Specimens were tested for the presence of 33 viral and bacterial respiratory pathogens. "The presence of Streptococcus pneumoniae in individuals between the age of 6 and 55, those most affected by the current pandemic, was associated with a 125-fold increased risk of severe disease," said Mady Hornig, MD, associate professor of epidemiology and a co-first author of the paper. "Whereas the association of S. pneumoniae with morbidity and mortality had been established in current and previous influenza pandemics, this study is the first to demonstrate that the diagnosis of S. pneumoniae, when it is still actionable, might have an impact on clinical management."

"Three practical implications emerge from our study," said CII Director W. Ian Lipkin, MD, John Snow Professor of Epidemiology, and professor of Neurology and Pathology at Columbia University. "First, S. pneumoniae is important in the pathogenesis and prognosis of H1N1pdm-associated disease. Whether this effect is associated with all S. pneumoniae or only with specific serotypes remains to be determined. Second, easily accessible samples such as nasopharyngeal swab samples may be used as an index to risk of severe disease. Third, multiplex diagnostic methods like MassTag PCR can enable rapid detection of a broad spectrum of viral and bacterial agents and inform clinical care."

Source: Columbia University's Mailman School of Public Health