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Community-acquired Moraxella catarrhalis pneumonia in previously healthy children
Magdalena G Sy1, Joan L Robinson
1University of Alberta, Edmonton, Alberta, Canada.
Background:
The aim of this study was to determine if Moraxella catarrhalis is a common cause of community acquired pneumonia in children with no chronic medical problems. A secondary goal was to describe the clinical features of children with M. catarrhalis pneumonia.
Methods:
A systematic literature search was conducted for (i) case series of pediatric community-acquired pneumonia (CAP) where one or more diagnostic tests for M. catarrhalis were applied to all cases and (ii) case reports of previously healthy children with proven M. catarrhalis pneumonia.
Results:
There were nine case series describing a total of 1,500 children with CAP. The number of children tested and yield was as follows: blood cultures 0/402 (0%); sputum cultures 15/157 (10%); nasopharyngeal, or postnasal cultures 129/521 (25%); sputum or nasopharyngeal cultures 0/74 (0%) (one study allowed either); nucleic acid amplification testing 2/100 (2%); serology 30/976 (3%). There were eight case reports of CAP with M. catarrhalis in previously well children. Children were ages 3 weeks to 7 years of age (median 14 months). Six of 8 (75%) children required mechanical ventilation. All survived.
Conclusion:
It is common to detect M. catarrhalis in upper respiratory secretions in children with pneumonia, but bacteremia or seroconversion is rare. There are only eight well-documented case reports CAP due to M. catarrhalis in previously well children, with there being no distinctive features in the eight cases described to date. This organism is likely a rare cause of CAP in previously healthy children.
Insights
Moraxella catarrhalis is rarely a cause of community-acquired pneumonia (CAP) in healthy children, despite being common in upper respiratory secretions. Documented cases of M. catarrhalis CAP in previously well children are infrequent.
Area of Science:
- Pediatric Infectious Diseases
- Respiratory Medicine
- Microbiology
Background:
- Community-acquired pneumonia (CAP) is a significant pediatric illness.
- Investigating the role of Moraxella catarrhalis in pediatric CAP is crucial for understanding disease etiology.
- Focus on children without pre-existing chronic medical conditions.
Purpose of the Study:
- Determine the prevalence of Moraxella catarrhalis as a cause of CAP in healthy children.
- Describe the clinical characteristics of pediatric M. catarrhalis pneumonia.
Main Methods:
- Systematic literature search for pediatric CAP case series and case reports.
- Inclusion criteria: studies with diagnostic tests for M. catarrhalis or proven M. catarrhalis pneumonia in healthy children.
- Analysis of diagnostic yields from various testing methods.
Main Results:
- Nine case series included 1,500 children with CAP; M. catarrhalis detection varied by method (e.g., nasopharyngeal cultures 25%, nucleic acid amplification testing 2%).
- Eight case reports identified M. catarrhalis pneumonia in previously healthy children (ages 3 weeks to 7 years).
- Three-quarters of reported M. catarrhalis pneumonia cases required mechanical ventilation; all patients survived.
Conclusions:
- Moraxella catarrhalis is frequently found in upper respiratory secretions of children with pneumonia.
- Bacteremia and seroconversion due to M. catarrhalis are rare in pediatric CAP.
- M. catarrhalis is an uncommon cause of CAP in previously healthy children, with no distinct clinical features identified.
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