{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T12:54:15Z","timestamp":1777726455581,"version":"3.51.4"},"reference-count":25,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Natural Science Foundation of Xiamen Science and Technology Bureau","award":["Grant No.: 3502Z20227147"],"award-info":[{"award-number":["Grant No.: 3502Z20227147"]}]},{"name":"Natural Science Foundation of Xiamen Science and Technology Bureau","award":["Grant No.: 3502Z20227301"],"award-info":[{"award-number":["Grant No.: 3502Z20227301"]}]},{"name":"1125 Talent Project of Xiamen Children's Hospital","award":["Grant No.: 2020-1125-YQ-040"],"award-info":[{"award-number":["Grant No.: 2020-1125-YQ-040"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Med Res"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>We aimed to investigate the clinical characteristics and influencing factors of severe influenza A virus pneumonia complicated by gram-negative bacterial infection in children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analysed data from 43 paediatric patients with severe influenza A virus pneumonia who had been treated at our hospital. The patients were divided into observation (28 patients) and control (15 patients) groups based on whether they had a coinfection with gram-negative bacteria. The clinical data of the two groups were compared, and multivariate regression analysis was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean age in the observation group was 2.5\u2009\u00b1\u20091.53 years; 26 (92.86%) patients were aged \u22645 years, and 11 (39.3%) had underlying diseases. The mean age in the control group was 4.07\u2009\u00b1\u20092.11 years; 10 (66.67%) patients were aged \u22645 years, and 2 (13.33%) had underlying diseases. The differences in age and the proportion of children with underlying diseases were statistically significant (\n                      <jats:italic toggle=\"yes\">P\u2009<\/jats:italic>\n                      &lt;\n                      <jats:italic toggle=\"yes\">\u2009<\/jats:italic>\n                      0.05). The observation group had a longer duration of fever, higher number of patients with fever lasting \u22657 days and higher incidence of gasping, with statistically significant differences (\n                      <jats:italic toggle=\"yes\">P\u2009<\/jats:italic>\n                      &lt;\n                      <jats:italic toggle=\"yes\">\u2009<\/jats:italic>\n                      0.05). The C-reactive protein level, procalcitonin level, platelet count and monocyte count in the observation group were significantly higher than those in the control group (\n                      <jats:italic toggle=\"yes\">P\u2009<\/jats:italic>\n                      &lt;\n                      <jats:italic toggle=\"yes\">\u2009<\/jats:italic>\n                      0.05). Among the gram-negative bacterial coinfections in the observation group, coinfections with\n                      <jats:italic toggle=\"yes\">Haemophilus influenzae<\/jats:italic>\n                      (21 cases, 75%) and\n                      <jats:italic toggle=\"yes\">Moraxella catarrhalis<\/jats:italic>\n                      (7 cases, 25%) were predominant. The observation group had a higher proportion of paediatric intensive care unit admissions and longer hospital stays than the control group. Additionally, significantly fewer patients in the observation group received neuraminidase inhibitor antiviral therapy within 48\u2009h (\n                      <jats:italic toggle=\"yes\">P\u2009<\/jats:italic>\n                      &lt;\u20090.05). In the observation group, all\n                      <jats:italic toggle=\"yes\">H. influenzae<\/jats:italic>\n                      isolates were sensitive to ceftriaxone, cefotaxime and meropenem, while resistance rates to ampicillin, trimethoprim\u2013sulfamethoxazole, cefuroxime and ampicillin\/sulbactam were 60.4%, 75%, 27.8% and 6.2%, respectively. All\n                      <jats:italic toggle=\"yes\">M. catarrhalis<\/jats:italic>\n                      isolates were sensitive to ampicillin\/sulbactam, amoxicillin\/sulbactam and ciprofloxacin, whereas resistance rates to ampicillin and trimethoprim\u2013sulfamethoxazole were 67.9% and 10.7%, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Severe influenza A virus pneumonia complicated by gram-negative bacterial infection is more common in children aged &lt;5 years. Younger age and the presence of underlying diseases increase the likelihood of gram-negative bacterial coinfection. Persistent fever, wheezing and significant elevations in C-reactive protein level, procalcitonin level, platelet count and monocyte count are important early warning signs for the clinical identification of gram-negative bacterial infection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03000605251391949","type":"journal-article","created":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T03:34:05Z","timestamp":1762486445000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical