Brealey Jaelle C, Sly Peter D, Young Paul R, Chappell Keith J
School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, QLD 4072, Australia.
Queensland Children's Medical Research Institute, The University of Queensland, Brisbane, QLD 4006, Australia Australian Infectious Diseases Research Centre, The University of Queensland, St Lucia, QLD 4072, Australia.
FEMS Microbiol Lett. 2015 May;362(10). doi: 10.1093/femsle/fnv062. Epub 2015 Apr 15.
Acute respiratory infection (ARI) is an important cause of morbidity in children. Mixed aetiology is frequent, with pathogenic viruses and bacteria co-detected in respiratory secretions. However, the clinical significance of these viral/bacterial co-infections has long been a controversial topic. While severe bacterial pneumonia following influenza infection has been well described, associations are less clear among infections caused by viruses that are more common in young children, such as respiratory syncytial virus. Although assessing the overall contribution of bacteria to disease severity is complicated by the presence of many confounding factors in clinical studies, understanding the role of viral/bacterial co-infections in defining the outcome of paediatric ARI will potentially reveal novel treatment and prevention strategies, improving patient outcomes. This review summarizes current evidence for the clinical significance of respiratory viral/bacterial co-infections in young children, discusses possible mechanisms of cooperative interaction between these pathogens and highlights areas that require further investigation.
急性呼吸道感染（ARI）是儿童发病的重要原因。病因混合的情况很常见，呼吸道分泌物中常同时检测到致病病毒和细菌。然而，这些病毒/细菌合并感染的临床意义长期以来一直是一个有争议的话题。虽然流感感染后严重细菌性肺炎已有充分描述，但在幼儿中更常见的病毒（如呼吸道合胞病毒）引起的感染之间的关联尚不清楚。尽管在临床研究中存在许多混杂因素，评估细菌对疾病严重程度的总体影响很复杂，但了解病毒/细菌合并感染在确定小儿ARI结局中的作用可能会揭示新的治疗和预防策略，改善患者预后。本综述总结了目前关于幼儿呼吸道病毒/细菌合并感染临床意义的证据，讨论了这些病原体之间协同相互作用的可能机制，并强调了需要进一步研究的领域。
