Martin-Loeches Ignacio, van Someren Gréve Frank, Schultz Marcus J
aMultidisciplinary Intensive Care Research Organization (MICRO) bDepartment of Clinical Medicine, Trinity Centre for Health Sciences, Trinity College Dublin (TCD), St James's University Hospitals, Dublin, Ireland cDepartment of Intensive Care dDepartment of Medical Microbiology eLaboratory of Experimental Intensive Care and Anesthesiology (LEICA), Academic Medical Center, Amsterdam, the Netherlands.
Curr Opin Infect Dis. 2017 Apr;30(2):201-207. doi: 10.1097/QCO.0000000000000347.
The pathogenesis and impact of coinfection, in particular bacterial coinfection, in influenza are incompletely understood. This review summarizes results from studies on bacterial coinfection in the recent pandemic influenza outbreak.
Systemic immune mechanisms play a key role in the development of coinfection based on the complexity of the interaction of the host and the viral and bacterial pathogens. Several studies were performed to determine the point prevalence of bacterial coinfection in influenza. Coinfection in influenza is frequent in critically ill patients with Streptococcus pneumoniae being the most frequent bacterial pathogen and higher rates of potentially resistant pathogens over the years.
Bacterial pneumonia is certainly an influenza complication. The recent epidemiology findings have helped to partially resolve the contribution of different pathogens. Immunosuppression is a risk factor for bacterial coinfection in influenza, and the epidemiology of coinfection has changed over the years during the last influenza pandemic, and these recent findings should be taken into account during present outbreaks.
流感合并感染，尤其是细菌合并感染的发病机制和影响尚未完全明确。本综述总结了近期大流行性流感爆发中细菌合并感染研究的结果。
基于宿主与病毒及细菌病原体相互作用的复杂性，全身免疫机制在合并感染的发生发展中起关键作用。开展了多项研究以确定流感中细菌合并感染的时点患病率。流感合并感染在重症患者中很常见，肺炎链球菌是最常见的细菌病原体，且多年来潜在耐药病原体的发生率更高。
细菌性肺炎无疑是流感的一种并发症。近期的流行病学研究结果有助于部分阐明不同病原体的作用。免疫抑制是流感中细菌合并感染的一个危险因素，在过去的流感大流行期间，合并感染的流行病学情况随时间发生了变化，在当前疫情爆发期间应考虑这些最新发现。
