Methods: From 2009-2014, we conducted an observational study of ILI at five US military treatment facilities, enrolling participants 0-65y with no co-morbidities. Nasopharyngeal specimens were obtained at study entry and were tested by target-enriched multiplex PCR (TEM-PCR) for the detection of 11 bacterial and 10 viral respiratory pathogens (Diatherix Laboratories, Inc.; Huntsville, AL). Odds ratios (OR) and 95% confidence intervals (CI) for associations between viral and bacterial pathogens were calculated.
Results: 895 specimens were evaluated by TEM-PCR with 583 (65%) positive for at least one virus, 643 (72%) positive for at least one bacterium, and 399 (44%) positive for both. The most common viruses were: rhinovirus, n=140 (16%); Influenza A, n=119 (13%); Coxsackie/Echovirus, n=89 (10%); Coronavirus, n=111 (12%); and RSV, n=89 (10%). The most common bacteria were: Streptococcus pneumoniae, n=330 (36.1%); Haemophilus influenzae, n=224 (24.5%); Moraxella catarrhalis, n=209 (22.9%); and Staphylococcus aureus, n=184 (20.1%). Detection of S. aureus was more common among those with influenza (OR: 1.68; 95% CI:1.12, 2.5) and coxsackie virus (OR:1.66; 95% CI:1.01, 2.72). These associations were significantly higher among children (OR: 2.33, and OR: 2.48, respectively). Increased detection of S. pneumoniae was observed only for children with RSV (OR: 2.06; 95% CI:1.13, 3.73). Increased detection of H. influenzae was not observed for any viral pathogen nor either age group.
Conclusion: Increased detection of S. aureus was found for several viral pathogens, whereas increases in S. pneumoniae were only observed in pediatric RSV. Further evaluations of viral/bacterial co-detections are warranted, particularly as related to symptom severity.
W. J. Chen, None
M. Fairchok, None
C. Schofield, None
K. J. St. Clair, None
L. Malone, Diatherix Lab: Investigator , Salary
E. Grigorenko, Diatherix lab: Investigator , Salary
D. Stalons, Diatherix Lab: Investigator , Salary
D. Mor, None
T. Burgess, None
E. Millar, None