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, Yoshiro, Vaska, Vikram L., Baba, Hisashi, Nimmo, Graeme R., Davis, Louise and Paterson, David L. (2012) Influenza-associated bacterial pathogens in patients with 2009 Influenza A (H1N1) infection: impact of community-associated methicillin resistant Staphylococcus aureus (MRSA) in Queensland, Australia. Internal Medicine Journal, 42 7: 755-760. doi:10.1111/j.1445-5994.2011.02602.x


Author Hayashi, Yoshiro
Vaska, Vikram L.
Baba, Hisashi
Nimmo, Graeme R.
Davis, Louise
Paterson, David L.
Title Influenza-associated bacterial pathogens in patients with 2009 Influenza A (H1N1) infection: impact of community-associated methicillin resistant Staphylococcus aureus (MRSA) in Queensland, Australia
Formatted title
Influenza-associated bacterial pathogens in patients with 2009 Influenza A (H1N1) infection: impact of community-associated methicillin resistant Staphylococcus aureus (MRSA) in Queensland, Australia
Journal name Internal Medicine Journal   Check publisher's open access policy
ISSN 1444-0903
1445-5994
Publication date 2012-07
Year available 2011
Sub-type Article (original research)
DOI 10.1111/j.1445-5994.2011.02602.x
Volume 42
Issue 7
Start page 755
End page 760
Total pages 21
Place of publication Richmond, VIC, Australia
Publisher Wiley-Blackwell Publishing Asia
Collection year 2012
Language eng
Formatted 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 postinfluenza MRSA pneumonia is of great concern, its influence on empiric prescribing guidelines should take into account its incidence relative to other secondary bacterial pathogens.

Keyword H1N1
MRSA
Influenza
Australia
Secondary bacterial pneumonia
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes © 2011 Sydney South West Area Health Service. Journal compilation © 2011 Royal Australasian College of Physicians

Document type: Journal Article
Sub-type: Article (original research)
Collections: UQ Centre for Clinical Research Publications
Official 2012 Collection
School of Medicine Publications
 
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Created: Fri, 21 Oct 2011, 14:19:50 EST by Laurie Beechey on behalf of UQ Centre for Clinical Research