Table 1.

Viral and bacterial co-infections and associated complications

Virus	Bacteria	Co-infection complication
Influenza	S. pneumoniae	CAP, AOM, acute and chronic rhinosinusitis [15], invasive pneumococcal diseasea [69]
	S. aureus	Necrotizing pneumonia, CAP [70], bacteremia [71] chronic sinusitis [72]
	Haemophilus influenza	AOM, exacerbation of COPD, sinusitis [73], bronchial necrosis, bronchitis [74]
Rhinovirus	S. pneumoniae	Acute and chronic rhinosinusitis [2] CAP [75], AOM [76], invasive pneumococcal diseasea [77]
	S. aureus	Chronic rhinosinusitis [78]
	H. influenza	AOM [79], Acute and chronic rhinosinusitis [2], exacerbation of COPD [80]
	Moraxella catarrhalis	AOM [76]
RSV	S. pneumoniae	AOM [81], CAP [75], invasive pneumococcal diseasea [77]
	S. aureus	CAP, LRTI [70]
	H. influenza	AOM [81], CAP, LRTI [82]
	M. catarrhalis	AOM [81], CAP, LRTI [82]
	Pseudomonas aeruginosa	Cystic fibrosis exacerbation [83]
Human metapneumovirus	S. pneumoniae	Pneumonia [46]
Parainfluenza	S. pneumoniae	AOM, acute rhinosinuisitis [78]

^aInvasive pneumococcal disease: pneumococcus is isolated from a sterile site, i.e., sepsis, meningitis [84]

CAP community acquired pneumonia, AOM acute otitis media, COPD chronic obstructive pulmonary disease, LRTI lower respiratory tract infection