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Epidemiology and microbiological investigations of community-acquired pneumonia in children admitted at the emergency department of a university hospi

tetano

Editor, Senior Moderator
J Clin Virol. 2014 May 22. pii: S1386-6532(14)00183-8. doi: 10.1016/j.jcv.2014.05.006. [Epub ahead of print]
Epidemiology and microbiological investigations of community-acquired pneumonia in children admitted at the emergency department of a university hospital.
Cantais A1, Mory O1, Pillet S2, Verhoeven PO2, Bonneau J2, Patural H3, Pozzetto B4.
Author information
Abstract
BACKGROUND:

The management of children with community-acquired pneumonia (CAP) is largely influenced by the development of new molecular diagnostic tests that allow the simultaneous detection of a wide range of pathogens.
OBJECTIVES:

Evaluation of a diagnostic approach including multiplex PCR assays for revisiting the epidemiology and etiology of CAP in children at hospital.
STUDY DESIGN:

Children of all ages consulting at the Emergency Department of the University hospital of Saint-Etienne, France, during the 2012-2013 winter period were included. In addition to bacterial cultures, the following pathogens were detected using biplex commercially-available rt-PCR tests: adenovirus, respiratory syncytial virus, human metapneumovirus, bocavirus, rhinovirus/enterovirus, coronavirus, influenza viruses A and B, parainfluenza viruses, Mycoplasma pneumoniae and Chlamydophila pneumonia.
RESULTS:

From 85 patients with CAP, at least one pathogen was identified in 81 cases (95.3%), including 4 bacterial exclusive infections (4.7%), 53 viral exclusive infections (62.4%) and 24 mixed infections (28.2%). Coinfection by at least two viruses was observed in 37 cases (43.5%). Mean age was higher in the case of documented bacterial infection (P<0.05). In the subgroup of viral exclusive infection, the mean age of severe cases was 2.0 years vs 3.8 years in mild and moderate cases (P<0.05).
CONCLUSIONS:

These findings highlight the huge proportion of CAP of viral origin, the high number of co-infection by multiple viruses and the low number of bacterial CAP, notably in children under 5 years, and address the need to re-evaluate the indications of empiric antimicrobial treatment in this age group.

Copyright ? 2014. Published by Elsevier B.V.
KEYWORDS:

Children; Community-acquired-pneumonia; Epidemiology; PCR; Viral pneumonia

PMID:
24915939
[PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/24915939
 
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