Association of 2009 Pandemic Influenza A (H1N1) Infection and Increased Hospitalization With Parapneumonic Empyema in Children in Utah
- 1 October 2010
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in The Pediatric Infectious Disease Journal
- Vol. 29 (10), 905-909
- https://doi.org/10.1097/inf.0b013e3181df2c70
Abstract
Background: During previous influenza pandemics, many deaths were associated with secondary bacterial infection. In April 2009, a previously unknown 2009 influenza A virus (2009 H1N1) emerged, causing a global influenza pandemic. We examined the relationship between circulating 2009 H1N1 and the occurrence of secondary bacterial parapneumonic empyema in children. Methods: Children hospitalized with parapneumonic empyema from August 2004 to July 2009, including a period when the 2009 H1N1 circulated in Utah, were identified using International Classification of Diseases, Ninth Revision codes. We compared the average number of children diagnosed with influenza A and the number of admissions for empyema per month for the previous 4 seasons to rates of empyema during the 2009 H1N1 outbreak. We identified causative bacteria using culture and polymerase chain reaction (PCR). Results: We observed an increase in hospitalization of children with pneumonia complicated by empyema during a severe outbreak of 2009 H1N1 during the spring and summer of 2009, compared with historical data for the previous 4 seasons. Streptococcus pneumoniae and Streptococcus pyogenes were the predominant bacteria identified. Conclusions: Similar to previous pandemics, secondary bacterial infection with S. pneumoniae and S. pyogenes were associated with the 2009 H1N1 outbreak. There is an urgent need to better understand bacterial complications of pandemic influenza. In the interim, influenza vaccines, antiviral agents, and pneumococcal vaccines should be used to prevent cases of secondary bacterial pneumonia whenever possible.Keywords
This publication has 24 references indexed in Scilit:
- Hospitalized Patients with 2009 H1N1 Influenza in the United States, April–June 2009The New England Journal of Medicine, 2009
- Insights into the Interaction between Influenza Virus and PneumococcusClinical Microbiology Reviews, 2006
- Occurrence of invasive pneumococcal disease and number of excess cases due to influenzaBMC Infectious Diseases, 2006
- Impact of the Pneumococcal Conjugate Vaccine on Pneumococcal Parapneumonic EmpyemaThe Pediatric Infectious Disease Journal, 2006
- Parapneumonic Effusions and EmpyemaProceedings of the American Thoracic Society, 2006
- Sequential Multiplex PCR Approach for Determining Capsular Serotypes of Streptococcus pneumoniae IsolatesJournal of Clinical Microbiology, 2006
- Seasonality of invasive pneumococcal disease: Temporal relation to documented influenza and respiratory syncytial viral circulationAmerican Journal Of Medicine, 2005
- A role for Streptococcus pneumoniae in virus-associated pneumoniaNature Medicine, 2004
- Clinical features, aetiology and outcome of empyema in children in the north east of EnglandThorax, 2004
- Severe Pneumococcal Pneumonia in Previously Healthy Children: The Role of Preceding Influenza InfectionClinical Infectious Diseases, 2000