結果:
A型流感個案共336例， B型流感共414例。其中23例細菌培養陽性。最常見的細菌為肺炎鏈球菌（39.1％）及金黃色葡萄球菌（30.4％），尤其是在18歲以下組別。合併細菌感染之流感病患之住院時間顯著較高。A型流感合併細菌感染以肺炎鏈球菌為主，感染後易得肺炎。B型流感合併細菌感染以金黃色葡萄球菌為主。本研究中一位B型流感合併金黃色葡萄球菌死亡。研究中，白血球計數，C反應球蛋白對流感嚴重度並無關聯性。
結論:
繼發細菌感染仍是小童及老年人常見且潛在致命的併發症。建立經驗性治療，及早以抗生素合併抗病毒劑可顯著改善繼發細菌感染患者的預後。流感及肺炎連球菌疫苗接種率高，也提高高風險患者的預防能力。最後，希望醫界對流感合併細菌性感染能提高警覺性。
Background:
To review the presentation of type A and B influenza with bacterial co-infection in medical center and describe the epidemiology of co-infection. We also discuss the clinical course, pathogenesis, and rational clinical management of co-infection.
Material and method:
We retrospectively analyzed the medical records of 1702 influenza-like patients who underwent nasopharyngeal swab, from January 2011 to March 2012, at the medical center of Chung Shan Medical University Hospital. Totally 750 patients were included in this study. Patients were divided into two groups, all age group and under 18 years group.
Results:
336 cases with influenza type A, 414 cases with influenza type B infection. There are 23 reports presented positive bacterial culture. The most common bacterial organisms causing co-infections were Streptococcus Pneumoniae (39.1%), and Staphylococcus aureus (30.4%), especially in under 18 years group. The length of hospitalization stay was higher in positive culture with pneumonia.
Conclusion:
Secondary bacterial infection following influenza remains a common and potentially deadly complication for older adults. Therapeutic options are shrinking with the emergence of antibiotic resistance in community-acquired respiratory pathogens, particularly Streptococcus pneumoniae. Empiric therapy with anti-virus agents may significantly improve prognosis. Higher rates of influenza vaccination would also improve our ability to protest these at-risk patients.
