Background
Methods
Search strategy
Inclusion and exclusion criteria
Data extraction and assessment
Results
Summary of included studies
Bacterial co-infection among fatal cases of A(H1N1)2009pdm
Author (year) Study location/ period | Study type | Study population | N (%) autopsied | N (%) hospitalised prior to death | Requirement for | Antiviralsa n/N (%) any n/N (%) 48 h | Antibioticsb n/N (%) pre n/N (%) on n/N (%) during admission | Positive bacterial growth | N (%) bacterial pneumonia | N (%) with S.pneumoniae Site of isolation | |
---|---|---|---|---|---|---|---|---|---|---|---|
ICU | Mechanical Ventilation | ||||||||||
Fajardo-Dolci (2009) [14] Mexico 16/3/09–16/5/09 | Medical record review | N = 100 Consecutive notified hospitalized fatal cases | 0/100 (0) | 100/100 (100) | NR | 84/100 (84.0) | 56/100 (56) NR | 94/100 (94) | 2/100 (2%) (Site not mentioned) | 77/82 (94.0) CXR suggestive of pneumonia. | NR |
Lee (2010) [1] USA 4/09–7/09 | Enhanced surveillance/confirmed cases in New York City. | N = 47 | 31/47 (66) | 47/47 (100.0) | All 28 cases who died after > 24 in hospital were admitted to ICU | 25/47 (80.6) | 32/47 (68.0) NR | NR | NR | 13/47 (27.6) By immunohistochemical analysis or PCR 21/28 with abnormal CXR and multilobar infiltrates. | 8/47 (17.0) Lung/airway tissue By immunohistochemical analysis or PCR |
Lucas (2010) [19] UK 4/09–1/10 | Case series. 15% of reported H1N1 deaths | N = 68 Autopsied fatal cases | 68/68 (100) | 68/68 (100) | NR | NR | NR | NR | 20/68 (29.4) (Culture of lung/ blood) | 28/68 (41.2) - Autopsy findings - Culture and histopathology | 7/68 (10.3) (6 confirmed and 1 possible through histology) isolation site Lung/ and or blood |
Gill (2010) [2] USA 5/09–7/09 | Case series. Autopsy request New York City (NYC) Office of chief medical examiner (n = 32), family requests (n = 10), deaths outside of NYC (n = 2) | N = 34 Autopsied fatal cases | 34/34 (100) | 21/34 (61.8) | NR | 12/21 (57.1) | NR | NR | 10/30 (33.3) Positive bacteria by culture, immunohistochemistry, and/or PCR | 18/33 (54.4) have evidence of bacterial co-infection by tissue Gram stain. | 6/30 (20) Positive for streptococcus by culture, immunohistochemistry, and/or PCR 16/33 (55) have evidence of bacterial co-infection by tissue Gram stain morphologically compatible with streptococcus. |
CDC (2009) [15] USA 4/09–8/09 | Multicenter case series. 100% of reported deaths | N = 36 Pediatric (< 18 yrs). Hospitalized fatal cases | NR | 28/33 (84.8) | 24/36 (66.7) | NR | 19/30 (63.3) Status unknown for 6 cases 4/30 (13%) | NR | NR | 10/23 (43.5) Based on culture and pathology results | 3/23 (13) from multiple sites in px (BC, lung tissue, pleural fluid, CSF) |
Shieh (2010) [18] USA 5/09–10/09 | Notified fatal case series/US CDC | N = 100 Autopsied fatal cases | 100/100 (100) | 58/87 (66.7) | NR | 42/57 (73.7) | 44/67 (65.7) NR | NR | NR | 29/100 (29) Bacterial co-infection positive through PCR and histopathology on lung tissue 38/64 (59) radiological diagnosis of pneumonia | 10/100 (10) Lung tissue through PCR |
CDC (2009) [16] USA 5/09–8/09 | Case series (US CDC), multiple (8) states | N = 77 Autopsied fatal cases | 77/77 (100) | 8/18 (44.0) | NR | 7/7 (100.0) | NR | 7/9 (77.8) | NR | 22/77 (28.6) Histopathology and positive PCR for bacteria | 10/77 (positive through immunohistochemical assays) respiratory tissue |
