tetano
Editor, Senior Moderator
Intern Med J. 2011 Oct 7. doi: 10.1111/j.1445-5994.2011.02602.x. [Epub ahead of print]
Influenza-associated Bacterial Pathogens in Patients with 2009 Influenza A (H1N1) Infection: Impact of Community-Associated Methicillin Resistant Staphylococcus aureus (MRSA) in Queensland, Australia.
Hayashi Y, Vaska VL, Baba H, Nimmo GR, Davis L, Paterson DL.
Source
The University of Queensland, UQ Centre for Clinical Research, Herston, Brisbane, Australia Department of Intensive Care Medicine, Royal Brisbane and Women's Hospital, Herston, Brisbane, Australia Department of Infectious Diseases, Kanazawa Medical University, Uchinada, Kahoku, Japan Central Microbiology Laboratory, Pathology Queensland, Herston, Brisbane, Australia Centre for Healthcare Related Infection Surveillance and Prevention, Herston, Brisbane, Australia Department of Infectious Diseases, Royal Brisbane and Women's Hospital, Herston, Brisbane, Australia.
Abstract
Background Secondary bacterial pneumonia due to community onset methicillin-resistant Staphylococcus aureus (MRSA) has become a highly publicized cause of influenza-associated death. There is a risk that case reports of fatal outcomes with post-influenza MRSA pneumonia may unduly influence antibiotic prescribing. Aims The aim of this study is to demonstrate the incidence of community onset MRSA pneumonia in 2009 H1N1 influenza patients. Methods The microbiology records of patients positive for Influenza A (H1N1) in 2009 were reviewed for positive blood or respiratory tract cultures and urinary pneumococcal antigen results within a Queensland database. Patients with such positive results within 48 hours of hospital admission and a positive H1N1 influenza result in the prior six weeks were included. Results 4491 laboratory confirmed pandemic influenza A (H1N1) infections were detected in 2009. 50 patients (1.1% of the H1N1 cohort) who were hospitalized with H1N1 and who had a bacterial respiratory tract pathogen were identified. Streptococcus pneumoniae (16 patients; 32%), Staphylococcus aureus (13 patients; 26%) and Haemophilus influenzae (9 patients; 18%) were the most commonly cultured organisms. Of the cohort of 4491 patients, MRSA was detected in only 2 patients, both of whom were admitted to ICU and survived after prolonged admissions. Conclusions Influenza-associated community onset-MRSA pneumonia was infrequently identified in the 2009 H1N1 season in Queensland, despite community-onset MRSA skin and soft tissue infections being very common. Although post-influenza MRSA pneumonia is of great concern, its influence on empiric prescribing guidelines should take into account its incidence relative to other secondary bacterial pathogens.
? 2011 Sydney South West Area Health Service. Journal compilation ? 2011 Royal Australasian College of Physicians.
PMID:
21981384
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/21981384
Influenza-associated Bacterial Pathogens in Patients with 2009 Influenza A (H1N1) Infection: Impact of Community-Associated Methicillin Resistant Staphylococcus aureus (MRSA) in Queensland, Australia.
Hayashi Y, Vaska VL, Baba H, Nimmo GR, Davis L, Paterson DL.
Source
The University of Queensland, UQ Centre for Clinical Research, Herston, Brisbane, Australia Department of Intensive Care Medicine, Royal Brisbane and Women's Hospital, Herston, Brisbane, Australia Department of Infectious Diseases, Kanazawa Medical University, Uchinada, Kahoku, Japan Central Microbiology Laboratory, Pathology Queensland, Herston, Brisbane, Australia Centre for Healthcare Related Infection Surveillance and Prevention, Herston, Brisbane, Australia Department of Infectious Diseases, Royal Brisbane and Women's Hospital, Herston, Brisbane, Australia.
Abstract
Background Secondary bacterial pneumonia due to community onset methicillin-resistant Staphylococcus aureus (MRSA) has become a highly publicized cause of influenza-associated death. There is a risk that case reports of fatal outcomes with post-influenza MRSA pneumonia may unduly influence antibiotic prescribing. Aims The aim of this study is to demonstrate the incidence of community onset MRSA pneumonia in 2009 H1N1 influenza patients. Methods The microbiology records of patients positive for Influenza A (H1N1) in 2009 were reviewed for positive blood or respiratory tract cultures and urinary pneumococcal antigen results within a Queensland database. Patients with such positive results within 48 hours of hospital admission and a positive H1N1 influenza result in the prior six weeks were included. Results 4491 laboratory confirmed pandemic influenza A (H1N1) infections were detected in 2009. 50 patients (1.1% of the H1N1 cohort) who were hospitalized with H1N1 and who had a bacterial respiratory tract pathogen were identified. Streptococcus pneumoniae (16 patients; 32%), Staphylococcus aureus (13 patients; 26%) and Haemophilus influenzae (9 patients; 18%) were the most commonly cultured organisms. Of the cohort of 4491 patients, MRSA was detected in only 2 patients, both of whom were admitted to ICU and survived after prolonged admissions. Conclusions Influenza-associated community onset-MRSA pneumonia was infrequently identified in the 2009 H1N1 season in Queensland, despite community-onset MRSA skin and soft tissue infections being very common. Although post-influenza MRSA pneumonia is of great concern, its influence on empiric prescribing guidelines should take into account its incidence relative to other secondary bacterial pathogens.
? 2011 Sydney South West Area Health Service. Journal compilation ? 2011 Royal Australasian College of Physicians.
PMID:
21981384
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/21981384