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Severe outcomes more likely in children coinfected with S. aureus and influenza

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Children who were coinfected with Staphylococcus and influenza were more likely to have more complications and die from complications related to these illnesses than children who had one illness or the other. The rate of children who were coinfected and died from these illnesses rose from 2% of 47 patients in 2004-2005 to 22 of 73 deaths reported in the 2006-2007 influenza season.

“Physicians should be aware of the potentially serious outcomes associated with influenza–S. aureus coinfection and should consider coinfection in children with respiratory illness during the influenza season, including those with suspected community-acquired pneumonia so that appropriate treatment may be offered,” the researchers wrote.

They performed a retrospective medical record review of all children with lab-confirmed influenza or S. aureus (n=220) within 72 hours of admission at three Atlanta pediatric hospitals. From October 2006 to April 2007, they identified the following characteristics:

• Among the 65 children with influenza, seven had influenza and S. aureus coinfection and were more frequently admitted to the ICU (71%; P=.05) compared with other children who had influenza (28%) or S. aureus (36%) alone.

• Case fatality rates among children with coinfections were higher (29%; P=.01) than those with either influenza (0%) or S. aureus (5%).

• Children with coinfections were more likely to have had a recent skin or soft tissue infection (29%) than those with influenza alone (2%; P=.03).

• The most common clinical syndromes among children with coinfections included pneumonia (72%), bacteremia (14%) and cystic fibrosis exacerbation (14%).

“Additional research will be needed to better understand the prevalence of and risk factors for coinfection and to determine the role of influenza vaccination, influenza antiviral medications and antibiotics in reducing severe illness and death,” the researchers wrote.

Reed C. Pediatr Infect Dis J. 2009;doi:10.1097/INF.0b013e31819d8b71.