Mauad (2010) [17] Brazil 7/09–8/09 | Case series | N = 21 Autopsied fatal cases | 21 (100) | 21 (100.0) | 16/21 (76.2) | 21/21 (100.0) | 16/21 (76.2) NR | 13/21 (61.9) | 3/9 (33.3) | 8/21 (38.1) | 6/21 (28.6) diagnosed by culture of bronchial aspirate and/or tissue PCR |
Kim (2011) [20] Korea 8/09–11/09 | Active mortality inpatient surveillance | N = 115 Notified hospitalized fatal cases | 0/115 (0) | 115/115 (100%) | 63/115 (54.8) | NR | 100/115 (87%) 41/115 (35.6) | NR | 34/115 (29.6) positive on blood or sputum culture | 34/115 (29.6) positive on blood or sputum culture 97/113 (85.8) CXR suggestive of pneumonia | 3/115 (2.6) bronchoalveolar lavage (BAL) Streptococcus was also isolated from blood of one case |
Nakajima (2012) [21] Japan 8/09–2/10 | Multicenter (15), case series, Tokyo. | N = 20 Autopsied fatal cases | 20/20 (100) | 11/20 (55.0) | NR | 7/20 (35.0) | 14/20 (70%) 13/20 (65%) | 10/20 (50%) | 4/11 (36.4%) | 5/20 (25%) Based on histopathological finding (bacteria isolated in 4 of 5) | 2/10 (20%) sputum, blood cultures; lung tissue |
Tamme (2012) [22] Estonia 10/09–5/10 | Case series | N = 21 Autopsied fatal cases | 19/21 (90) | 17/21 (81.0) | 15/21(71.4) | NR | 3/21 (14.3) 1/21 (4.8%) | 16/21 (76.2) | 8/21 (38.1) (Culture performed on 14 samples) | 9/21 (42.8) Culture or Autopsy findings consistent with sepsis or bacterial infection | 2/21 (9.5) Blood and/or lung tissue culture |
Bacterial co-infection among hospitalised cases of A(H1N1)2009pdm with confirmed pneumonia
Author and year | Study type | Study population | Case severity | Antivirals* n/N (%) any n/N (%) 48 h | Antibiotics† n/N (%) pre n/N (%) on n/N (%) during admission | Any positive bacterial growth | n/N (%) S.pneumoniae [Site of isolation] | N (%)pneumonia Method Diff/no diff | ||
---|---|---|---|---|---|---|---|---|---|---|
ICU | Mechanical Ventilation | Deaths | ||||||||
Perez-Padilla (2009) [23] Mexico 3/09–4/09 | Single-centre case series (retrospective medical record review) of patients admitted to hospital with pneumonia and A(H1N1)pdm09 (N = 18) | N = 18 | 12/18 (66.7) | 12/18 (66.7) | 7/18 (38.9) | 14/18 (77.7) | 12/18 pre (66.7) 17/18 post (94.4) | 0/6 (0) BC 0/2 (0) BA 0/1 (0) pleural fluid 4/18 (22.2) Ventilator Associated pneumonia | 0/18 [NR] NP swab and bronchial aspirates | 18 (100) CXR No diff |
Chien (2010) [3] Taiwan 07/09–8/09 | Nation-wide notified cases (retrospective medical record review) New pulmonary infiltrates consistent with pneumonia, compatible clinical presentations. Identification of clinicalyl significant bacteria in respiratory secretion or specimens from sterile compartments was recorded as secondary bacterial infection. | N = 96 | 35/96 (36.5) | NR | 10/96 (10.4) | 96/96 (100.0) - NR | NR | 13/96 (13.2) pulmonary NFI (13.5) | 2/99 (2) [Respiratory secretions] | 13 (13.5) CXR positive |
Champunot (2010) [53] Thailand 7/09–10/09 | Single-centre case series (prospective); Community acquired, new pulmonary infiltrate (CXR) within 24 h of admission, clinical symptoms | N = 24 | 13/24 (54.2) | 11/24 (45.8) | 5/24 (8.3) | 24/24 (100%) - NR | 21/24 (87.5) - Pre = 6 | Blood culture 0/24 (0) Sputum culture 2/24(8.3) 1/24 (4.2) [urine pneumococcal Ag TOTAL 3/24 (12.5) | 1/24 (4.2) [urine pneumococcal Ag] | 24 (100.0) CXR No diff |
