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Observational Study
. 2024 Aug 29;24(1):881.
doi: 10.1186/s12879-024-09687-1.

Co-detection of respiratory pathogens among ILI patients: characterization of samples collected during the 2018/19 and 2019/20 pre-pandemic seasons

Allegra Ferrari  1 , Irene Schiavetti  2 , Matilde Ogliastro  2 , Carola Minet  2 , Raffaella Sibilio  2 , Irene Giberti  2 , Elisabetta Costa  2 , Elvira Massaro  2 , Piero Luigi Lai  2   3 , Stefano Mosca  3 , Bianca Bruzzone  4 , Andrea Orsi  2   3   4 , Donatella Panatto  2   3 , Giancarlo Icardi  2   3   4
Affiliations
Observational Study

Co-detection of respiratory pathogens among ILI patients: characterization of samples collected during the 2018/19 and 2019/20 pre-pandemic seasons

Allegra Ferrari et al. BMC Infect Dis. .

Abstract

Influenza-like illness (ILI) patients co-detected with respiratory pathogens exhibit poorer health outcomes than those with single infections. To address the paucity of knowledge concerning the incidence of concurrent respiratory pathogens, their relationships, and the clinical differences between patients detected with single and multiple pathogens, we performed an in-depth characterization of the oropharyngeal samples of primary care patients collected in Genoa (Northwest Italy), during winter seasons 2018/19-2019/20.The apriori algorithm was employed to evaluate the incidence of viral, bacterial, and viral-bacterial pairs during the study period. The grade of correlation between pathogens was investigated using the Phi coefficient. Factors associated with viral, bacterial or viral-bacterial co-detection were assessed using logistic regression.The most frequently identified pathogens included influenza A, rhinovirus, Haemophilus influenzae and Streptococcus pneumoniae. The highest correlations were found between bacterial-bacterial and viral-bacterial pairs, such as Haemophilus influenzae-Streptococcus pneumoniae, adenovirus-Haemophilus influenzae, adenovirus-Streptococcus pneumoniae, RSV-A-Bordetella pertussis, and influenza B Victoria-Bordetella parapertussis. Viruses were detected together at significantly lower rates. Notably, rhinovirus, influenza, and RSV exhibited significant negative correlations with each other. Co-detection was more prevalent in children aged < 4, and cough was shown to be a reliable indicator of viral co-detection.Given the evolving epidemiological landscape following the COVID-19 pandemic, future research utilizing the methodology described here, while considering the circulation of SARS-CoV-2, could further enrich the understanding of concurrent respiratory pathogens.

Keywords: Co-infection; LRI; Respiratory pathogens; Respiratory tract infection; Syndromic surveillance; URI.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Grade of correlation between different viral and bacterial respiratory pathogens
Fig. 2
Fig. 2
Proportion of the main pathogens of interest (a-b); incidence of multiple viral, bacterial and viral-bacterial species (c)
See this image and copyright information in PMC

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