Wang Yue, Swayze Sarah, Brown Kevin A, MacFadden Derek R, Lee Samantha M, Schwartz Kevin L, Daneman Nick, Langford Bradley J
ICES, Toronto, Ontario, Canada.
Department of Biology, McMaster University, Hamilton, Ontario, Canada.
Open Forum Infect Dis. 2024 Dec 3;11(12):ofae701. doi: 10.1093/ofid/ofae701. eCollection 2024 Dec.
To investigate the prevalence of concomitant bacterial infection across common viral infections.
This population-based cohort study included patients infected with influenza A and B (FLUA, FLUB) and respiratory syncytial virus (RSV) in Ontario between 2017 and 2019 and patients with SARS-CoV-2 between 2020 and 2021. Specific bacteria present in concomitant infections were identified. Concomitant infections were further classified into different categories (eg, coinfection -2 to +2 days from viral infection and secondary infection >2 days after viral infection). We used logistic regression models to estimate the odds of bacterial infections for FLUA, FLUB, and RSV relative to SARS-CoV-2 while adjusting for confounders.
A total of 4230 (0.5%, 885 004) viral cases had concomitant bacterial infections, encompassing 422 of FLUB (4.7%, 8891), 861 of FLUA (3.9%, 22 313), 428 of RSV (3.4%, 12 774), and 2519 of COVID-19 (0.3%, 841 026). The most prevalent species causing concomitant bacterial infection were , , and . When compared with SARS-CoV-2, the adjusted odds ratio for bacterial infection was 1.69 (95% CI, 1.48-1.93) for FLUA, 2.30 (95% CI, 1.97-2.69) for FLUB, and 1.56 (95% CI, 1.33-1.82) for RSV. The adjusted odds of coinfection in patients with SARS-CoV-2 were lower but higher for secondary infection as compared with the other viruses.
A higher prevalence and risk of concomitant bacterial infection were found in FLUA, FLUB, and RSV as compared with SARS-CoV-2, although this is largely driven by coinfections. Ongoing surveillance efforts are needed to compare the risk of concomitant infections during periods when these viruses are cocirculating.
调查常见病毒感染中合并细菌感染的患病率。
这项基于人群的队列研究纳入了2017年至2019年安大略省感染甲型和乙型流感（FLUA、FLUB）和呼吸道合胞病毒（RSV）的患者以及2020年至2021年感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的患者。确定合并感染中存在的特定细菌。合并感染进一步分为不同类别（例如，病毒感染后-2至+2天的混合感染以及病毒感染后>2天的继发感染）。我们使用逻辑回归模型来估计FLUA、FLUB和RSV相对于SARS-CoV-2发生细菌感染的几率，同时对混杂因素进行调整。
共有4230例（0.5%，885004例）病毒感染病例合并细菌感染，其中包括422例FLUB（4.7%，8891例）、861例FLUA（3.9%，22313例）、428例RSV（3.4%，12774例）和2519例新型冠状病毒肺炎（COVID-19，0.3%，841026例）。引起合并细菌感染最常见的菌种是 、 和 。与SARS-CoV-2相比，FLUA发生细菌感染的调整比值比为1.69（95%置信区间，1.48-1.93），FLUB为2.30（95%置信区间，1.97-2.69），RSV为1.56（95%置信区间，1.33-1.82）。与其他病毒相比，SARS-CoV-2患者发生混合感染的调整几率较低，但继发感染的几率较高。
与SARS-CoV-2相比，FLUA、FLUB和RSV中合并细菌感染的患病率和风险更高，尽管这在很大程度上是由混合感染导致的。需要持续进行监测，以比较这些病毒共同流行期间合并感染的风险。