Cui (2010) [24] China 11/09–12/09 | Single-centre case series (retrospective medical record review) of patients admitted to a tertiary hospital with pneumonia and H1N1(N = 68) Blood cultures (BC) - Any patient with high fever > 38.0 °C for ≥3 days or repeated fever. Sputum cultures (SC) - patients with symptoms of expectoration especially with yellowish/purulent sputum. | N = 68 | 30/68 (44) | 13/68 (19.1) | 10/68 (14.7) | 68/68 (100.0) 50/68 (74%) | All received antibiotics 65/68 (95.6) received preadmission antibiotics | 5/11 (45.5) [BC] 9/29 (31.0) [SC] Total 11/29 (37.9) | 0/11 (0.0) [BC] 0/29 (0.0) [SC] | 68/68 (100.0) CXR No diff |
Cuquemelle [54] (2011) France 11/09–4/10 | Multicenter (24) case series (retrospective)/ not having received prior antibiotics (N = 103) Microbiological investigations and biomarker levels were obtained as part of the routine clinical management of patients, at the discretion of the treating physician | N = 103 | 103/103 (100) | 62/103 (60.2) | 18/103 (17.5) | NR | 0/103 (0) | 48/103 (46.6) Isolation of bacteria | 26/103 (25.2) [NS] | Infiltrates on all CXR |
Choi [55] | Definition: the presence of an infiltrate on plain chest radiograph. | N = 17 | 17/17 (100) All in acute care unit | 1/17 (5.9) | 1/17 (5.9) | 17/17 (100) | 17/17 (100) | 0/17 (0) BC 0/17 (0) SC 2/17 (11.8) urine Ag test (Legionella) 1/17 (5.9) PCR (TB) | 0/17 (100) Testing for S. pneumo | 16/17 (94.1) CXR No diff |
Viasus [56] | Pneumonia was defined as the presence of a new infiltrate on a chest radiograph plus fever (temperature 38.0-C) and/or respiratory symptoms | N = 234 (210 tested for microbiologic studies) | 53/234 (22.6) | 42/234 (17.9) | 12/234 (5.1) | 229/234 (97.9) 50/234 (22.4) | 228/234 (97.9) | 36/210 (17.1) Specimens included: culture of blood, normally sterile fluids, or sputum and/or a positive urinary antigen test | 26/210 (12.4) | All CXR positive |
Piacentini [57] | Compares H1N1 with pneumonia in ICU and community acquired | N = 10 | 10/10 (100) | 5/10 (50) | 0/10 (0) | 10/10 (100) | 10/10 (100) | 2/10 (20.0) Pre-treatment BC, SC, and urinary Ag for S. pneumoniae and Legionella sp. | 2/10 (20) Specimen type NR | CXR positive (multilobar infiltrates) all except 2 (single lobe infiltrates) |
Mulrennan [58] | New pulmonary infiltrates on imaging + clinical symptoms Compared with non-pneumonia H1N1 | N = 35 | 11/35 (31.4) | 10/35 (28.6) | 2/35 (5.7) | 35/35 (100) | NR | 5/35 (14.3) NP, lower resp. tarct | NR | 35/35 (100) CXR no diff |
Ugarte (2010) [25] Chile 5/09–9/09 Adults | Multicenter (11) case series (retrospective) / adult ICU admissions Definition: positive culture from a sterile site (e.g. blood) and/or lower respiratory tract specimens, or seroconversion to atypical bacterial pathogens. LRT specimens included expectorated sputum, ET aspirated sputum and BAL | N = 75 | 75/75 (100.0)) | 56/75 (74.7) - | 19/75 (25.3) | NR | NR | 7/75 (9.3) Specimens NR | 4/75 (5.3) on admission. Site NR 1/5 (20) empyema patients BC | 74 (98.7) CXR No diff |
Busi [4] | N = 40 | NR | NR | 1/40 (2.5) | NR | NR | 0/40 (0) Specimen NR | 40/40 (100) 40 had findings consistent with pneumonia. These 28/40 (70 bilaterial) Non-Diff |
Bacterial co-infection reported among severe cases of A(H1N1)pdm09 admitted to ICUs
