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BACTERIAL Primary infection Secondary infection Prevalence Bacterial Pseudomonas spp Gram-negative Sepsis Stenotrophomonas spp Escherichia coli(1) Acinetobacter spp Klebsiella species(1) Enterococcus spp Pseudomonas aeruginosa(1) Fungal Various(4-6) Candida spp (C.Albicans) Very common(7, 8) Gram-positive Sepsis Aspergillus spp (A.fumigates) Common(7, 9-11) Staphylococcus aureus(2, 3) Viral reactivation Streptococcus pneumonia(2, 3) Herpes viridae (CMV, HSV, HHV-6) Common(4, 12-15) EBV Very common(12) Polyomaviruses (BK and JC) Common(12) Anelloviruses Very common(12) Predominant type of primary infection: Pulmonary(1) VIRAL Primary infection Secondary infection Bacterial Prevalence Influenza Streptococcus pneumonia Very common(6, 16-21) Staphylococcus aureus Very common(6, 16, 18, 20) Haemophilus influenza Very common(6, 16, 18-20) Streptococcus pyogenes Common(6, 16, 20) Mycoplasma pneumoniae Common(16) Fungal Aspergillus spp (A.fumigates) Common(10) Viral co-infection HRV Rare(19, 22-24) RSV Common(19, 25, 26) Coronavirus Rare(19, 24) Viral reactivation HSV Very common(27) Bacterial RSV Streptococcus pneumonia Common(20, 28, 29) Staphylococcus aureus Common(28-30) Haemophilus influenzae Common(28, 29, 31) Streptococcus pyogenes Common(28) Moraxella catarrhalis Common(28) Fungal Aspergillus fumigates Unknown(32, 33) Viral co-infection Influenza Common(19, 25, 26) Parainfluenza Rare(34) Adenovirus Rare(35) HRV Common(22, 26, 36) Viral reactivation CMV Rare(35) Bacterial HRV Streptococcus pneumonia Common(21, 37-39) Haemophilus influenzae Common(38) Moraxella catarrhalis Common(22, 31, 38, 40) Mycoplasma pneumonia Rare(22, 41) Chlamydophila pneumoniae Rare(22) Fungal Aspergillus fumigates Common(42) Viral co-infection Influenza Rare(19, 22-24) Parainfluenza Rare(36) RSV Common(22, 26, 36) Coronavirus Rare(22) Viral reactivation CMV Rare(42) Predominant type of secondary infection: Pneumonia in adults(29, 37) / OM in children(16, 43, 44) Table 1: Secondary infections occurring following sepsis, influenza, RSV and HRV infections. 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