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Table 5 Bacterial co-infection reported among paediatric hospitalised cases (including PICU) of influenza A(H1N1)pdm09 (n = 15)

From: The role of pneumonia and secondary bacterial infection in fatal and serious outcomes of pandemic influenza a(H1N1)pdm09

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)

  1. Antibiotics: time started – “Pre” = started prior admission, “On” = started on admission, “During” = started during admission
  2. Diff Differentiated between bacterial pneumonia, viral pneumonia and ARDS
  3. No diff Did not differentiate between aetiology of abnormal chest imaging