Pneumopathies bactériennes secondaires aux infections respiratoires virales : de l’étude expérimentale in vitro à l’analyse descriptive des données hospitalières en passant par l’étude prospective d’une cohorte de patients

Abstract : Post-influenza bacterial pneumonia is a leading cause of morbidity and mortality with severe influenza virus illness. Staphylococcus aureus is one of the most common pathogen found in this context. The severity of post-influenza Staphylococcus aureus pneumonia is due both to an inadequate responsiveness of the immune system (either too important or too weak) and to the weak efficacy of treatments used during these severe infections. A better knowledge of the pathophysiology of influenza/S. aureus co-infection is needed in order to improve patients care. In this study, we showed using in vitro experiments that influenza virus increased the inflammation and cytotoxicity induced by S. aureus virulence factors in human monocytes. However ex vivo experiments performed on leucocytes isolated from hospitalized patients with severe influenza showed an anergy of the immune system after exposition to S. aureus virulence factors. Immunomonitoring of patients with severe post-influenza Staphylococcus aureus pneumonia may allow to optimize the therapeutic regimen towards a more individualized immunomodulatory therapy. This can be extended to other viral bacterial co-infections including RSV. We studied the epidemiology of bacterial superinfections associated with RSV pneumonia in adults. Our results suggested that there was no main differences between the microbiological epidemiology of RSV/bacterial co-infections and influenza/bacterial co-infections. Knowledge of this epidemiology is important to assess to improve patients care
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Marion Jeannoël. Pneumopathies bactériennes secondaires aux infections respiratoires virales : de l’étude expérimentale in vitro à l’analyse descriptive des données hospitalières en passant par l’étude prospective d’une cohorte de patients. Virologie. Université de Lyon, 2019. Français. ⟨NNT : 2019LYSE1039⟩. ⟨tel-02150592⟩

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