Institute of Inflammation and Repair, Faculty of Medical and Human Sciences, University of Manchester, Manchester, UK.Department of Clinical Virology, Central Manchester University Hospitals - NHS Foundation Trust, Manchester, UK.
Influenza Other Respir Viruses. 2013 Nov;7(6):1079-87. doi: 10.1111/irv.12020. Epub 2012 Oct 19.
Recent literature suggests that dual or multiple virus infections may affect disease severity. However, few studies have investigated the effect of co-infection with influenza A viruses.
To identify the association between influenza A and respiratory viruses co-infections with disease outcome.
Data for samples from North West England tested between January 2007 and June 2011 was analysed for patterns of co-infection between influenza A viruses and eight respiratory viruses. Risk of hospitalisation to ICU or general ward in single versus co-infections was assessed using logistic regression.
Of the 25,596 samples analysed for respiratory viruses 40·7% (10,501) were positive for any virus. Co-infections were detected in 4·7% (137/2879) of all patients with influenza A(H1N1)pdm09, and 7·3% (57/779) of those with other influenza A virus infections. Co-infection between seasonal influenza A viruses and influenza B virus was associated with a significant increase in the risk of admission to ICU/death (OR: 22·0, 95% CI: 2·21-219·8, P=0·008). Respiratory syncytial virus/influenza A (RSV/Flu A) co-infection also increased this risk but was not statistically significant. For influenza A(H1N1)pdm09, RSV and AdV co-infection increased risk of hospitalisation to general ward whereas Flu B increased risk of admission to ICU, but none of these were statistically significant.
Co-infection is a significant predictor of disease outcome; combined treatment, introduction of an integrated vaccine for all respiratory viruses and development of multi-target rapid diagnostic tests is recommended. Integration of respiratory viruses' co-infections into public health reports could also contribute to the accumulation of evidence.
近期文献表明，双重或多重病毒感染可能会影响疾病的严重程度。然而，很少有研究调查甲型流感病毒合并感染的影响。
确定甲型流感病毒与呼吸道病毒合并感染与疾病结局的关系。
分析了 2007 年 1 月至 2011 年 6 月期间在英格兰西北部采集的样本数据，以研究甲型流感病毒与八种呼吸道病毒之间的合并感染模式。使用逻辑回归评估了单一感染与合并感染患者住院至 ICU 或普通病房的风险。
在分析的 25596 份呼吸道病毒样本中，40.7%（10501 份）为任何病毒阳性。在甲型流感（H1N1）pdm09 患者中，合并感染率为 4.7%（137/2879），在其他甲型流感病毒感染患者中为 7.3%（57/779）。季节性甲型流感病毒与流感 B 病毒之间的合并感染与 ICU 入院/死亡风险显著增加相关（OR：22.0，95%CI：2.21-219.8，P=0.008）。呼吸道合胞病毒/甲型流感（RSV/Flu A）合并感染也增加了这种风险，但没有统计学意义。对于甲型流感（H1N1）pdm09，RSV 和 AdV 合并感染增加了住院至普通病房的风险，而 Flu B 增加了 ICU 入院的风险，但均无统计学意义。
合并感染是疾病结局的重要预测指标；建议联合治疗、引入所有呼吸道病毒的综合疫苗以及开发多靶点快速诊断检测方法。将呼吸道病毒合并感染纳入公共卫生报告也有助于证据的积累。
