Pulmonary antibacterial defenses during mild and severe influenza virus infection.

Severe influenza virus infections with pneumonic involvement are known to predispose the lungs to bacterial superinfections due to dysfunctions in the alveolar macrophage (AM) phagocytic system. To determine whether milder forms of influenza without pneumonic involvement have a similar outcome, pulmonary antibacterial defenses and AM phagocytosis were compared in murine models of mild and severe influenza virus A/HK/68 infections. Bactericidal activity was quantitated by the intrapulmonary killing of Staphylococcus aureus following aerosol challenge, whereas the functional capacity of the AMs was determined by Fc-receptor-mediated phagocytosis. With the severe virus infection, maximal suppression of bactericidal activity occurred on day 8 of infection and correlated with impairment of AM phagocytosis. A lesser but significant degree of suppression of pulmonary antibacterial defenses and AM phagocytosis was observed on the third day of the mild virus infection. The data demonstrate that mild influenza virus infections that are limited to the upper respiratory tract also impair pulmonary antibacterial defenses and may predispose the lungs to bacterial superinfections.