ArticleThe Journal of infectious diseases2013
Bacterial complications of respiratory tract viral illness: a comprehensive evaluation.
Article in The Journal of infectious diseases, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 98 papers, 3 of them syntheses that pooled it.
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Who cites it
98 citing papers in PubMed, 3 syntheses or guidelines pooled it, 160 citations in OpenAlex.
- The neglected model validation of antimicrobial resistance transmission models - a systematic review.Antimicrobial resistance and infection control · 2025Pooled it
- Practical Guidance for Clinical Microbiology Laboratories: Viruses Causing Acute Respiratory Tract Infections.Clinical microbiology reviews · 2019Guideline
- The frequency of influenza and bacterial coinfection: a systematic review and meta-analysis.Influenza and other respiratory viruses · 2016Pooled it
- Effect of host-protein test (TRAIL/IP-10/CRP) on antibiotic prescription and emergency department or urgent care center return visits: The JUNO pilot randomized controlled trial.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2025Trial
- Routine molecular point-of-care testing for respiratory viruses in adults presenting to hospital with acute respiratory illness (ResPOC): a pragmatic, open-label, randomised controlled trial.The Lancet. Respiratory medicine · 2017Trial
- Viral load is strongly associated with length of stay in adults hospitalised with viral acute respiratory illness.The Journal of infection · 2016Trial
- Serum Procalcitonin Measurement and Viral Testing to Guide Antibiotic Use for Respiratory Infections in Hospitalized Adults: A Randomized Controlled Trial.The Journal of infectious diseases · 2015Trial
- A novel host-proteome signature for distinguishing between acute bacterial and viral infections.PloS one · 2015Trial
- Diabetes affects the composition of the respiratory tract microbiome and transcriptome in patients with viral pneumonia.Microbiology spectrum · 2026Article
- Lipoteichoic acid mediates binding ofmSphere · 2025Article
- A four-gene signature from blood to exclude bacterial etiology of lower respiratory tract infection in adults.Nature communications · 2025Article
- Clinical Features and Gene Expression Patterns in Adults Hospitalized With Respiratory Syncytial Virus and Human Metapneumovirus Infection.The Journal of infectious diseases · 2025Article
- A Four-Gene Signature from Blood to Exclude Bacterial Etiology of Lower Respiratory Tract Infection in Adults.Research square · 2025Article
- Host-response testing with MeMed BV in community-acquired pneumonia: an economic evaluation from the UK NHS perspective.JAC-antimicrobial resistance · 2025Article
- National Trends in Antibiotic Prescribing for Adults Hospitalized With Coronavirus Disease 2019 and Other Viral Respiratory Infections.Open forum infectious diseases · 2025Article
- NLRP3 promotes inflammatory signaling and IL-1β cleavage in acute lung injury caused by cell wall extract of Lactobacillus casei.Communications biology · 2025Article
- Can clinical findings at admission allow withholding of antibiotics in patients hospitalized for community acquired pneumonia when a test for a respiratory virus is positive?Pneumonia (Nathan Qld.) · 2025Article
- Article
- Insights from respiratory virus co-infections.World journal of virology · 2024Review
- Respiratory tract barrier dysfunction in viral-bacterial co-infection cases.The Japanese dental science review · 2024Review
38 more citing papers are in PubMed but not listed here.
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Authors and funding
10 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundRespiratory tract infection is one of the most common reasons for hospitalization among adults, and recent evidence suggests that many of these illnesses are associated with viruses. Although bacterial infection is known to complicate viral infections, the frequency and impact of mixed viral-bacterial infections has not been well studied.
methodsAdults hospitalized with respiratory illness during 3 winters underwent comprehensive viral and bacterial testing. This assessment was augmented by measuring the serum level of procalcitonin (PCT) as a marker of bacterial infection. Mixed viral-bacterial infection was defined as a positive viral test result plus a positive bacterial assay result or a serum PCT level of ≥ 0.25 ng/mL on admission or day 2 of hospitalization.
resultsOf 842 hospitalizations (771 patients) evaluated, 348 (41%) had evidence of viral infection. A total of 212 hospitalizations (61%) involved patients with viral infection alone. Of the remaining 136 hospitalizations (39%) involving viral infection, results of bacterial tests were positive in 64 (18%), and PCT analysis identified bacterial infection in an additional 72 (21%). Subjects hospitalized with mixed viral-bacterial infections were older and more commonly received a diagnosis of pneumonia. Over 90% of hospitalizations in both groups involved subjects who received antibiotics. Notably, 4 of 10 deaths among subjects hospitalized with viral infection alone were secondary to complications of Clostridium difficile colitis.
conclusionsBacterial coinfection is associated with approximately 40% of viral respiratory tract infections requiring hospitalization. Patients with positive results of viral tests should be carefully evaluated for concomitant bacterial infection. Early empirical antibiotic therapy for patients with an unstable condition is appropriate but is not without risk.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.