Are there more "mixed infections" this year? How to prevent severe illness? Tianjin doctors explain!

Recent

Our city is in

Respiratory disease epidemic period

Influenza, Mycoplasma pneumoniae

Respiratory syncytial virus, adenovirus

All in epidemic stage

Simultaneous or sequential infection

Multiple respiratory pathogens

"Mixed infection"

Yang Wenjie, director of the infectious department of the First Central Hospital of the city, said that since December , the number of influenza-like cases among patients with respiratory diseases has increased, the number of new crown infection cases has slowed down, and the number of Mycoplasma pneumoniae infection cases in children has begun to decline . "Mixed infections" occur from time to time among patients, mostly with a combination of viruses, mycoplasmas and bacteria . Some of these people were found to be infected with both influenza virus and Mycoplasma pneumoniae in a single illness test, and some had just recovered from Mycoplasma pneumoniae infection and were infected with influenza virus.

Yang Wenjie reminded the public that "mixed infection" has a greater impact on high-risk groups of severe illness, such as the elderly, pregnant women, children under 5 years old, and people with underlying diseases. Timely identification of pathogens after illness is very important for treatment, but ordinary people do not have the ability to identify pathogens. Therefore, high-risk groups should seek medical treatment in time after infection and fever , and conduct necessary pathogen detection and related examinations. Usually, influenza antigens, Mycoplasma pneumoniae antibodies, new crown antigens or nucleic acids are tested. Doctors will try their best to identify the pathogens and then conduct targeted treatment. Most "mixed infections" are only mild cases, and patients tend to heal themselves. Symptomatic treatment can relieve symptoms. It is not necessary to identify the pathogens and conduct antiviral treatment.

Three factors lead to an increase in "mixed infection" and most ordinary adults have mild symptoms <br /> Yang Wenjie said that recently, pathogens such as influenza virus, Mycoplasma pneumoniae, and new coronavirus are more common, as well as other bacteria and viruses. "Mixed infection" is manifested in the possibility of simultaneous infection with multiple pathogens, or infection with several pathogens in succession. Relatively speaking, successive infections are more common, which is also an important reason for some people to have repeated fevers recently. There may be many reasons for the rise and fall of various pathogens and the emergence of "mixed infection" in the autumn and winter of this year.

First, the human immune system will produce antibodies and immunity to infected pathogens, but this immunity has a protection period. The longer the time, the weaker the protection will be . This is true for the new coronavirus, as well as the antibodies produced by influenza viruses and mycoplasmas. During the COVID-19 epidemic prevention and control period, the public has formed a good habit of wearing masks. Although it has played a protective role, it also reduces the chances of the body coming into contact with various pathogens, resulting in the body's lack of immune stimulation from pathogens. After contacting these pathogens again, the body is easily unable to recognize them, thus provoking a stronger reaction.

Second, there is no "cross-immunity" between multiple pathogens. Coupled with environmental factors such as colder weather, there are relatively more "mixed infections" this year.

Third, citizens have mastered certain knowledge about pathogen infections, and pathogen testing is more convenient than before, which has led to a corresponding increase in the detection rate of "mixed infection".

Yang Wenjie said that whether it is influenza, new coronavirus, mycoplasma pneumoniae infection or "mixed infection", the clinical symptoms of adults after infection are generally mild, but the elderly, pregnant women, children under 5 years old, and people with underlying diseases have relatively poor resistance and are at high risk of developing severe illness. **These "vulnerable groups" are prone to destroying the upper respiratory tract immune barrier after infection, and some secondary bacterial infections, which lead to worsening of the condition. When "mixed infection" occurs, the condition will be relatively severe. **Because "mixed infection" will cause multiple pathogens to damage the body, it usually causes immune cell damage. The high-risk group has a relatively serious condition, and the probability of high fever, severe cough, dyspnea, hypoxemia, etc. is higher. If they are not treated for a long time, they may suffer from liver damage, kidney damage, and myocardial damage, and even septic shock. Lung CT can show large areas of consolidation and other serious conditions. Therefore, it is very important for high-risk groups to seek medical treatment in time.

“Mixed infection” can be cured by medicine

No need to use multiple drugs to increase risk

"Once a 'mixed infection' is confirmed, there is no need to panic. There are effective drug treatments for many of the pathogens that are currently rampant," said Yang Wenjie.

Influenza virus treatment mainly involves oral administration of anti-influenza drugs such as oseltamivir . So far, the influenza strains that are prevalent have good specificity. Taking them in the early stage of the disease can inhibit viral replication and quickly relieve symptoms. When children take oseltamivir, they should pay attention to choosing a reasonable dose according to their weight and pay attention to monitoring possible adverse reactions such as nausea and vomiting.

The drugs for the new coronavirus include Mononavir, Azvudine, Naimategravir Tablets/Ritonavir Tablets, etc. Different drugs have their own advantages and disadvantages.

The treatment drugs for mycoplasma infection are mainly macrolide antibiotics, such as erythromycin, azithromycin, etc. , and quinolone drugs such as moxifloxacin, levofloxacin, etc. and new tetracycline drugs such as minocycline are used to treat respiratory diseases. They can be administered orally or by infusion.

It should be emphasized that these drugs must be used under the guidance of professional infectious disease doctors to avoid blindly taking them on your own and increasing adverse drug reactions. For example, quinolone drugs are limited to those over 18 years old, otherwise they may affect bone growth; tetracycline drugs are limited to those over 8 years old, otherwise they may cause tetracycline teeth, etc.; macrolide drugs may affect cardiac electrophysiological activity, and patients with related heart diseases should avoid using them.

In addition, even though the patient may have a "mixed infection", it does not mean that all drugs targeting various pathogens need to be used. This approach not only wastes medical resources, but may also cause greater harm to the patient. When using drugs in combination, it is also necessary to consider whether there is a synergistic effect between the drugs and the superposition of side effects. They must be used under the guidance of a professional infectious disease doctor.

Early identification of high-risk groups and correct medication

Flu and pneumonia vaccination can prevent

For people at high risk of severe illness, accurate differential diagnosis and timely targeted medication in the early stage are crucial to prevent the disease from turning into severe illness. If high-risk people have symptoms such as high fever, severe cough, and coughing up yellow sputum , they should go to the hospital in time for diagnosis, pathogen detection, and correct medication . At present, most fever clinics in tertiary hospitals have the ability to detect multiple pathogens, but the detection time of some pathogens may be longer. For example, antibodies to Mycoplasma pneumoniae appear in 7 to 10 days of the disease. Therefore, "mixed infection" may not be able to accurately determine which pathogens are infected before treatment, and treatment needs to be carried out under the guidance of experienced infectious disease doctors.

In addition, personal protection during the high-incidence season of respiratory diseases is the key to preventing "mixed infection". For example, develop good hygiene habits, wash hands frequently, wear masks, gather less, and ventilate more. Wearing masks in confined spaces is an important measure to reduce the risk of infection for high-risk groups; for high-risk key groups, if there are no contraindications, it is recommended to get influenza vaccine, pneumonia vaccine, and new crown vaccine. Although vaccination cannot eliminate the possibility of disease infection, it can reduce the severity and risk of severe illness after viral infection ; pay attention to protecting and improving immunity, maintain adequate rest, exercise appropriately, ensure adequate and balanced nutrition, drink plenty of water, quit smoking, and limit alcohol.