• Wei-Chun Lee, Meng-Chin Ho, Shaw-Woei Leu, Che-Chia Chang, Chin-Kuo Lin, Chieh-Mo Lin, Yu-Hung Fang, Shu-Yi Huang, Yu-Ching Lin, Min-Chun Chuang, Tsung-Ming Yang, Ming-Szu Hung, Yen-Li Chou, Ying-Huang Tsai, and Meng-Jer Hsieh.
• Department of Pulmonary and Critical Care Medicine, Chiayi Chang-Gung Memorial Hospital, Chang-Gung Medical Foundation, Chiayi, Taiwan.
• J Crit Care. 2022 Dec 1; 72: 154164154164.

PurposesThis study investigated the prevalence and clinical outcomes of pulmonary bacterial co-infections and secondary bacterial infections in patients with severe influenza pneumonitis.MethodsWe retrospectively analyzed the data of adult patients with severe influenza pneumonitis admitted to medical ICUs. Bacterial co-infections and secondary bacterial infections were identified. The risk factors of bacterial infection were evaluated. The outcomes of patients regarding co-infection or secondary bacterial infection were analyzed.ResultsWe identified 117 critically ill patients with laboratory-confirmed influenza pneumonitis admitted to the medical ICUs. Klebsiella pneumoniae (31.4%) and Staphylococcus aureus (22.8%) were the most identified bacteria in patients with bacterial co-infection. A high proportion of methicillin-resistant Staphylococcus aureus (17.1%) was noted. Liver cirrhosis and diabetes mellitus were the independent risk factors for bacterial co-infection. Acinetobacter baumannii (30.7%) and S. aureus (23.1%) were the most often identified bacteria in patients with secondary bacterial pneumonia. Patients with secondary bacterial infections had a longer duration of mechanical ventilation, and longer ICU and hospital stay.ConclusionsHigh rates of drug-resistant bacterial co-infections and secondary bacterial infections were identified in patients with severe influenza pneumonitis requiring ICU care and were associated with more morbidity in these patients.Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.

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