Author and year | Study type | Study population | Case severity | Antiviralsa n/N (%) any n/N (%) 48 h | Antibiotics† n/N (%) pre n/N (%) on n/N (%) during admission | Any positive bacterial growth | Number (%) patients with S.pneumoniae and site of isolation | Number (%) with bacterial pneumonia - Method - Diff/no diff | ||
---|---|---|---|---|---|---|---|---|---|---|
ICU - ECMO | Mechanical Ventilation | Deaths | ||||||||
Miller (2010) [36] Utah, USA 5/09–6/09 Adults(16+) | Multicentre (4) case series (+ comparison with local resident population) / Adult (> 15 y) ICU admissions | N = 47 | 47/47 (100) - 0 | 13/47 (27.7) IV = 11/47 (84.6) | 8/47 (14) | 47/47 (100.0) - 45/47 (95.7) | 44/47 (93.6) - NS | 6/47 (13) | 0/47 (0) BC 0/47 (0) ET aspirate 0/47 (0) SC 0/47 (0) BAL fluid | 43/47(91.5) - CXR - No diff |
Rello [29] (2009) Spain 6/09–7/09 Adults | Multicentre (20) case series (retrospective) / ICU adult admissions with ARF | N = 32 | 32/32 (100) - 0 | 24/32 (75.0) - IV = 22/32 (91.7) - NIV = 2/32 (8.3) | 8/32 (25) | 32/32 (100.0) -NS | 32/32 (100.0) | 1/32 (3.1) Secondary superinfection with Pseudomonas aeruginosa were also documented in three patients (9.3). | 1/32 (3.1) aspirate 0/32 (0) BC | 1/32 (3.1) respiratory culture |
ANZ ECMO [34] (2009) Australia and New Zealand 6/09–8/09 All ages | Multicentre (15) cohort study (retrospective) / All ages ICU admission with ARDS treated with ECMO Includes probable casesa | N = 68 | 68/68 (100) - 68/68 (100) | 68/68 (100) | 14/68 (20.6) | 64/68 (94.1) - NS | NR | 19/68 (28) | 10/68 (14.7) [respiratory secretion/BC] | 66/68 (97.1) CXR/CT No diff |
Estenssoro (2010) [5] Argentina 6/09–9/09 Adults(15+) | Multicentre (35) inception cohort study (prospective & retrospective) / adult (≥ 15 years) ICU admissions with ILI & ARF requiring MV Includes probable casesa | N = 337 | 337/337 (100) | 337/337 (100) NIV = 64/337 (19.0) | 156/337 (46.3) | 328/336 (98) - NS | 337/337 (100) - NS | 28/337 (8.3) | 28 /337 [NS] 8.3 | 80/337 (23.7) CXR/CT Diff |
Nin [31] (2011) Chile, Uruguay 6/09–9/09 | Multicenter (10) case series (> 18 yrs) (retrospective and prospective) / Respiratory failure requiring ICU mechanical ventilation ** (confirmed = 77/ 96) Includes probable casesa | N = 96 | 96/96 (100) 13/96 (13.5) | 96/96 (100) NIV = 10/96 (10.4) IV = 86/96 (89.6) Prone ventilation = 44 /96 (45.8)HFOV = 10/96 (10.4) | 48/96 (50) | 84/96 (87.5) - NS | 91/96 (94.8) - NS | 8/96 (8) | NR | 32/96 (33.3, 8 within first week of admission) - Purulent sputum, significant growth of pathogen in ET aspirate - diff |
Koegelenberg (2010) [30] South Africa 8/09–9/09 Adults(18+) | Single-centre case series (prospective)/Adult (> = 18 y) ICU admissions with ARF requiring MV | N = 19 | 19/19 (100) - NR | 19/19 (100) - NIV = 2/19 (10.5) | 13/19 (68.4) | 19/19 (100) - 14 (73.7) | NR | 0/19 (19) | 0/19 (0) BC 0/19 (0) ET aspirates 0/19 (0) other NS | 0/19 (0) (10 cases of nosocomial infection (> = 48 h admission) - CXR |
Martin-Loeches [28] (2010) Spain 1st case - 12/09 Adults (16+) | Multicentre (148) case series (prospective) /Adult (> = 15 y) ICU admissions with ARF | N = 645 | 645/645 (100) | NR - IV = 389/645 (60.3) | 112/645 (17.4) | 620/645 (96.1) - NS | 645/645 (100) - NS | 113/645 (17.5) | 62 /645 (9.6) site NS Cultures routinely every day | 113/645 (17.5) - CXR + pos culture - diff |
