Editorial: Immune Correlates Of Protection: Insight Into Microbial Co-Infection With Special Emphasis On Influenza-Streptococcus Pneumoniae Superinfection

Tarani Kanta Barman^1*Avijit Dutta^2,3Heather W Stout-Delgado⁴

• ¹University of Texas Medical Branch at Galveston, Galveston, United States
• ²Amity University Noida, Noida, India
• ³Amity Institute of Virology & Immunology, Amity University Uttar Pradesh, Noida, India, Noida, India
• ⁴Weill Cornell Medicine, New York, United States

Editorial on the Research Topic: Immune correlates of protection: Insight into microbial coinfection with special emphasis on influenza-Streptococcus pneumoniae superinfection *Correspondence: taranib@yahoo.com (Tarani Kanta Barman) Influenza virus infections are the leading cause of respiratory infections worldwide. It affects around one billion people, including 3-5 million severe cases, with 290,000 to 650,000 deaths annually (WHO, 2025). The major complications of influenza virus infections are secondary bacterial infections, such as Streptococcus pneumoniae, Staphylococcus aureus, group B Streptococcus, and Hemophilus influenzae, or fungal infections, such as Aspergillus spores, leading to exacerbation of lung pathology resulting in a considerable number of hospitalizations and deaths each year (Jamieson et al., 2013;McCullers et al., 2006;Hament et al., 1999;Barman et al., 2022). Among these infections, a unique synergy between influenza and Streptococcus pneumoniae co-infection results in hyperinflammation, leading to superinfection and death. It was reported that 95% of all deaths during the 1918 pandemic were due to influenza-Streptococcus In a rare case study, Yang et al. reported Streptococcus constellatus coinfection that manifested as gelatinous pleural effusion in an HIV patient. They described the effusion as gelatinous and partially encapsulated; it was fully resolved with antibiotics, eliminating the need for thoracic drainage, urokinase administration, or surgery. In another case study, Feng et al described a 72year-old woman co-infected with four pathogens during the influenza season. They reported that early detection and timely treatment can reduce hospitalization, complication rates, and mortality.Further studies are needed to understand clinical characteristics and outcomes of co-infection, especially during the influenza season. Furthermore, additional research is needed to investigate the potential impact of SARS-CoV-2 infection on the co-occurrence of multiple respiratory pathogens.In conclusion, the five papers on our research topic provide fresh scientific findings and valuable insights into bacterial-viral coinfection. The immunological correlates of protection during superinfection, the interaction of immune signaling molecules, the microbiome/colonization, and virome impacting coinfection susceptibility would remain a future area of research in bacterialviral coinfection.