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Published on: February 23, 2014
Etiology of community-acquired pneumonia in 254 hospitalized children
1Department of Pediatrics, Turku University Hospital, Finland.
Insights
In hospitalized children, most community-acquired pneumonia cases have identifiable viral or bacterial causes. Streptococcus pneumoniae and respiratory syncytial virus were common, suggesting prevention through immunization.
Area of Science:
- Pediatric Infectious Diseases
- Microbiology
- Respiratory Medicine
Background:
- Childhood community-acquired pneumonia (CAP) is prevalent but lacks comprehensive etiological studies in developed nations.
- Investigated the viral and bacterial causes of CAP in hospitalized children using multiple laboratory methods.
Purpose of the Study:
- To determine the etiology of community-acquired pneumonia in hospitalized children.
- Identify common viral and bacterial pathogens responsible for CAP in pediatric patients.
Main Methods:
- Prospective 3-year study involving 254 children with radiographically confirmed pneumonia.
- Collected nasopharyngeal aspirates for viral studies and serum samples for viral and bacterial serology.
- Investigated the role of 17 potential microbial agents.
Main Results:
- Identified a potential causative agent in 85% of patients.
- Viral infections occurred in 62%, bacterial in 53%, and 30% had co-infections.
- Most common agents: Streptococcus pneumoniae (37%), respiratory syncytial virus (29%), and rhinovirus (24%).
Conclusions:
- Most childhood CAP cases have detectable etiological agents.
- Further research needed to optimize etiological investigations for clinical management.
- Immunization against S. pneumoniae and RSV could prevent over half of CAP cases.
Background:
Childhood community-acquired pneumonia is a common illness, but there have been relatively few comprehensive studies of the viral and bacterial etiology in developed countries. The aim of the present investigation was to determine the etiology of community-acquired pneumonia in hospitalized children by several laboratory methods.
Methods:
In a 3-year prospective study a nasopharyngeal aspirate for viral studies and acute and convalescent serum samples for viral and bacterial serology were taken from 254 children with symptoms of acute infection and infiltrates compatible with pneumonia in the chest radiograph. The role of 17 microbes was investigated.
Results:
A potential causative agent was detected in 215 (85%) of the 254 patients. Sixty-two percent of the patients had viral infection, 53% had bacterial infection and 30% had evidence of concomitant viral-bacterial infection. Streptococcus pneumoniae (37%), respiratory syncytial virus (29%) and rhinovirus (24%) were the most common agents associated with community-acquired pneumonia. Only one patient had a positive blood culture (S. pneumoniae) of 125 cultured. A dual viral infection was detected in 35 patients, and a dual bacterial infection was detected in 19 patients.
Conclusions:
The possible causative agent of childhood community-acquired pneumonia can be detected in most cases. Further studies are warranted to determine what etiologic investigations would aid in the management of pneumonia. With effective immunization for S. pneumoniae and respiratory syncytial virus infections, more than one-half of the pneumonia cases in this study could have been prevented.
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The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed.