Epidemiology, microbiology, and treatment considerations for bacterial pneumonia complicating influenza
Mark L Metersky1, Robert G Masterton, Hartmut Lode
1Division of Pulmonary and Critical Care Medicine, University of Connecticut School of Medicine, 263 Farmington Ave, Farmington, CT 06030-1321, USA. Metersky@nso.uchc.edu
Abstract:
Post-influenza bacterial pneumonia is a major cause of morbidity and mortality associated with both seasonal and pandemic influenza virus illness. However, despite much interest in influenza and its complications in recent years, good clinical trial data to inform clinicians in their assessment of treatment options are scant. This paucity of evidence needs to be addressed urgently in order to improve guidance on the management of post-influenza bacterial pneumonia. The objectives of the current article are to evaluate the emergence of the 2009 H1N1 influenza pandemic and use this information as background for an in-depth review of the epidemiology of bacterial pneumonia complicating influenza, to review the bacterial pathogens most likely to be associated with post-influenza bacterial pneumonia, and to discuss treatment considerations in these patients. When determining optimal management approaches, both antiviral and antibacterial agents should be considered, and their selection should be based upon a clear understanding of how their mechanisms of action intervene in the pathogenesis of post-influenza acute bacterial pneumonia.
Insights
Post-influenza bacterial pneumonia is a significant cause of illness and death. Limited clinical trial data necessitates urgent research to improve treatment guidance for this serious complication of influenza.
Area of Science:
- Infectious Diseases
- Pulmonology
- Epidemiology
Background:
- Post-influenza bacterial pneumonia is a major cause of morbidity and mortality.
- Limited clinical trial data exists for managing this complication.
- The 2009 H1N1 influenza pandemic highlights the need for better understanding.
Purpose of the Study:
- Review the epidemiology of bacterial pneumonia complicating influenza.
- Identify common bacterial pathogens involved.
- Discuss treatment strategies for affected patients.
Main Methods:
- Literature review focusing on influenza and secondary bacterial pneumonia.
- Analysis of data related to the 2009 H1N1 pandemic.
- Evaluation of treatment options, including antiviral and antibacterial agents.
Main Results:
- Influenza increases susceptibility to bacterial pneumonia.
- Common pathogens include Streptococcus pneumoniae, Staphylococcus aureus, and Haemophilus influenzae.
- Optimal treatment requires consideration of both viral and bacterial factors.
Conclusions:
- Urgent need for robust clinical trials to guide management.
- Treatment decisions should integrate understanding of pathogenesis.
- Antiviral and antibacterial therapies are crucial components of care.
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