Table 5.
Bacterial co-infection reported among paediatric hospitalised cases (including PICU) of influenza A(H1N1)pdm09 (n = 15)
| Author and year | Study type | Diagnosis of influenza/ cases | Antiviral agents - Number (%) started ≤48 h of symptoms |
Number (%) patients with S.pneumoniae and site of isolation | Any bacteria positive | Number (%) with bacterial pneumonia - Method - Diff/no diff |
Antibiotics used (Pre, on, during) | Required | ||
|---|---|---|---|---|---|---|---|---|---|---|
| ICU - ECMO | MV | Deaths | ||||||||
| Hospitalised | ||||||||||
| Louie (2010) [7] California USA 4/09–8/09 |
State-wide surveillance (California) / Hospitalized or died cases (< 18 years) | PCR/345 | 221/345 (64.1) 88/ 345 (25.5) with in 48 h |
3/345 (0.9) isolation site NR |
15/345 (4.3) | 138/229 (60.3) (F: 4/5; H: 134/224) 163/278 (CT + CXR pos) - No diff |
NR | 94/345 (27.4) | 35/94 (37) in text | 9/345 (2.6) |
| Libster [78] (2010) Argentina 5/09–7/09 |
Multicentre (6) case series (retrospective)/ Hospitalized cases (< 18 years) | PCR/ 251 | - 22/ 171(12.9) with in 48 h (4/34 PICU Px, 18/137 ward px) |
2/121 (1.7) BC 1/4 (25.0) empyema |
10 /121 (8) Blood culture |
25/251 (10.0) bacterial confirm - Among 92 CXR, 78% diagnosis was pneumonia -NonDiff |
186/251 (74.1) - On = 82 |
47/251 (18.7) | 42/251 (16.7) | 13/251 (5.2) |
| Okada [43] 2011 Japan 7/09–1/10 |
Single-centre case series (retrospective) / Pneumonia, pharyngitis or bronchitis cases (< 15 years) (n = unclear). | PCR/46 | 44/46 (95.6) - NR |
28/46 (60.9) NP |
40/46 (86.9) NP positive swab |
40/46 (86.9%) NP swab Bac pneumonia 21/46 (45.6%) unilateral infiltrates - CXR - No diff |
32/46 (69.6) - NS |
NR | NR | 0/46 (0) |
| Kumar [79] (2010) Wisconsin, USA 4/09–8/09 |
Single-centre case series (retrospective record review)/ Hospitalized (> = 24 h) cases (< 19 years) | PCR/75 | 74/75 (98.7) - NR |
0 /75 (0) | 0/75 (0) | 23/75 (34.3) - CXR - Diff |
60/75 (80.0) - Pre = 12 - On/during = 48 |
14/75 (18.7) | 4/75 (5.3) | 2/75 (2.7) |
| Miroballi [80] (2010) New York, USA 05/09–07/09 |
Multicentre (2) case series (retrospective) / Hospitalized cases (< 18) | PCR (54), EIA, DFA, viral culture/ 115 | 97/115 (84.3) - NR |
2/115 (1.7) BC 1/115 (0.9) respiratory secretions |
4/115 (3.5) | Total NR (11/35 in PICU) - NR - Diff NS |
89/115 (77.4) - NS |
35/115 (30.4) | 11/115 (9.6) in PICU | 1/115 (0.9) |
| O’Riordan [81] | Retrospective case review/hospitalised cases (< 18 yrs) | PCR/ 58 | 12/58 (20.7) - NR |
1/58 (1.7) BC |
1/58 (1.7) bacterial culture positive |
17/58 (29.3) - CXR - No diff |
56/58 (96.6) - NS |
12/58 (20.7) | 7/58 (12.1) | 0/58 (0) |
| Bettinger [82] (2010) Canada 5/09–8/09 |
National active surveillance / hospitalized cases (< 17 years) | PCR/235 | 107/235 (45.5) - NR |
3/235 (1.3) isolation site NR | 8/235 (3.4) culture positive | 8/235 (3.4) culture positive | 203/235 (86.4) - NS |
39/235 (16.6) | 15/235 (6.4) | 2/235 (0.9) |
| Lockman [83] 2010 | Retrospective case review (notes)/cases admitted to ICU | PCR/ 13 | 11/13 (84.6) - 5 (45.5) |
0/13 (0) | 0/13 (0) | 3/13 (23%) Nondiff CXR |
3/13 (23.1) - NS |
13/13 (100) | 6/13 (46.2) - IV =4 (66.7) - NIV = 2 (33.3) |
0/13 (0) |
| Stein [84] | < 18 year, ARI cases, hospitalized in 7 medical centers in Israel | PCR/ 478 | 413/478 (87.1) | 2/478 (0.4) | 4/478 (0.8) | 172/478 (35.9) CXR non-diff | 215/478 (45) | 42/478 (8.8) | 15/478 (3.1) | 3/478 (0.6%) |
| Tamma [85] | 1 hospital, lab confirm US, < 18 years, retrospective cohot in US | PCR/ 133 | 106/133 (79.7) 51/133 < 48 h |
0/133 (0) | 0/133 (0) | 28/122 (22.9) CXR nondiff |
61/85 (72%) | 27 (20.3) | 11/133 (8%) | 0 |
| Parakh [86] | 1 hospital, retrospective record review, India PICU and ICU, cases with age < 18 with ILI | PCR/ 25 | 25/25 (100) | 0/25 (0) | 0/25 (0) | 8/25 (32) CXR nondiff |
NR | 7/25 (28) | 4/25 (16) | 3/25 (12) |
| PICU | ||||||||||
| Farias [87] | Prospective multicentred study/includes nosocomial cases in Argentina(n = 147) | PCR/ 147 | 135/147 (91.8) - 116/147 (85.9) |
6/147 (4) isolation site NR | 50/147 (34) | NR | 143/147 (97.3) | 147/147 (100) | 139/147 (94.6) - IV = 117 (84.2) - NIV = 22 (15.8) |
57/147 (38.8) |
| Randolph (2011) [88] USA 4/09–4/10 |
Multicentre (35) case series (retrospective & prospective). Probable 293/838 (35%) cases PICU cases (< 21 years) |
Confirmed- PCR, viral culture Probable- direct fluorescent antibody, rapid influenza diagnostic test (n = 838) |
751/838 (89.6) - NR (before ICU admission =49) |
0/38 (0) BC 15/274 (5.5) respiratory secretions BC: 0 |
274/838 (32.7) had pneumonia/other bacterial co-infection From resp. secretions |
274/838 (32.7) had pneumonia/other bacterial co-infection From resp. secretions |
NR | 838/838 (100) - 33 (3.9) |
546/838 (67.3) | 75/838 (8.9) |
| Shin [89] | South Korea, critically ill cases | PCR/30 | 29/30 (96.7) | 0/30 (0) | 4/30 (13.3) Blood c/s positive |
22/29 (75.9) CXR non diff |
NR | 30/30 (0) | 16/30 (53.3) | 14//30 (46.7) |
| Jouvet [8] | Canada PICUs, | PCR or culture positive /57 | 44/57 (77.2) | 5/27 (18.5) Lower resp. samples |
12/57 (21.1) Lower resp. samples |
12/57 (21.1) Lower resp. samples |
54/57 (94.7) | 2/57 (3.5) | 39/57 (68.4) | 4/57 (7) |
Antibiotics: time started – “Pre” = started prior admission, “On” = started on admission, “During” = started during admission
Diff Differentiated between bacterial pneumonia, viral pneumonia and ARDS
No diff Did not differentiate between aetiology of abnormal chest imaging