Epidemic Intelligence Service, Office of Workforce and Career Development Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Clin Infect Dis. 2010 Jan 15;50(2):175-83. doi: 10.1086/649208.
Animal models and data from influenza pandemics suggest that influenza infection predisposes individuals to pneumococcal pneumonia. Influenza may contribute to high winter rates of pneumococcal pneumonia during non-pandemic periods, but the magnitude of this effect is unknown. With use of United States surveillance data during 1995-2006, we estimated the association between influenza circulation and invasive pneumococcal pneumonia rates.
Weekly invasive pneumococcal pneumonia incidence, defined by isolation of pneumococci from normally sterile sites in persons with clinical or radiographic pneumonia, was estimated from active population-based surveillance in 3 regions of the United States. We used influenza virus data collected by World Health Organization collaborating laboratories in the same 3 regions in seasonally adjusted negative binomial regression models to estimate the influenza-associated fraction of pneumococcal pneumonia.
During approximately 185 million person-years of surveillance, we observed 21,239 episodes of invasive pneumococcal pneumonia; 485,691 specimens were tested for influenza. Influenza circulation was associated with 11%-14% of pneumococcal pneumonia during periods of influenza circulation and 5%-6% overall. In 2 of 3 regions, the association was strongest when influenza circulation data were lagged by 1 week.
During recent seasonal influenza epidemics in the United States, a modest but potentially preventable fraction of invasive pneumococcal pneumonia was associated with influenza circulation.
流感大流行期间的动物模型和数据表明，流感感染会使个体易患肺炎球菌性肺炎。流感可能导致非大流行期间冬季肺炎球菌性肺炎的高发，但这种影响的程度尚不清楚。利用 1995-2006 年美国监测数据，我们评估了流感流行与侵袭性肺炎球菌性肺炎发生率之间的关联。
通过对美国 3 个地区进行基于人群的主动监测，估计每周侵袭性肺炎球菌性肺炎的发病率，定义为从具有临床或影像学肺炎的正常人无菌部位分离出肺炎球菌。我们使用世界卫生组织合作实验室在同一 3 个地区收集的流感病毒数据，在季节性调整的负二项回归模型中估计流感相关肺炎球菌性肺炎的比例。
在大约 1.85 亿人年的监测期间，我们观察到 21239 例侵袭性肺炎球菌性肺炎；485691 份标本检测流感。在流感流行期间，流感流行与 11%-14%的肺炎球菌性肺炎相关，而总体上则为 5%-6%。在 3 个地区中的 2 个地区，当流感流行数据滞后 1 周时，关联最强。
在美国最近的季节性流感流行期间，侵袭性肺炎球菌性肺炎的发病率与流感流行有一定的关联，但这种关联是可以预防的。
