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The role of respiratory viruses in the etiology of bacterial pneumonia: an ecological perspective

tetano

Editor, Senior Moderator
Evol Med Public Health. 2016 Feb 15. pii: eow007. [Epub ahead of print]
[h=1]The role of respiratory viruses in the etiology of bacterial pneumonia: an ecological perspective.[/h] Lee KH[SUP]1[/SUP], Gordon A[SUP]1[/SUP], Foxman B.
[h=3]Author information[/h]

[h=3]Abstract[/h] Pneumonia is the leading cause of death among children less than five years old worldwide. A wide range of viral, bacterial, and fungal agents can cause pneumonia: although viruses are the most common etiologic agent, the severity of clinical symptoms associated with bacterial pneumonia and increasing antibiotic resistance make bacterial pneumonia a major public health concern. Bacterial pneumonia can follow upper respiratory viral infection and complicate lower respiratory viral infection. Secondary bacterial pneumonia is a major cause of influenza-related deaths. In this review, we evaluate the following hypotheses: 1) Respiratory viruses influence the etiology of pneumonia by altering bacterial community structure in the upper respiratory tract (URT); and, 2) Respiratory viruses promote or inhibit colonization of the lower respiratory tract (LRT) by certain bacterial species residing in the URT. We conducted a systematic review of the literature to examine temporal associations between respiratory viruses and bacteria and a targeted review to identify potential mechanisms of interactions. We conclude that viruses both alter the bacterial community in the URT and promote bacterial colonization of the LRT. However, it is uncertain whether changes in the URT bacterial community play a substantial role in pneumonia etiology. The exception is Streptococcus pneumoniae where a strong link between viral co-infection, increased carriage, and pneumococcal pneumonia has been established.
? The Author(s) 2016. Published by Oxford University Press on behalf of the Foundation for Evolution, Medicine, and Public Health.


PMID: 26884414 [PubMed - as supplied by publisher]
 
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