characteristics and influencing factors of severe influenza A virus pneumonia in children coinfected with gram-negative bacteria: A retrospective analysis"],"prefix":"10.1177","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-0718-8016","authenticated-orcid":false,"given":"Qiong-Yu","family":"Wang","sequence":"first","affiliation":[{"name":"Xiamen Children\u2019s Hospital\/Children\u2019s Hospital of Fudan University at Xiamen, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7165-4293","authenticated-orcid":false,"given":"Jing-Jing","family":"Huang","sequence":"additional","affiliation":[{"name":"Xiamen Children\u2019s Hospital\/Children\u2019s Hospital of Fudan University at Xiamen, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fu-Chun","family":"Wang","sequence":"additional","affiliation":[{"name":"Xiamen Children\u2019s Hospital\/Children\u2019s Hospital of Fudan University at Xiamen, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ya-Ping","family":"Guo","sequence":"additional","affiliation":[{"name":"Xiamen Children\u2019s Hospital\/Children\u2019s Hospital of Fudan University at Xiamen, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yong-Mei","family":"Wang","sequence":"additional","affiliation":[{"name":"Xiamen Children\u2019s Hospital\/Children\u2019s Hospital of Fudan University at Xiamen, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Si-Si","family":"Li","sequence":"additional","affiliation":[{"name":"Xiamen Children\u2019s Hospital\/Children\u2019s Hospital of Fudan University at Xiamen, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8417-8388","authenticated-orcid":false,"given":"Lin","family":"Yuan","sequence":"additional","affiliation":[{"name":"Xiamen Children\u2019s Hospital\/Children\u2019s Hospital of Fudan University at Xiamen, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhi-Qiang","family":"Zhuo","sequence":"additional","affiliation":[{"name":"Xiamen Children\u2019s Hospital\/Children\u2019s Hospital of Fudan University at Xiamen, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,11,6]]},"reference":[{"key":"e_1_3_9_2_2","doi-asserted-by":"publisher","DOI":"10.1080\/14760584.2017.1324302"},{"key":"e_1_3_9_3_2","first-page":"192","article-title":"Analysis of clinical characteristics and risk factors of influenza virus complicated with gram-positive bacterial infection in children","volume":"29","author":"Zhou H","year":"2022","unstructured":"Zhou H, Wu YH, Yu Q, et\u00a0al. Analysis of clinical characteristics and risk factors of influenza virus complicated with gram-positive bacterial infection in children. Chinese Pediatric Emergency Medicine 2022; 29: 192\u2013198.","journal-title":"Chinese Pediatric Emergency Medicine"},{"key":"e_1_3_9_4_2","first-page":"910","article-title":"Analysis of clinical characteristics and risk factors of influenza-related deaths in children","volume":"58","author":"Yu Q","year":"2020","unstructured":"Yu Q, Zhou H, Zhang T, et\u00a0al. Analysis of clinical characteristics and risk factors of influenza-related deaths in children. Zhonghua Er Ke Za Zhi 2020; 58: 910\u2013916.","journal-title":"Zhonghua Er Ke Za Zhi"},{"key":"e_1_3_9_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.virol.2015.03.009"},{"key":"e_1_3_9_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.12160"},{"key":"e_1_3_9_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2014.07.023"},{"key":"e_1_3_9_8_2","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.17-0494"},{"key":"e_1_3_9_9_2","first-page":"726","article-title":"Research progress of secondary bacterial infection after viral infection","volume":"09","author":"Chen Y.","year":"2012","unstructured":"Chen Y. Research progress of secondary bacterial infection after viral infection. Chinese Journal of Practical Internal Medicine 2012; 09: 726\u2013728.","journal-title":"Chinese Journal of Practical Internal Medicine"},{"key":"e_1_3_9_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-023-08536-x"},{"key":"e_1_3_9_11_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-147-8-200710160-00010"},{"key":"e_1_3_9_12_2","first-page":"733","article-title":"Multi-center investigation of the hospitalized children with 2009 influenza A(H1N1)infection","volume":"10","author":"Zhen YJ","year":"2010","unstructured":"Zhen YJ, Cao L, Ji W, et\u00a0al. Multi-center investigation of the hospitalized children with 2009 influenza A(H1N1)infection. Chinese Journal of Pediatrics 2010; 10: 733\u2013738.","journal-title":"Chinese Journal of Pediatrics"},{"key":"e_1_3_9_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/irv.12398"},{"key":"e_1_3_9_14_2","first-page":"179","article-title":"Distribution characteristics and drug resistance of pathogenic bacteria cultured from sputum of 140 children with infectious pneumonia","volume":"24","author":"Jinwen D","year":"2024","unstructured":"Jinwen D, Cheng Z. Distribution characteristics and drug resistance of pathogenic bacteria cultured