Influenza A and B co-infection: a case-control study and review of the literature

Eur J Clin Microbiol Infect Dis. 2016 Jun;35(6):941-6. doi: 10.1007/s10096-016-2620-1. Epub 2016 Mar 15.

Abstract

Influenza virus infection remains a major cause of morbidity and mortality during winter seasons. Bacterial and virus co-infection is a commonly described situation in these patients. However, data on co-infection by influenza A and B viruses are lacking. In this study, we present the cases of co-infection by influenza A and B viruses during the winter season of 2014-2015 in our institution. We analyzed 2759 samples from 2111 patients and found that 625 samples corresponding to 609 patients were positive for influenza A or B virus. A total of 371 patients had influenza A, 228 had influenza B, and 10 (1.6 %) had influenza A and B virus detection in the same sample. The median age of co-infected patients was 78.6 years, and only one of the co-infected patients died because of the infection. Comparison with a control group of mono-infected patients revealed that co-infection was significantly associated with nosocomial acquisition [odds ratio (OR) = 4.5, 95 % confidence interval (CI) = 1.05-19.25, p = 0.042]. However, co-infection was not associated with worse outcome, previous underlying condition, or vaccination status. Multivariate analysis revealed that co-infection was not an independent risk factor for death and that no single risk factor could predict co-infection.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Case-Control Studies
  • Coinfection*
  • Comorbidity
  • Female
  • Humans
  • Influenza A virus* / classification
  • Influenza A virus* / genetics
  • Influenza B virus* / classification
  • Influenza B virus* / genetics
  • Influenza, Human / diagnosis
  • Influenza, Human / epidemiology*
  • Influenza, Human / mortality
  • Influenza, Human / virology*
  • Length of Stay
  • Male
  • Middle Aged
  • Mortality
  • Odds Ratio
  • Patient Outcome Assessment
  • Retrospective Studies
  • Risk Factors