza-related complications,” the investigators wrote. And 15 patients had conditions that were indications for vaccination with the 23-valent pneumococcal polysaccharide vaccine (PPSV23), the investigators added. Data were not available on the vaccination status of any of the 22 bacterial coinfection cases.
Although two early reviews of severe 2009 H1N1 cases this year showed no evidence of coinfection with bacterial pneumonia, the current results support findings from autopsy studies in previous pandemics, in which bacterial coinfections were found in the majority of the deaths attributed to influenza A infections, the investigators wrote.
The results were limited by incomplete patient information, a lack of specimens from unaffected lung tissue, and a limited evaluation of potential bacterial pathogens, they noted.
For the complete MMWR report, visit www.cdc.gov/mmwr
Bacterial coinfections likely played a role in almost one-third of fatal cases of 2009 pandemic influenza A(H1N1) in the United States, based on data from 77 patients published online in the Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.
“These findings confirm that bacterial lung infections are occurring among patients with fatal cases of 2009 H1N1 and underscore both the importance of pneumococcal vaccination for persons at increased risk for pneumococcal pneumonia and the need for early recognition of bacterial pneumonia in persons with influenza,” the investigators wrote (MMWR 2009;58:1–4).
The investigators found evidence of concurrent bacterial infection in lung specimens from 22 of 77 patients (29%) with fatal cases of 2009 H1N1 infection. The specimens were submitted to the CDC by medical examiners and local health departments between May 1 and Aug. 20, 2009.
A total of 10 fatal cases were coinfections with Streptococcus pneumoniae, 6 were Streptococcus pyogenes, 7 were Staphylococcus aureus, 2 were Streptococcus mitis, and 1 was Haemophilus influenzae. Four of the fatal cases involved multiple pathogens. The age of the patients ranged from 2 months to 56 years, with an average age of 31 years. The 22 patients were divided evenly by sex. The average duration of illness was 6 days, based on data from 17 of the 22 coinfection cases for whom this information was available.
Medical history was available for 21 of the coinfection patients, and 16 of these had underlying medical conditions “that were known to increase the risk for influenza-related complications,” the investigators wrote. And 15 patients had conditions that were indications for vaccination with the 23-valent pneumococcal polysaccharide vaccine (PPSV23), the investigators added. Data were not available on the vaccination status of any of the 22 bacterial coinfection cases.
Although two early reviews of severe 2009 H1N1 cases this year showed no evidence of coinfection with bacterial pneumonia, the current results support findings from autopsy studies in previous pandemics, in which bacterial coinfections were found in the majority of the deaths attributed to influenza A infections, the investigators wrote.
The results were limited by incomplete patient information, a lack of specimens from unaffected lung tissue, and a limited evaluation of potential bacterial pathogens, they noted.
For the complete MMWR report, visit www.cdc.gov/mmwr
Bacterial coinfections likely played a role in almost one-third of fatal cases of 2009 pandemic influenza A(H1N1) in the United States, based on data from 77 patients published online in the Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.
“These findings confirm that bacterial lung infections are occurring among patients with fatal cases of 2009 H1N1 and underscore both the importance of pneumococcal vaccination for persons at increased risk for pneumococcal pneumonia and the need for early recognition of bacterial pneumonia in persons with influenza,” the investigators wrote (MMWR 2009;58:1–4).
The investigators found evidence of concurrent bacterial infection in lung specimens from 22 of 77 patients (29%) with fatal cases of 2009 H1N1 infection. The specimens were submitted to the CDC by medical examiners and local health departments between May 1 and Aug. 20, 2009.
A total of 10 fatal cases were coinfections with Streptococcus pneumoniae, 6 were Streptococcus pyogenes, 7 were Staphylococcus aureus, 2 were Streptococcus mitis, and 1 was Haemophilus influenzae. Four of the fatal cases involved multiple pathogens. The age of the patients ranged from 2 months to 56 years, with an average age of 31 years. The 22 patients were divided evenly by sex. The average duration of illness was 6 days, based on data from 17 of the 22 coinfection cases for whom this information was available.
Medical history was available for 21 of the coinfection patients, and 16 of these had underlying medical conditions “that were known to increase the risk for influenza-related complications,” the investigators wrote. And 15 patients had conditions that were indications for vaccination with the 23-valent pneumococcal polysaccharide vaccine (PPSV23), the investigators added. Data were not available on the vaccination status of any of the 22 bacterial coinfection cases.
Although two early reviews of severe 2009 H1N1 cases this year showed no evidence of coinfection with bacterial pneumonia, the current results support findings from autopsy studies in previous pandemics, in which bacterial coinfections were found in the majority of the deaths attributed to influenza A infections, the investigators wrote.
The results were limited by incomplete patient information, a lack of specimens from unaffected lung tissue, and a limited evaluation of potential bacterial pathogens, they noted.
For the complete MMWR report, visit www.cdc.gov/mmwr