Rice [39] (2012) US 4/09–4/10 | Multicenter (35) case series (retrospective and prospective) / Critically ill cases (> 13 years) admitted to adult ICU’s (Confirmed = 424/683, 62%) Includes probable casesa | N = 683 | 683/683 (100) | 231/683 (33.8) - IV = 175/683 (75.8) - NIV = 56/683 (24.2) | 309/683 (45.2) | 683/683 (100) -NS | NR | Total 154/683 (22.5) Sputum specimen 84/683 (12.3) Bacteraemia 50 (7.3) Both 20 (2.9) | 10/683 (1.5) BC | 207/683 (30.3) clinical coinfection, non-diff |
CDC [27] | Patients at a tertiary care hospital in Michigan | N = 10 | 10/10 (100) | 10/10 (100) | 3/10 (30%) | 10/10 (100) | 10/10 (100) | NR | NR | NR |
Kim [32] | ICU in 28 Hospitals in SK | 245 | 245/245 (100) | 162/245 (100) | 99/245 (40.4) | 103/245 (42) | 243/245 (99.2) | 91/245 (37.1) | 0/245 (0) | 91/245 (37.1) |
Malato [35] | ICU in one hosiptal | 24 | 24/24 (100) | 6/24 (25) | 4/24 (16.7) | 20/20 (100) | NR | 6/24 (25) | 0/24 (0) | 6/24 (25) |
Kumar [33] (2009) Canada 4/09–8/09 All ages | Multicentre (38) cohort study (prospective & retrospective) /All age critically ill patients = ICU & requiring MV or IV medication or ≥ 60% inspired O2 fraction Includes probable casesa | N = 168 | 168/168 (100) - 7/168 (4.2) | 136/168 (81.0) - IV = 128/168 (94.1) - HFOV = 20/168 (14.7) | 29/168 (17.3) | NR | NR | 5/168 (2.9) site NS | 54/168 (32.1) possible at presentation; 41/168 (24.4) clinically dx cases following ICU admission - CXR + culture /clinical opinion | |
Roch [26] | ARDS cases in ICU | N = 18 | 18/18 (100) | 10/18 (100) | 10/10 (100) | NR | NR | 0/18 (0) | 0/18 (0) | 0/18 (0) |
Lucker [37] | One hospital ICU, medical charts reviewed | 14 | 14/14 (100) | 10/14 (71.4) | 2/14 (14.3) | 14/14 (100) | 13/14 (92.9) | 6/14 (42.8) Of ICU cases | 0/14 (0) | 6/14 (42.9) |
Leen [38] | 22 bed ICU in one hospital | N = 31 | 31/31 (100) | 3/31 (10) | NR | NR | NR | NR | 10/31 (32.2) Method not mentioned | |
Torres [40] | Hospital in Chile. Includes probable casesa | N = 11 | 11/11 (100) | 11/11 (100) | 0/11 (0) | 11/11 (100) | 7/11 (63.6) | 1/11 (0.9) Group A Streptococcus Site NR | 0/11 (0) | 6/11 (54.5) Non Diff |
Bacterial co-infection reported among hospitalised cases of influenza A(H1N1)pdm09, not requiring ICU
Author and year | Study type | Study population | Case severity n (%) | Antiviral agents - Number (%) started ≤48 h of symptoms | Antibiotics† n/N (%) pre n/N (%) on n/N (%) during admission | Any positive bacterial growth | Number (%) patients with S.pneumoniae and site of isolation | Number (%) with bacterial pneumonia - Method - Diff/no diff | ||
---|---|---|---|---|---|---|---|---|---|---|
ICU
N
| MV - type | Deaths | ||||||||
CDC (2009) [59] California, USA 4/09–5/09 | State-wide passive surveillance of notified cases / Hospitalized cases for > 24 h | N = 30 | 6/30 (20) | 4/30 (13.3) | 0/23 (0) 7 were still hospitalised | 15/30 (50) 5/30 (16.7) | 0 | 0/100 (0) | 0/100 (0) | 15/25 (60) CXR Non diff |
Jain [60] (2009) USA 4/09–6/09 | Notified cases from 24 state health departments to CDC / Hospitalized ≥24 h | N = 272 | 67/272 (24.6) | 42/272 (15.4) | 19/272 (7.0) | 200/268 (74.6) 78 (29.1) | 206/260 (79.2) - Pre: 30/198 - on: 117/198 | 3/182 (1.6) | 2/182 (1.1) 1 had positive lung tissue culture) 1/n urinary antigen test 1/n BAL fluid 0/n ET aspirate | - CXR 100/249 (40) (66 patients with bilateral infiltrates) 26 limited to 1 lobe, 6 limited to multiple lobes - not diff |
