tetano
Editor, Senior Moderator
Clin Infect Dis
. 2026 May 20:ciag242.
doi: 10.1093/cid/ciag242. Online ahead of print.
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
Mark W Tenforde[SUP] 1 [/SUP], Dawud Ujamaa[SUP] 1 [/SUP], H Keipp Talbot[SUP] 2 [/SUP], Alissa C O'Halloran[SUP] 1 [/SUP], Shua J Chai[SUP] 3 4 [/SUP], Darpun Sachdev[SUP] 5 [/SUP], Isaac Armistead[SUP] 6 [/SUP], Nisha B Alden[SUP] 6 [/SUP], James Meek[SUP] 7 [/SUP], Kimberly Yousey-Hindes[SUP] 7 [/SUP], Lucy S Witt[SUP] 8 9 [/SUP], Kyle P Openo[SUP] 8 9 [/SUP], Patricia A Ryan[SUP] 10 [/SUP], Maya L Monroe[SUP] 10 [/SUP], Sue Kim[SUP] 11 [/SUP], Val Tellez Nunez[SUP] 11 [/SUP], Ruth Lynfield[SUP] 12 [/SUP], Melissa McMahon[SUP] 12 [/SUP], Caroline McCahon[SUP] 13 [/SUP], Molly Bleecker[SUP] 14 [/SUP], Grant Barney[SUP] 15 [/SUP], Kaylee Mahoney[SUP] 15 [/SUP], Brenda L Tesini[SUP] 16 [/SUP], Maria A Gaitan[SUP] 16 [/SUP], Denise Ingabire-Smith[SUP] 17 [/SUP], Nancy E Moran[SUP] 17 [/SUP], Melissa Sutton[SUP] 18 [/SUP], Andie Hendrick[SUP] 18 [/SUP], William Schaffner[SUP] 2 [/SUP], Ryan Chatelain[SUP] 19 [/SUP], Ashley Swain[SUP] 19 [/SUP], Shikha Garg[SUP] 1 [/SUP], Catherine H Bozio[SUP] 1 [/SUP]
Affiliations
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.
Keywords: Influenza; bacteremia; blood culture; hospitalization; outcomes.
. 2026 May 20:ciag242.
doi: 10.1093/cid/ciag242. Online ahead of print.
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
Mark W Tenforde[SUP] 1 [/SUP], Dawud Ujamaa[SUP] 1 [/SUP], H Keipp Talbot[SUP] 2 [/SUP], Alissa C O'Halloran[SUP] 1 [/SUP], Shua J Chai[SUP] 3 4 [/SUP], Darpun Sachdev[SUP] 5 [/SUP], Isaac Armistead[SUP] 6 [/SUP], Nisha B Alden[SUP] 6 [/SUP], James Meek[SUP] 7 [/SUP], Kimberly Yousey-Hindes[SUP] 7 [/SUP], Lucy S Witt[SUP] 8 9 [/SUP], Kyle P Openo[SUP] 8 9 [/SUP], Patricia A Ryan[SUP] 10 [/SUP], Maya L Monroe[SUP] 10 [/SUP], Sue Kim[SUP] 11 [/SUP], Val Tellez Nunez[SUP] 11 [/SUP], Ruth Lynfield[SUP] 12 [/SUP], Melissa McMahon[SUP] 12 [/SUP], Caroline McCahon[SUP] 13 [/SUP], Molly Bleecker[SUP] 14 [/SUP], Grant Barney[SUP] 15 [/SUP], Kaylee Mahoney[SUP] 15 [/SUP], Brenda L Tesini[SUP] 16 [/SUP], Maria A Gaitan[SUP] 16 [/SUP], Denise Ingabire-Smith[SUP] 17 [/SUP], Nancy E Moran[SUP] 17 [/SUP], Melissa Sutton[SUP] 18 [/SUP], Andie Hendrick[SUP] 18 [/SUP], William Schaffner[SUP] 2 [/SUP], Ryan Chatelain[SUP] 19 [/SUP], Ashley Swain[SUP] 19 [/SUP], Shikha Garg[SUP] 1 [/SUP], Catherine H Bozio[SUP] 1 [/SUP]
Affiliations
- PMID: 42161336
- DOI: 10.1093/cid/ciag242
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.
Keywords: Influenza; bacteremia; blood culture; hospitalization; outcomes.