ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2019
Vancomycin Monotherapy May Be Insufficient to Treat Methicillin-resistant Staphylococcus aureus Coinfection in Children With Influenza-related Critical Illness.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers.
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Who cites it
36 citing papers in PubMed, 50 citations in OpenAlex.
- Clinical Data on Daptomycin plus Ceftaroline versus Standard of Care Monotherapy in the Treatment of Methicillin-Resistant Staphylococcus aureus Bacteremia.Antimicrobial agents and chemotherapy · 2019Trial
- Evaluation of Mannose Binding Lectin Gene Variants in Pediatric Influenza Virus-Related Critical Illness.Frontiers in immunology · 2019Trial
- A macrophage-mimetic nanocarrier co-loaded with geraniol and FK13-a1 for MRSA-induced acute lung injury.Drug delivery · 2026Article
- Coinfection Patterns ofInternational journal of molecular sciences · 2026Article
- Severe pneumonia in children withFrontiers in pediatrics · 2026Article
- Severe co-infection with influenza A virus H3N2 and community-acquired methicillin-susceptibleFrontiers in cellular and infection microbiology · 2026Article
- Pediatric necrotizing pneumonia caused by mixed infection with influenza A virus and Panton-Valentine Leucocidin-producing Staphylococcus aureus: case report and literature review.BMC pediatrics · 2025Review
- A Comprehensive Review of Pediatric Necrotizing Pneumonia.Children (Basel, Switzerland) · 2025Review
- Article
- Fatal Influenza B-MRSA Coinfection in a Healthy Adolescent: Necrotizing Pneumonia, Cytokine Storm, and Multi-Organ Failure.Children (Basel, Switzerland) · 2025Article
- Probiotic peptidoglycan skeleton enhances vaccine efficacy against MRSA by inducing trained immunity via the TLR2/JAK-STAT3 pathway.Frontiers in immunology · 2025Article
- A Review Vancomycin Role in Gram Positive Biofilm-Associated Infections: Challenges and Emerging Solutions.Therapeutics and clinical risk management · 2025Review
- A Tale of Two Cytokines: IL-10 Blocks IFN-γ in Influenza A Virus-American journal of respiratory cell and molecular biology · 2024Article
- Rescue of alveolar wall liquid secretion blocks fatal lung injury due to influenza-staphylococcal coinfection.The Journal of clinical investigation · 2023Article
- Altered Respiratory Microbiomes, Plasma Metabolites, and Immune Responses in Influenza A Virus and Methicillin-Resistant Staphylococcus aureus Coinfection.Microbiology spectrum · 2023Article
- Necrotizing Pneumonia in Children: Early Recognition and Management.Journal of clinical medicine · 2023Review
- Pathobiology, Severity, and Risk Stratification of Pediatric Acute Respiratory Distress Syndrome: From the Second Pediatric Acute Lung Injury Consensus Conference.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2023Review
- Vancomycin efficiency and safety of a dosage of 40-60 mg/kg/d and corresponding trough concentrations in children with Gram-positive bacterial sepsis.Frontiers in cellular and infection microbiology · 2023Article
- Host Respiratory Transcriptome Signature Associated with Poor Outcome in Children with Influenza-Staphylococcus aureus Pneumonia.The Journal of infectious diseases · 2022Article
- Mycoplasma pneumoniae and Adenovirus Coinfection Cause Pediatric Severe Community-Acquired Pneumonia.Microbiology spectrum · 2022Article
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Authors and funding
20 authors at 14 institutions in 1 country.
Funding
Abstract
Background: Coinfection with influenza virus and methicillin-resistant Staphylococcus aureus (MRSA) causes life-threatening necrotizing pneumonia in children. Sporadic incidence precludes evaluation of antimicrobial efficacy. We assessed the clinical characteristics and outcomes of critically ill children with influenza-MRSA pneumonia and evaluated antibiotic use. Methods: We enrolled children (<18 years) with influenza infection and respiratory failure across 34 pediatric intensive care units 11/2008-5/2016. We compared baseline characteristics, clinical courses, and therapies in children with MRSA coinfection, non-MRSA bacterial coinfection, and no bacterial coinfection. Results: We enrolled 170 children (127 influenza A, 43 influenza B). Children with influenza-MRSA pneumonia (N = 30, 87% previously healthy) were older than those with non-MRSA (N = 61) or no (N = 79) bacterial coinfections. Influenza-MRSA was associated with increased leukopenia, acute lung injury, vasopressor use, extracorporeal life support, and mortality than either group (P ≤ .0001). Influenza-related mortality was 40% with MRSA compared to 4.3% without (relative risk [RR], 9.3; 95% confidence interval [CI], 3.8-22.9). Of 29/30 children with MRSA who received vancomycin within the first 24 hours of hospitalization, mortality was 12.5% (N = 2/16) if treatment also included a second anti-MRSA antibiotic compared to 69.2% (N = 9/13) with vancomycin monotherapy (RR, 5.5; 95% CI, 1.4, 21.3; P = .003). Vancomycin dosing did not influence initial trough levels; 78% were <10 µg/mL. Conclusions: Influenza-MRSA coinfection is associated with high fatality in critically ill children. These data support early addition of a second anti-MRSA antibiotic to vancomycin in suspected severe cases.
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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.