ArticleInfection control and hospital epidemiology2022
Bacterial coinfection in influenza pneumonia: Rates, pathogens, and outcomes.
Article in Infection control and hospital epidemiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
27 citing papers in PubMed, 2 syntheses or guidelines pooled it, 36 citations in OpenAlex.
- Pooled it
- The global trends and clinical progress in influenza co-infection: a visualization and bibliometric analysis (2005-2025).Frontiers in microbiology · 2025Pooled it
- Prevalence and Outcomes of Bacterial Co-detections by Blood Culture Among Children and Adults Hospitalized With Laboratory-confirmed Influenza, Influenza Hospitalization Surveillance Network, 2022-2024.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Using interpretable machine learning models to predict the occurrence of severe influenza in hospitalized children: a retrospective cohort study.BMC medical informatics and decision making · 2026Article
- Impact of Procalcitonin Testing on Antibiotic Use in Patients Hospitalized With Community-Acquired Pneumonia: A Multi-Hospital Cohort Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Comparison of the Clinical Course of Viral Respiratory Infections in Hospitalized Patients During the 2025/2026 Season in Poland.Vaccines · 2026Article
- Potential Non-Specific Benefits of Seasonal Influenza Vaccination: Evidence, Knowledge Gaps, and Future Directions.Vaccines · 2026Review
- A Pilot Study ofDiagnostics (Basel, Switzerland) · 2026Article
- A multi-omics case-control study identifying oropharyngeal microbiome-metabolite patterns that characterize secondary bacterial pneumonia among influenza patients.Frontiers in microbiology · 2026Article
- Laboratory characteristics and immune-inflammatory profiles ofFrontiers in pediatrics · 2026Article
- Lymphopenia is Associated with Altered Pathogen Distribution and Increased Disease Severity in Viral Pneumonia: A Multicenter Retrospective Cohort Study.Infection and drug resistance · 2026Article
- Severe co-infection with influenza A virus H3N2 and community-acquired methicillin-susceptibleFrontiers in cellular and infection microbiology · 2026Article
- Construction of an auxiliary diagnostic model for secondary pulmonary bacterial infection in influenza based on routine detection indicators.American journal of translational research · 2026Article
- UMPlex™: a targeted next-generation sequencing primer design workflow.Virology journal · 2025Article
- Analysis of co-infection in severe and critical patients with influenza A (H1N1) pneumonia using metagenomic next-generation sequencing on bronchoalveolar lavage samples.Frontiers in cellular and infection microbiology · 2025Article
- Post-influenza bacterial infection: mechanisms of pathogenesis and advances in therapeutic strategies.Frontiers in microbiology · 2025Review
- Characteristics of adults with influenza A virus pneumonia and co-infections identified by mNGS in Jilin, China during 2024-2025.Frontiers in cellular and infection microbiology · 2025Article
- Patients with influenza admitted to a tertiary-care hospital in Riyadh between 2018 and 2022: characteristics, outcomes and factors associated with ICU admission and mortality.BMC pulmonary medicine · 2024Article
- Development and validation of a nomogram to predict severe influenza.Immunity, inflammation and disease · 2024Article
- ProcCluster® and procaine hydrochloride inhibit the growth ofFrontiers in cellular and infection microbiology · 2024Article
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundEvidence from pandemics suggests that influenza is often associated with bacterial coinfection. Among patients hospitalized for influenza pneumonia, we report the rate of coinfection and distribution of pathogens, and we compare outcomes of patients with and without bacterial coinfection.
methodsWe included adults admitted with community-acquired pneumonia (CAP) and tested for influenza from 2010 to 2015 at 179 US hospitals participating in the Premier database. Pneumonia was identified using an International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) algorithm. We used multiple logistic and gamma-generalized linear mixed models to assess the relationships between coinfection and inpatient mortality, intensive care unit (ICU) admission, length of stay, and cost.
resultsAmong 38,665 patients hospitalized with CAP and tested for influenza, 4,313 (11.2%) were positive. In the first 3 hospital days, patients with influenza were less likely than those without to have a positive culture (10.3% vs 16.2%; P < .001), and cultures were more likely to contain Staphylococcus aureus (34.2% vs 28.2%; P = .007) and less likely to contain Streptococcus pneumoniae (24.9% vs 31.0%; P = .008). Of S. aureus isolates, 42.8% were methicillin resistant among influenza patients versus 53.2% among those without influenza (P = .01). After hospital day 3, pathogens for both groups were similar. Bacterial coinfection was associated with increased odds of in-hospital mortality (aOR, 3.00; 95% CI, 2.17-4.16), late ICU transfer (aOR, 2.83; 95% CI, 1.98-4.04), and higher cost (risk-adjusted mean multiplier, 1.77; 95% CI, 1.59-1.96).
conclusionsIn a large US inpatient sample hospitalized with influenza and CAP, S. aureus was the most frequent cause of bacterial coinfection. Coinfection was associated with worse outcomes and higher costs.
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