Louie [61] (2009) California, USA 4/09–8/09 | State-wide enhanced surveillance /Hospitalized or fatal all ages cases | N = 1088 | 340/1088 (31.3) | 193/297 (64.9) | 118/1088 (10.8) | 701/884 (79.3) - 357 (40.4) | NR | 46/1088 (4.2) | NR | 547/833 (65.7) - CXR/CT + pos bacterial culture(s) 46 - No diff |
Dhanoa [62] (2011) Malaysia 9/09–5/10 | Single-centre case series (retrospective)/ Hospitalised patients all ages | N = 50 | 9/50 (18.0) | 6/50 (12.0) | 2/50 (4.0) | 50/50 (100) | 49 (98.0) - Pre = 8 - On =41 | 14/45 (31.1) total 45 culture samples sent | 2/45 (4.4) site NR | 25/50 (50) -CXR + clinical opinion - No diff |
To [63] (2010) China 6/09–10/09 | Single-centre case series (retrospective)/ Hospitalized adult patients | N = 69 | 28/69 (40.6) | 26/69 (37.7) - NS | 13/69 (18.8) | 69/69 (100) | 37/69 (53.6) - On = 37 | 0/69 (0) | 0/69 (0) | 25/69 (36.2) CXR Non-diff |
Viasus [64] (2011) Spain 6/09–11/09 | Multicentre (13) case series (prospective)/ Hospitalized ≥24 h and had a chest radiograph done | N = 585 | 71/585 (12.1) | 52/585 (8.9) | 13/585 (2.2) | 545/585 (93.3) | 416/585 (71.7) | 45/585 (7.7) | 28/585 (4.8) | 234/585 (40) CXR non diff |
Palacios (2009) [42] Argentina 6/09–7/09 | Random sample specimens | N = 199 | 19/199 (9.5) | NR | 20/199 (10) | 96/120 (80) | 14/120 (11.7) | 152/199 (76.3) | 62/199 (31.1) | 152//199 (76) Culture pos |
Chitnis [6] | Wisconsin, hospital acute care PCR + cases | N = 252 | 59/252 (23.4) | 34/59 (58) Of tho9se cases admitted to ICU | 11/252 (4.3) | 215/250 (86) | 204/249 (81.9) | 19/241 (7.9) | NR | 123/229 (53.7) CXR non diff |
Riera [65] | 13 Hospitals in Spain | N = 585 | 71/585 (12.1) | 52/585 (8.9) | 13/585 (2.2) | 545/585 (93.1) 202/585 (34.5) | 316/585 (54) | 45/585 (7.7) (Sputum) | 2/585 (0.3) (1 sputum and 1 antigenuria positive | CXR infil 234/585 (40) Multilobarl infilt 135/585 (23.1) |
Semionov [66] | 147 cases with CXR results available in Montreal | N = 147 | 8/147 (5.4) | 6/147 (4.1) | 4/147 (2.7) | NR | NR | 21/42 (50) (of 42 radiological positive cases) | 5/21 (23.8) (of 21 positive bacterial cases) | 42/147 (28.6) cases positive CXR Non diff |
To [67] | 74 cases in Hong Kong | N = 74 | 28/74 (37.8) | 26/74 (35.1) | 2/74 (2.7) | 69/74 (93.2) | 52/74 (70.3) | 9/74 (12.2) bacterial positive 8 sputum 1 blood | 0/74 (0) | 9/74 (12.2) bacterial positive 8 sputum 1 blood Diff |
Masia [68] | Complicated hospital admitted cases in Spain > 18 years, out patients | N = 100 | 4/100 (4) | NR | 0/100 (0) | NR | NR | 14/100 (14) | 14/100 (14) Diff 8 urinary antigen pos, 2 isolated from blood and 4 from sputum | 14/100 (14) Diff |
Pecavar [69] | Hospitalized cases | N = 66 | 7/66 (10.6) | NR | NR | 62/64 (96.9) | 35/61 (57.4) | 5/63 (7.9) | 2/63 (3.2) | 29/57 (50.9) CXR Non diff |
Liu [70] | One hospital in China | N = 46 | NR | NR | NR | 46/46 (100) | 9/46 (19.6) | 9/15 (60) | NR | 44/46 (95.6) CXR or CT scan abnormal Non diff |
Nguyen (2010) [71] UK 4/09–9/09 | Multicentre (55) case series (retrospective)/ Hospitalized cases | N = 631 | 53/631 (8.4) | NR - IV = 21/631 (3.3) | 29/631 (4.6) | 474/631 (75.1) - NS | 366/631 (58) | 4/102 (3.9%) of cases with radiological pneumonia | 1/102 (0.9) sputum culture 0/102 (0) BC | 102/349 (29.2) - CXR - No diff |
Santa-Olalla Peralta [72] (2010) Spain 4/09–12/09 | National surveillance of severe cases (retrospective) / Hospitalized patients all ages (, in Spain | N = 3025 | 852/3025 (28.2) | 438/3.25 (14.5) | 200/3025 (6.6) | 2521/2779 (90.7) - 711/2020 (35.2) | NR | 292/957 (30.5, bacteria isolated not reported) | NR | NR |
