Table 3 Bacterial co-infection reported among severe cases of A(H1N1)pdm09 admitted in ICUs (n = 16)
Author and year | Study type | Study population | Case severity | Antiviralsa n/N (%) any n/N (%) 48 h | Antibiotics† n/N (%) pre n/N (%) on n/N (%) during admission | Any positive bacterial growth | Number (%) patients with S.pneumoniae and site of isolation | Number (%) with bacterial pneumonia - Method - Diff/no diff | ||
|---|---|---|---|---|---|---|---|---|---|---|
ICU - ECMO | Mechanical Ventilation | Deaths | ||||||||
Miller (2010) [36] Utah, USA 5/09–6/09 Adults(16+) | Multicentre (4) case series (+ comparison with local resident population) / Adult (> 15 y) ICU admissions | N = 47 | 47/47 (100) - 0 | 13/47 (27.7) IV = 11/47 (84.6) | 8/47 (14) | 47/47 (100.0) - 45/47 (95.7) | 44/47 (93.6) - NS | 6/47 (13) | 0/47 (0) BC 0/47 (0) ET aspirate 0/47 (0) SC 0/47 (0) BAL fluid | 43/47(91.5) - CXR - No diff |
Rello [29] (2009) Spain 6/09–7/09 Adults | Multicentre (20) case series (retrospective) / ICU adult admissions with ARF | N = 32 | 32/32 (100) - 0 | 24/32 (75.0) - IV = 22/32 (91.7) - NIV = 2/32 (8.3) | 8/32 (25) | 32/32 (100.0) -NS | 32/32 (100.0) | 1/32 (3.1) Secondary superinfection with Pseudomonas aeruginosa were also documented in three patients (9.3). | 1/32 (3.1) aspirate 0/32 (0) BC | 1/32 (3.1) respiratory culture |
ANZ ECMO [34] (2009) Australia and New Zealand 6/09–8/09 All ages | Multicentre (15) cohort study (retrospective) / All ages ICU admission with ARDS treated with ECMO Includes probable casesa | N = 68 | 68/68 (100) - 68/68 (100) | 68/68 (100) | 14/68 (20.6) | 64/68 (94.1) - NS | NR | 19/68 (28) | 10/68 (14.7) [respiratory secretion/BC] | 66/68 (97.1) CXR/CT No diff |
Estenssoro (2010) [5] Argentina 6/09–9/09 Adults(15+) | Multicentre (35) inception cohort study (prospective & retrospective) / adult (≥ 15 years) ICU admissions with ILI & ARF requiring MV Includes probable casesa | N = 337 | 337/337 (100) | 337/337 (100) NIV = 64/337 (19.0) | 156/337 (46.3) | 328/336 (98) - NS | 337/337 (100) - NS | 28/337 (8.3) | 28 /337 [NS] 8.3 | 80/337 (23.7) CXR/CT Diff |
Nin [31] (2011) Chile, Uruguay 6/09–9/09 | Multicenter (10) case series (> 18 yrs) (retrospective and prospective) / Respiratory failure requiring ICU mechanical ventilation ** (confirmed = 77/ 96) Includes probable casesa | N = 96 | 96/96 (100) 13/96 (13.5) | 96/96 (100) NIV = 10/96 (10.4) IV = 86/96 (89.6) Prone ventilation = 44 /96 (45.8)HFOV = 10/96 (10.4) | 48/96 (50) | 84/96 (87.5) - NS | 91/96 (94.8) - NS | 8/96 (8) | NR | 32/96 (33.3, 8 within first week of admission) - Purulent sputum, significant growth of pathogen in ET aspirate - diff |