from sputum of 140 children with infectious pneumonia. Chinese Drugs and Clinical practice 2024; 24: 179\u2013182.","journal-title":"Chinese Drugs and Clinical practice"},{"key":"e_1_3_9_15_2","first-page":"57","article-title":"Bacterial culture results of sputum from children with lower respiratory tract infections and drug sensitivity analysis of Haemophilus influenzae and Moraxella catarrhalis","volume":"23","author":"Qian L","year":"2025","unstructured":"Qian L, Fangyuan C, , andHuihui X. Bacterial culture results of sputum from children with lower respiratory tract infections and drug sensitivity analysis of Haemophilus influenzae and Moraxella catarrhalis. Chinese Medical Guidelines 2025; 23: 57\u201359.","journal-title":"Chinese Medical Guidelines"},{"key":"e_1_3_9_16_2","first-page":"135","article-title":"Clinical characteristics and severe risk factors analysis of 711 children with influenza virus pneumonia","volume":"49","author":"Rong Y","year":"2022","unstructured":"Rong Y, Tao Z, Dai G, et\u00a0al. Clinical characteristics and severe risk factors analysis of 711 children with influenza virus pneumonia. International Journal of Pediatrics 2022; 49: 135\u2013139.","journal-title":"International Journal of Pediatrics"},{"key":"e_1_3_9_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mib.2016.11.003"},{"key":"e_1_3_9_18_2","first-page":"696","article-title":"Progress in research on influenza viruses","volume":"38","author":"Chen D","year":"2023","unstructured":"Chen D, Zheng S, Zheng R, et\u00a0al. Progress in research on influenza viruses. Laboratory Medicine 2023; 38: 696\u2013703.","journal-title":"Laboratory Medicine"},{"key":"e_1_3_9_19_2","first-page":"265","article-title":"Characteristics of Haemophilus influenzae infection in children and influencing factors of disease progression","volume":"31","author":"Xiangyu L","year":"2025","unstructured":"Xiangyu L, Huijuan Z, , andYanting F. Characteristics of Haemophilus influenzae infection in children and influencing factors of disease progression. International Medical and Health Report 2025; 31: 265\u2013269.","journal-title":"International Medical and Health Report"},{"key":"e_1_3_9_20_2","first-page":"30","article-title":"(2015\u20132021) Drug resistance changes of Haemophilus influenzae and Moraxella catarrhalis clinically isolated from CHINET","volume":"25","author":"Hui F","year":"2025","unstructured":"Hui F, Chunhong S, Jia W, et\u00a0al. (2015\u20132021) Drug resistance changes of Haemophilus influenzae and Moraxella catarrhalis clinically isolated from CHINET. Chinese Journal of Infection and Chemotherapy 2025; 25: 30\u201338.","journal-title":"Chinese Journal of Infection and Chemotherapy"},{"key":"e_1_3_9_21_2","first-page":"2577","article-title":"Liu Yuhuan, etc A study on risk factors for hospitalization of children under 5 years old with influenza A","volume":"25","author":"Yang L","year":"2022","unstructured":"Yang L, Aibin W. Liu Yuhuan, etc A study on risk factors for hospitalization of children under 5 years old with influenza A. Chinese General Practice Medicine 2022; 25: 2577\u20132581.","journal-title":"Chinese General Practice Medicine"},{"key":"e_1_3_9_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/MOP.0000000000000495"},{"key":"e_1_3_9_23_2","doi-asserted-by":"publisher","DOI":"10.1111\/irv.12633"},{"key":"e_1_3_9_24_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-021-05913-2"},{"key":"e_1_3_9_25_2","first-page":"3451","article-title":"The pathogenesis of multiple organ dysfunction caused by sepsis","volume":"32","author":"Mengqiu Y","year":"2016","unstructured":"Mengqiu Y, Min Y. The pathogenesis of multiple organ dysfunction caused by sepsis. Journal of Practical Medicine 2016; 32: 3451\u20133454.","journal-title":"Journal of Practical Medicine"},{"key":"e_1_3_9_26_2","first-page":"145","article-title":"Research progress of platelets in sepsis","volume":"28","author":"Chen Q","year":"2021","unstructured":"Chen Q, Wang X. Research progress of platelets in sepsis. Chinese Pediatric Emergency medicine 2021; 28: 145\u2013147.","journal-title":"Chinese Pediatric Emergency medicine"}],"container-title":["Journal of International Medical Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/03000605251391949","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/03000605251391949","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/03000605251391949","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T10:46:35Z","timestamp":1777459595000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/03000605251391949"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11]]},"references-count":25,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1177\/03000605251391949"],"URL":"https:\/\/doi.org\/10.1177\/03000605251391949","relation":{},"ISSN":["0300-0605","1473-2300"],"issn-type":[{"value":"0300-0605","type":"print"},{"value":"1473-2300","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11]]},"article-number":"03000605251391949"}}