Damasio Guilherme A C, Pereira Luciane A, Moreira Suzana D R, Duarte dos Santos Claudia N, Dalla-Costa Libera M, Raboni Sonia M
Postgraduate Program in Microbiology, Parasitology and Pathology, Universidade Federal do Paraná, Curitiba, Brazil.
Virology Laboratory, Universidade Federal do Paraná, Curitiba, PR, Brazil.
J Med Virol. 2015 Sep;87(9):1456-61. doi: 10.1002/jmv.24210. Epub 2015 May 14.
This retrospective cohort study investigated the presence of bacteria in respiratory secretions of patients hospitalized with acute respiratory infections and analyzed the impact of viral and bacterial coinfection on severity and the mortality rate. A total of 169 patients with acute respiratory infections were included, viruses and bacteria in respiratory samples were detected using molecular methods. Among all samples, 73.3% and 59.7% were positive for viruses and bacteria, respectively; 45% contained both virus and bacteria. Bacterial coinfection was more frequent in patients infected by community respiratory viruses than influenza A H1N1pdm (83.3% vs. 40.6%). The most frequently bacteria detected were Streptococcus pneumoniae and Haemophilus influenzae. Both species were co-detected in 54 patients and identified alone in 22 and 21 patients, respectively. Overall, there were no significant differences in the period of hospitalization, severity, or mortality rate between patients infected with respiratory viruses alone and those coinfected by viruses and bacteria. The detection of mixed respiratory pathogens is frequent in hospitalized patients with acute respiratory infections, but its impact on the clinical outcome does not appear substantial. However, it should be noted that most of the patients received broad-spectrum antibiotic therapy, which may have contributed to this favorable outcome.
这项回顾性队列研究调查了因急性呼吸道感染住院患者呼吸道分泌物中的细菌存在情况，并分析了病毒和细菌合并感染对病情严重程度和死亡率的影响。共纳入169例急性呼吸道感染患者，采用分子方法检测呼吸道样本中的病毒和细菌。在所有样本中，病毒和细菌检测阳性率分别为73.3%和59.7%；45%的样本同时含有病毒和细菌。社区呼吸道病毒感染患者的细菌合并感染比甲型H1N1pdm流感更常见（83.3%对40.6%）。最常检测到的细菌是肺炎链球菌和流感嗜血杆菌。这两种细菌在54例患者中同时被检测到，分别在22例和21例患者中单独被鉴定出来。总体而言，单纯呼吸道病毒感染患者与病毒和细菌合并感染患者在住院时间、病情严重程度或死亡率方面没有显著差异。在因急性呼吸道感染住院的患者中，混合呼吸道病原体的检测很常见，但其对临床结局的影响似乎不大。然而，应该注意的是，大多数患者接受了广谱抗生素治疗，这可能促成了这一良好结局。