Koegelenberg (2010) [30] South Africa 8/09–9/09 Adults(18+) | Single-centre case series (prospective)/Adult (> = 18 y) ICU admissions with ARF requiring MV | N = 19 | 19/19 (100) - NR | 19/19 (100) - NIV = 2/19 (10.5) | 13/19 (68.4) | 19/19 (100) - 14 (73.7) | NR | 0/19 (19) | 0/19 (0) BC 0/19 (0) ET aspirates 0/19 (0) other NS | 0/19 (0) (10 cases of nosocomial infection (> = 48 h admission) - CXR |
Martin-Loeches [28] (2010) Spain 1st case - 12/09 Adults (16+) | Multicentre (148) case series (prospective) /Adult (> = 15 y) ICU admissions with ARF | N = 645 | 645/645 (100) | NR - IV = 389/645 (60.3) | 112/645 (17.4) | 620/645 (96.1) - NS | 645/645 (100) - NS | 113/645 (17.5) | 62 /645 (9.6) site NS Cultures routinely every day | 113/645 (17.5) - CXR + pos culture - diff |
Rice [39] (2012) US 4/09–4/10 | Multicenter (35) case series (retrospective and prospective) / Critically ill cases (> 13 years) admitted to adult ICU’s (Confirmed = 424/683, 62%) Includes probable casesa | N = 683 | 683/683 (100) | 231/683 (33.8) - IV = 175/683 (75.8) - NIV = 56/683 (24.2) | 309/683 (45.2) | 683/683 (100) -NS | NR | Total 154/683 (22.5) Sputum specimen 84/683 (12.3) Bacteraemia 50 (7.3) Both 20 (2.9) | 10/683 (1.5) BC | 207/683 (30.3) clinical coinfection, non-diff |
CDC [27] | Patients at a tertiary care hospital in Michigan | N = 10 | 10/10 (100) | 10/10 (100) | 3/10 (30%) | 10/10 (100) | 10/10 (100) | NR | NR | NR |
Kim [32] | ICU in 28 Hospitals in SK | 245 | 245/245 (100) | 162/245 (100) | 99/245 (40.4) | 103/245 (42) | 243/245 (99.2) | 91/245 (37.1) | 0/245 (0) | 91/245 (37.1) |
Malato [35] | ICU in one hosiptal | 24 | 24/24 (100) | 6/24 (25) | 4/24 (16.7) | 20/20 (100) | NR | 6/24 (25) | 0/24 (0) | 6/24 (25) |
Kumar [33] (2009) Canada 4/09–8/09 All ages | Multicentre (38) cohort study (prospective & retrospective) /All age critically ill patients = ICU & requiring MV or IV medication or ≥ 60% inspired O2 fraction Includes probable casesa | N = 168 | 168/168 (100) - 7/168 (4.2) | 136/168 (81.0) - IV = 128/168 (94.1) - HFOV = 20/168 (14.7) | 29/168 (17.3) | NR | NR | 5/168 (2.9) site NS | 54/168 (32.1) possible at presentation; 41/168 (24.4) clinically dx cases following ICU admission - CXR + culture /clinical opinion | |
Roch [26] | ARDS cases in ICU | N = 18 | 18/18 (100) | 10/18 (100) | 10/10 (100) | NR | NR | 0/18 (0) | 0/18 (0) | 0/18 (0) |
Lucker [37] | One hospital ICU, medical charts reviewed | 14 | 14/14 (100) | 10/14 (71.4) | 2/14 (14.3) | 14/14 (100) | 13/14 (92.9) | 6/14 (42.8) Of ICU cases | 0/14 (0) | 6/14 (42.9) |
Leen [38] | 22 bed ICU in one hospital | N = 31 | 31/31 (100) | 3/31 (10) | NR | NR | NR | NR | 10/31 (32.2) Method not mentioned | |
Torres [40] | Hospital in Chile. Includes probable casesa | N = 11 | 11/11 (100) | 11/11 (100) | 0/11 (0) | 11/11 (100) | 7/11 (63.6) | 1/11 (0.9) Group A Streptococcus Site NR | 0/11 (0) | 6/11 (54.5) Non Diff |