Venkata [73] (2010) USA 5/09–12/09 | Single-centre case series (retrospective)/ Electronic medical records of hospitalized adult patients | N = 66 | 29/66 (43.9) | 23/66 (34.8) - IV = 17 (73.9) - NIV = 6 (26.1) | 5/66 (7.6) 4 more died after discharge from hospital | 60/66 (90.9) - NR | 14/ 29 (48.2) Bac culture pos | 3/29 (10.3), site NS | 14/29 (48.2) confirmed and 10/29 (34.5) probable bacterial pneumonia - NR - Diff | |
Jartti [74] | Cases with severe cases and CXR finding available, I hospital in Finland | N = 135 | 18/135 (13%) | 18/135 (13.3) | 3/135 (2.2) | NR | NR | 5/135 (3.7) Site not mentioned | 1 /135 (0.7) Isolated from Plural Fluid | 84/135 (62.2) |
Rizzo [75] | Sentinel sites, Italy | N = 1278 | NR | NR | NR | NR | NR | 33/1278 (2.6) | 0/1278 (0) | 271/1278 (21.2) Non-diff |
Kopel [76] | Til Aviv, cases in ICU and PICU | N = 17 | 17/17 (100) | NR | 7/17 (41.2) | NR | NR | 9/17 cases (52.9) (but likely nosocomial infection, so not included) | 0/17 (0) | NR |
D’Ortenzio [41] | ReUnion Island, all sites, included 785 reported cases, 282 hospitalized cases included here | N = 282 | 24/282 (8.5) | 15/282 (5.3) | 7/282 (2.5) | 92/171 (53.8) 39/163 (23.9) (within 48 h) | NR | NR | NR | 24/83 (28.9) (Confirmed and suspected) Sample not reported |
Dominguez-Cherit [77] | Critically ill, hospitalized in 6 hospital in Maxico | N = 58 | 58/58 (100) | 54/58 (93.1) | 24/ 58 (41.4) | 57/58 (98.3) | 52/58 (89.6) | 4/58 (6.9) | 0/58 (0) | NR |
Bacterial co-infection reported among paediatric hospitalised cases (including PICU) of influenza A(H1N1)pdm09
Author and year | Study type | Diagnosis of influenza/ cases | Antiviral agents - Number (%) started ≤48 h of symptoms | Number (%) patients with S.pneumoniae and site of isolation | Any bacteria positive | Number (%) with bacterial pneumonia - Method - Diff/no diff | Antibiotics used (Pre, on, during) | Required | ||
---|---|---|---|---|---|---|---|---|---|---|
ICU - ECMO | MV | Deaths | ||||||||
Hospitalised | ||||||||||
Louie (2010) [7] California USA 4/09–8/09 | State-wide surveillance (California) / Hospitalized or died cases (< 18 years) | PCR/345 | 221/345 (64.1) 88/ 345 (25.5) with in 48 h | 3/345 (0.9) isolation site NR | 15/345 (4.3) | 138/229 (60.3) (F: 4/5; H: 134/224) 163/278 (CT + CXR pos) - No diff | NR | 94/345 (27.4) | 35/94 (37) in text | 9/345 (2.6) |
Libster [78] (2010) Argentina 5/09–7/09 | Multicentre (6) case series (retrospective)/ Hospitalized cases (< 18 years) | PCR/ 251 | - 22/ 171(12.9) with in 48 h (4/34 PICU Px, 18/137 ward px) | 2/121 (1.7) BC 1/4 (25.0) empyema | 10 /121 (8) Blood culture | 25/251 (10.0) bacterial confirm - Among 92 CXR, 78% diagnosis was pneumonia -NonDiff | 186/251 (74.1) - On = 82 | 47/251 (18.7) | 42/251 (16.7) | 13/251 (5.2) |
Okada [43] 2011 Japan 7/09–1/10 | Single-centre case series (retrospective) / Pneumonia, pharyngitis or bronchitis cases (< 15 years) (n = unclear). | PCR/46 | 44/46 (95.6) - NR | 28/46 (60.9) NP | 40/46 (86.9) NP positive swab | 40/46 (86.9%) NP swab Bac pneumonia 21/46 (45.6%) unilateral infiltrates - CXR - No diff | 32/46 (69.6) - NS | NR | NR | 0/46 (0) |
