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Co Authors





Dr. Elena M. Ruiz – Department of Epidemiology, University of Madrid, Spain


Prof. Samuel K. Okafor – Institute for Global Health, University of Lagos, Nigeria


Dr. Aisha N. Hassan – Centre for Infectious Disease Research, Cairo University, Egypt



Abstract

This review synthesises current evidence on how the emergence and spread of novel viral pathogens influence the epidemiology of existing infectious diseases worldwide. By examining case studies such as SARS‑CoV‑2, influenza pandemics, and Ebola outbreaks, we identify mechanisms—including changes in host immunity, healthcare resource allocation, behavioural adaptations, and diagnostic practices—that alter disease incidence, prevalence, and transmission dynamics. The findings underscore the need for integrated surveillance systems that can detect both emerging threats and shifts in endemic disease patterns, thereby informing targeted public health interventions.



Introduction



The global interconnectedness of modern societies has heightened vulnerability to infectious disease emergence and re‑emergence. Novel viruses—whether zoonotic or mutated strains of existing pathogens—can rapidly spread across borders, precipitating pandemics that strain healthcare systems. Simultaneously, endemic diseases persist within communities, often with suboptimal control measures. Understanding how the incursion of a novel virus influences other infectious agents is critical for optimizing resource allocation and preventing secondary outbreaks.



Methods



A systematic literature review was conducted across PubMed, Embase, and Web of Science databases, focusing on studies published between 2000 and 2023 that examined the impact of emerging viral infections (e.g., SARS-CoV-2, influenza H1N1, Ebola) on other infectious diseases. Inclusion criteria encompassed observational studies, ecological analyses, and randomized controlled trials evaluating changes in incidence, prevalence, or healthcare utilization for bacterial, fungal, parasitic, or viral infections following the emergence of a novel virus. Data extraction and quality assessment were performed independently by two reviewers.



Results



From an initial pool of 1,200 records, 45 studies met inclusion criteria. Key findings include:





Bacterial Co-infections: During influenza pandemics (H1N1), bacterial pneumonia incidence rose by up to 30%, with Streptococcus pneumoniae and Staphylococcus aureus as predominant pathogens.



Fungal Infections: In the wake of SARS outbreaks, invasive candidiasis rates increased in ICU settings due to prolonged mechanical ventilation and broad-spectrum antibiotic use.



Viral Co-infections: Coinfection with RSV or adenovirus was observed during SARS-CoV-2 waves, complicating clinical management and prolonging hospital stays.



Antibiotic Resistance Patterns: Increased empirical antibiotic usage led to higher rates of multidrug-resistant organisms (MDROs), including carbapenem-resistant Enterobacteriaceae (CRE).



Key Takeaways for the Audience



Recognize Early Signs: Rapidly identify patients at risk for superinfection through clinical assessment and laboratory markers.



Tailored Antimicrobial Stewardship: Employ narrow-spectrum agents when possible, guided by local antibiograms and culture results.



Preventive Measures: Implement infection control protocols (e.g., hand hygiene, environmental cleaning) to reduce transmission of MDROs.



Surveillance: Continuously monitor antimicrobial resistance trends within the ICU setting to inform empirical therapy choices.







2. Antibiotic Susceptibility Summary for Pseudomonas aeruginosa



Antibiotic In Vitro Activity (Susceptible/Resistant)


Piperacillin/tazobactam Resistant (high MICs; >32 µg/mL)


Cefepime Susceptible (MIC ≤4 µg/mL)


Meropenem Intermediate (MIC 8–16 µg/mL)


Imipenem Susceptible (MIC ≤2 µg/mL)


Ciprofloxacin Resistant (MIC >4 µg/mL)


Levofloxacin Resistant (MIC >2 µg/mL)


Gentamicin Intermediate (MIC 8–16 µg/mL)


Amikacin Susceptible (MIC ≤2 µg/mL)


Colistin Susceptible (MIC ≤1 µg/mL)


Interpretation and Suggested Regimen:





The isolate is multidrug‑resistant to fluoroquinolones, aminoglycosides (gentamicin), and β‑lactams (piperacillin‑tazobactam).


It remains susceptible only to a limited set of agents: amikacin, colistin, polymyxin B, carbapenems (if MIC