Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026
Prevalence and outcomes of bacterial co-detections by blood culture among children and adults hospitalized with laboratory-confirmed influenza, Influenza Hospitalization Surveillance Network, 2022-2024.
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Tenforde Mark W, Ujamaa Dawud, Talbot H Keipp, O'Halloran Alissa C, Chai Shua J, Sachdev Darpun, Armistead Isaac, Alden Nisha B, Meek James, Yousey-Hindes Kimberly, Witt Lucy S, Openo Kyle P, Ryan Patricia A, Monroe Maya L, Kim Sue, Nunez Val Tellez, Lynfield Ruth, McMahon Melissa, McCahon Caroline, Bleecker Molly, Barney Grant, Mahoney Kaylee, Tesini Brenda L, Gaitan Maria A, Ingabire-Smith Denise, Moran Nancy E, Sutton Melissa, Hendrick Andie, Schaffner William, Chatelain Ryan, Swain Ashley, Garg Shikha, Bozio Catherine H
Аннотация
BACKGROUND: Influenza predisposes individuals to bacterial co-infections, which can result in disseminated infection and bacteremia. We describe the epidemiology and outcomes of blood culture co-detections among persons hospitalized with influenza over two influenza seasons.
METHODS: We sampled individuals of all ages from FluSurv-NET, a U.S. population-based surveillance network of persons hospitalized with laboratory-confirmed influenza, during the 2022-2023 and 2023-2024 seasons. Surveillance staff collected information on bacterial blood cultures within 3 days before or 3 days following admission. We described patient characteristics and in-hospital outcomes, stratified by culture positivity, number of positive cultures, and type of co-detection, using unweighted counts and weighted percentages to account for the complex survey design.
RESULTS: Overall, 14,316 patients were included, with a median (interquartile range) age of 57 (14-74) years, 53.6% female, 52.0% non-Hispanic white, and 25.6% with ≥4 categories of underlying medical conditions. Of these, 50.8% had ≥1 blood cultures obtained and 5.2% overall had ≥1 bacterial co-detections. Intensive care unit admission occurred for 9.6%, 19.2%, 31.2%, and 47.9% among patients with no blood cultures, negative cultures, 1 co-detection, and >1 co-detection documented, respectively; in-hospital mortality occurred in 1.5%, 3.3%, 9.4%, and 14.5%, respectively. Among patients with positive cultures, 22.1% had Staphylococcus aureus and 7.5% had Streptococcus pneumoniae co-detections; both were associated with severe illness (with 22.4% in-hospital mortality each).
DISCUSSION: Bacterial co-detections in persons hospitalized with influenza were associated with poor in-hospital outcomes. Efforts to prevent severe influenza and bacterial co-infections, including through vaccination, may reduce substantial morbidity and mortality from influenza.
METHODS: We sampled individuals of all ages from FluSurv-NET, a U.S. population-based surveillance network of persons hospitalized with laboratory-confirmed influenza, during the 2022-2023 and 2023-2024 seasons. Surveillance staff collected information on bacterial blood cultures within 3 days before or 3 days following admission. We described patient characteristics and in-hospital outcomes, stratified by culture positivity, number of positive cultures, and type of co-detection, using unweighted counts and weighted percentages to account for the complex survey design.
RESULTS: Overall, 14,316 patients were included, with a median (interquartile range) age of 57 (14-74) years, 53.6% female, 52.0% non-Hispanic white, and 25.6% with ≥4 categories of underlying medical conditions. Of these, 50.8% had ≥1 blood cultures obtained and 5.2% overall had ≥1 bacterial co-detections. Intensive care unit admission occurred for 9.6%, 19.2%, 31.2%, and 47.9% among patients with no blood cultures, negative cultures, 1 co-detection, and >1 co-detection documented, respectively; in-hospital mortality occurred in 1.5%, 3.3%, 9.4%, and 14.5%, respectively. Among patients with positive cultures, 22.1% had Staphylococcus aureus and 7.5% had Streptococcus pneumoniae co-detections; both were associated with severe illness (with 22.4% in-hospital mortality each).
DISCUSSION: Bacterial co-detections in persons hospitalized with influenza were associated with poor in-hospital outcomes. Efforts to prevent severe influenza and bacterial co-infections, including through vaccination, may reduce substantial morbidity and mortality from influenza.