Kumar [79] (2010) Wisconsin, USA 4/09–8/09 | Single-centre case series (retrospective record review)/ Hospitalized (> = 24 h) cases (< 19 years) | PCR/75 | 74/75 (98.7) - NR | 0 /75 (0) | 0/75 (0) | 23/75 (34.3) - CXR - Diff | 60/75 (80.0) - Pre = 12 - On/during = 48 | 14/75 (18.7) | 4/75 (5.3) | 2/75 (2.7) |
Miroballi [80] (2010) New York, USA 05/09–07/09 | Multicentre (2) case series (retrospective) / Hospitalized cases (< 18) | PCR (54), EIA, DFA, viral culture/ 115 | 97/115 (84.3) - NR | 2/115 (1.7) BC 1/115 (0.9) respiratory secretions | 4/115 (3.5) | Total NR (11/35 in PICU) - NR - Diff NS | 89/115 (77.4) - NS | 35/115 (30.4) | 11/115 (9.6) in PICU | 1/115 (0.9) |
O’Riordan [81] | Retrospective case review/hospitalised cases (< 18 yrs) | PCR/ 58 | 12/58 (20.7) - NR | 1/58 (1.7) BC | 1/58 (1.7) bacterial culture positive | 17/58 (29.3) - CXR - No diff | 56/58 (96.6) - NS | 12/58 (20.7) | 7/58 (12.1) | 0/58 (0) |
Bettinger [82] (2010) Canada 5/09–8/09 | National active surveillance / hospitalized cases (< 17 years) | PCR/235 | 107/235 (45.5) - NR | 3/235 (1.3) isolation site NR | 8/235 (3.4) culture positive | 8/235 (3.4) culture positive | 203/235 (86.4) - NS | 39/235 (16.6) | 15/235 (6.4) | 2/235 (0.9) |
Lockman [83] 2010 | Retrospective case review (notes)/cases admitted to ICU | PCR/ 13 | 11/13 (84.6) - 5 (45.5) | 0/13 (0) | 0/13 (0) | 3/13 (23%) Nondiff CXR | 3/13 (23.1) - NS | 13/13 (100) | 6/13 (46.2) - IV =4 (66.7) - NIV = 2 (33.3) | 0/13 (0) |
Stein [84] | < 18 year, ARI cases, hospitalized in 7 medical centers in Israel | PCR/ 478 | 413/478 (87.1) | 2/478 (0.4) | 4/478 (0.8) | 172/478 (35.9) CXR non-diff | 215/478 (45) | 42/478 (8.8) | 15/478 (3.1) | 3/478 (0.6%) |
Tamma [85] | 1 hospital, lab confirm US, < 18 years, retrospective cohot in US | PCR/ 133 | 106/133 (79.7) 51/133 < 48 h | 0/133 (0) | 0/133 (0) | 28/122 (22.9) CXR nondiff | 61/85 (72%) | 27 (20.3) | 11/133 (8%) | 0 |
Parakh [86] | 1 hospital, retrospective record review, India PICU and ICU, cases with age < 18 with ILI | PCR/ 25 | 25/25 (100) | 0/25 (0) | 0/25 (0) | 8/25 (32) CXR nondiff | NR | 7/25 (28) | 4/25 (16) | 3/25 (12) |
PICU | ||||||||||
Farias [87] | Prospective multicentred study/includes nosocomial cases in Argentina(n = 147) | PCR/ 147 | 135/147 (91.8) - 116/147 (85.9) | 6/147 (4) isolation site NR | 50/147 (34) | NR | 143/147 (97.3) | 147/147 (100) | 139/147 (94.6) - IV = 117 (84.2) - NIV = 22 (15.8) | 57/147 (38.8) |
Randolph (2011) [88] USA 4/09–4/10 | Multicentre (35) case series (retrospective & prospective). Probable 293/838 (35%) cases PICU cases (< 21 years) | Confirmed- PCR, viral culture Probable- direct fluorescent antibody, rapid influenza diagnostic test (n = 838) | 751/838 (89.6) - NR (before ICU admission =49) | 0/38 (0) BC 15/274 (5.5) respiratory secretions BC: 0 | 274/838 (32.7) had pneumonia/other bacterial co-infection From resp. secretions | 274/838 (32.7) had pneumonia/other bacterial co-infection From resp. secretions | NR | 838/838 (100) - 33 (3.9) | 546/838 (67.3) | 75/838 (8.9) |
Shin [89] | South Korea, critically ill cases | PCR/30 | 29/30 (96.7) | 0/30 (0) | 4/30 (13.3) Blood c/s positive | 22/29 (75.9) CXR non diff | NR | 30/30 (0) | 16/30 (53.3) | 14//30 (46.7) |
Jouvet [8] | Canada PICUs, | PCR or culture positive /57 | 44/57 (77.2) | 5/27 (18.5) Lower resp. samples | 12/57 (21.1) Lower resp. samples | 12/57 (21.1) Lower resp. samples | 54/57 (94.7) | 2/57 (3.5) | 39/57 (68.4) | 4/57 (7) |