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Interaction between influenza virus and Streptococcus pneumoniae in severe pneumonia

Shabir A Madhi1, Barry Schoub, Keith P Klugman

  • 1Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa. madhis@hivsa.com

Expert Review of Respiratory Medicine
|May 19, 2010
PubMed

Insights

Bacterial superinfections significantly worsen influenza pneumonia. Vaccinating against pneumococci and influenza, alongside antimicrobial availability, is crucial for pandemic preparedness.

Area of Science:

  • Infectious Diseases
  • Immunology
  • Public Health

Background:

  • Bacterial superinfections, particularly pneumococcal, are major contributors to influenza-associated pneumonia morbidity and mortality, as evidenced by historical pandemics and murine models.
  • Murine models illuminate the pathogenesis of influenza virus-pneumococcal interactions, revealing increased susceptibility to secondary bacterial infections.

Purpose of the Study:

  • To underscore the critical role of bacterial superinfections in influenza-associated pneumonia.
  • To highlight the importance of vaccination and antimicrobial availability for preventing and treating severe pneumonia during influenza outbreaks.

Main Methods:

  • Review of historical pandemic data (1918, 1957).
  • Analysis of murine model studies on influenza-pneumococcal interactions.
  • Evaluation of clinical evidence on the impact of pneumococcal conjugate vaccine on pneumonia burden.

Main Results:

  • Bacterial superinfections significantly increase influenza-associated pneumonia severity and death.
  • Pneumococcal conjugate vaccine demonstrates a reduction in confirmed influenza-associated pneumonia and all-cause pneumonia.
  • Influenza vaccination is effective against influenza-associated pneumonia.

Conclusions:

  • Preventive strategies for influenza pandemics must integrate broad-based pneumococcal vaccination.
  • Ensuring access to antimicrobials for treating influenza virus and bacterial infections is essential.
  • A combined approach of vaccination and timely antimicrobial treatment is imperative for mitigating severe pneumonia during influenza pandemics.

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