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Published on: February 23, 2014
[Pneumococcal infection among community-acquired pneumonia. A retrospective study of 230 hospitalized children]
M-H Odièvre1, E Sanni, F de Broucker
1Service de pédiatrie, hôpital Louis-Mourier, Assistance publique-Hôpitaux de Paris, 178, rue des Renouillers, 92700 Colombes, France. marie-helene.odievre@lmr.aphp.fr
Insights
This study suggests specific clinical criteria can help identify pneumococcal pneumonia in children. Early immunization against pneumococcus is recommended to reduce infection rates.
Area of Science:
- Pediatric Infectious Diseases
- Bacteriology
Context:
- Community-acquired pneumonia (CAP) is a common childhood illness.
- Determining the specific causative agent, particularly Streptococcus pneumoniae, can be challenging.
- Accurate diagnosis is crucial for effective treatment and public health strategies.
Purpose:
- To identify clinical and biological arguments supporting pneumococcal origin in pediatric CAP.
- To evaluate the utility of specific criteria in diagnosing pneumococcal infections.
- To inform early therapeutic decisions and preventative measures.
Summary:
- A retrospective analysis of 230 children with CAP was conducted, categorizing them into confirmed (positive blood culture), probable (biological markers), and possible pneumococcal infection groups.
- Children with confirmed pneumococcal pneumonia (n=7) exhibited high fever (>39°C) and elevated white blood cell counts, neutrophil counts, or C-reactive protein levels.
- Chest X-rays were not definitive, and prior antibiotic use complicated definitive diagnosis in probable and possible groups.
Impact:
- Findings suggest specific criteria can aid in selecting appropriate initial antibiotic therapy for suspected pneumococcal pneumonia.
- Highlights the importance of early pneumococcal immunization to decrease the incidence of this infection.
- Contributes to improved diagnostic and management strategies for pediatric CAP.
Objectives:
To find arguments in favour of pneumococcal origin in community-acquired pneumonia.
Population And Methods:
A retrospective analysis of the files of 230 children hospitalized between January 1st 1999 and June 30th 2001 for community acquired pneumonia was performed. The files were classified into 3 subgroups: I (N=7), confirmed (positive blood culture); II (N=134), probable (biological arguments); III (N=89), possible pneumococcal infection. Age of the children was also taken into consideration.
Results:
All children in the subgroup I had fever>39 degrees C at admission and at least 1 of the 3 criteria (WBC> or=20.10(9)/l, neutrophils > or =10.10(9)/l, C-reactive protein level> or =60 mg/l). Dyspnea was more frequently asthmatiform in the subgroup III. Chest X-ray was not contributive. Before admission, 39% of the children were given one or several antibiotics, and so some of patients belonging to the subgroups II and III could have been infected by pneumococcus without possibility to confirm that.
Conclusion:
Results of this analysis suggest that some criteria may be useful for selecting initial antibiotherapy even though systematic early specific antipneumococcal immunization should reduce the frequency of this infection.
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