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Published on: February 23, 2014
[Spectrum of pathogens for community-acquired pneumonia in children]
Xiang-Teng Liu1, Gui-Lan Wang, Xu-Feng Luo
1Department of Pediatrics, Bo'ai Hospital of Zhongshan, Zhongshan, Guangdong, China.
Insights
Community-acquired pneumonia (CAP) in children is frequently caused by Haemophilus influenzae, respiratory syncytial virus, Mycoplasma pneumoniae (MP), and Chlamydia pneumoniae (CP). Infants under one year old show higher infection rates, with frequent mixed pathogen infections.
Area of Science:
- Pediatric Infectious Diseases
- Microbiology
- Respiratory Medicine
Context:
- Community-acquired pneumonia (CAP) poses a significant health challenge in pediatric populations worldwide.
- Accurate identification of causative pathogens is crucial for effective CAP management in children.
Purpose:
- To determine the spectrum of bacterial and viral pathogens responsible for CAP in children.
- To establish a foundation for improved diagnosis and treatment strategies for pediatric CAP.
- To analyze pathogen prevalence based on age and identify common co-infections.
Summary:
- A study of 1560 children with CAP identified Haemophilus influenzae, Streptococcus pneumoniae, Staphylococcus aureus, Moraxella catarrhalis, and Escherichia coli as common bacterial pathogens.
- Respiratory syncytial virus, Mycoplasma pneumoniae (MP), and Chlamydia pneumoniae (CP) were the predominant non-bacterial pathogens.
- Mixed infections were prevalent, particularly respiratory syncytial virus with Haemophilus influenzae. Infection rates were higher in children under one year old.
Impact:
- This research highlights key pathogens in pediatric CAP, guiding empirical treatment and diagnostic focus.
- Understanding age-specific prevalence and co-infection patterns can optimize clinical management and reduce morbidity.
- The findings support targeted interventions and public health strategies for preventing and treating childhood pneumonia.
Objective:
To investigate the spectrum of pathogens for community-acquired pneumonia (CAP) in children, and to provide a basis for the diagnosis and treatment of CAP.
Methods:
Respiratory secretions and venous blood samples were collected from 1560 children with CAP aged from one month to 9 years within 2 hours after admission, for detection of multiple pathogens. Respiratory virus antigens in nasopharyngeal swab specimens were detected by immunofluorescence. Sputum was used for bacterial culture. Levels of Mycoplasma pneumoniae (MP)-IgM and Chlamydia pneumoniae (CP)-IgM in venous blood were measured by enzyme-linked immunosorbent assay.
Results:
A total of 579 strains of bacteria were isolated from all respiratory secretions, including 213 (36.8%) Gram-positive strains and 366 (63.2%) Gram-negative strains. The five most common strains were Haemophilus influenzae (7.50%), Streptococcus pneumoniae (6.73%), Staphylococcus aureus (6.35%), Moraxella catarrhalis (5.19%), and Escherichia coli (3.46%), wherein the beta-lactamase-producing strains accounted for 3.3% of all strains. The non-bacterial pathogens mainly included respiratory syncytial virus (12.88%), MP (7.88%), and CP (8.91%). Mixed infection of pathogens was serious, and the mixed infection of respiratory syncytial virus with Haemophilus influenzae infections were the most common. For most pathogens, the infection rate was higher in children aged under one year than in those aged over one year.
Conclusions:
Haemophilus influenzae, respiratory syncytial virus, MP and CP are the main pathogens for children with CAP. For most pathogens, the infection rate is higher in children aged under one year than in those aged over one year. Mixed infection rate of pathogens is high.
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