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It not only results in severe economic losses but also raises concerns over animal welfare and antimicrobial resistance and remains an important zoonotic agent in some countries. The definition and diagnosis of\n                    <jats:italic>S. suis<\/jats:italic>\n                    -associated diseases can be complex. Should\n                    <jats:italic>S. suis<\/jats:italic>\n                    be considered a primary or secondary pathogen? The situation is further complicated when referring to respiratory disease, since the pathogen has historically been considered as a secondary pathogen within the porcine respiratory disease complex (PRDC). Is\n                    <jats:italic>S. suis<\/jats:italic>\n                    a respiratory or strictly systemic pathogen?\n                    <jats:italic>S. suis<\/jats:italic>\n                    is a normal inhabitant of the upper respiratory tract, and the presence of potentially virulent strains alone does not guarantee the appearance of clinical signs. Within this unclear context, it has been largely proposed that co-infection with some viral and bacterial pathogens can significantly influence the severity of\n                    <jats:italic>S.\u00a0suis<\/jats:italic>\n                    -associated diseases and may be the key to understanding how the infection behaves in the field. In this review, we critically addressed studies reporting an epidemiological link (mixed infections or presence of more than one pathogen at the same time), as well as in vitro and in vivo studies of co-infection of\n                    <jats:italic>S. suis<\/jats:italic>\n                    with other pathogens and discussed their limitations and possibilities for improvement and proposed recommendations for future studies.\n                  <\/jats:p>","DOI":"10.1186\/s13567-021-00918-w","type":"journal-article","created":{"date-parts":[[2021,3,20]],"date-time":"2021-03-20T09:02:44Z","timestamp":1616230964000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":87,"title":["Review of the speculative role of co-infections in Streptococcus suis-associated diseases in pigs"],"prefix":"10.1186","volume":"52","author":[{"given":"Milan R.","family":"Obradovic","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariela","family":"Segura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joaquim","family":"Segal\u00e9s","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2196-2212","authenticated-orcid":false,"given":"Marcelo","family":"Gottschalk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,3,20]]},"reference":[{"key":"918_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/emi.2014.45","volume":"3","author":"G Goyette-Desjardins","year":"2014","unstructured":"Goyette-Desjardins G, Auger J-P, Xu J, Segura M, Gottschalk M (2014) Streptococcus suis, an important pig pathogen and emerging zoonotic agent\u2014an update on the worldwide distribution based on serotyping and sequence typing. 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