Aetiology of community-acquired pneumonia in children treated in hospital

Korppi, Matti; Heiskanen‐Kosma, Tarja; Jalonen, Erja; Saikku, Pekka; Leinonen, Maija; Halonen, Pekka; Mäkelä, P. Helena

doi:10.1007/bf02072512

Cited by 125 publications

(101 citation statements)

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“…Interstitial infiltrate was more frequent in viral infections. Previous studies have not found a correlation between etiologic agent and radiological pattern 18 . Viral identification by IFA and/or cell culture is widely recognized in the literature as a method to test for respiratory viruses 4 .…”

Section: Discussionmentioning

confidence: 80%

“…In the present study, the positivity of hemocultures was 38.5% (30 cases). Mixed lower respiratory tract infections are not uncommon, varying from 16 to 30%, especially in children under two years old 18,23,35 . Hence, the data of the present work appears to correspond to the etiologic patterns described by these authors.…”

Section: Discussionmentioning

confidence: 99%

“…The concentration of C-reactive protein (CRP) (immunonephelometry) was also determined from blood samples. CRP values > 40 mg/L were considered suggestive of bacterial or mixed viralbacterial infection 18,27 . Chest radiographs were done when necessary.…”

Section: Methodsmentioning

confidence: 99%

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Incidence of respiratory viruses in preterm infants submitted to mechanical ventilation

Diniz

Vieira

Ceccon

et al. 2005

Rev. Inst. Med. trop. S. Paulo

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The objectives of this study were to determine the incidence of infection by respiratory viruses in preterm infants submitted to mechanical ventilation, and to evaluate the clinical, laboratory and radiological patterns of viral infections among hospitalized infants in the neonatal intensive care unit (NICU) with any kind of acute respiratory failure. Seventy-eight preterm infants were studied from November 2000 to September 2002. The newborns were classified into two groups: with viral infection (Group I) and without viral infection (Group II). Respiratory viruses were diagnosed in 23 preterm infants (29.5%); the most frequent was respiratory syncytial virus (RSV) (14.1%), followed by influenza A virus (10.2%). Rhinorrhea, wheezing, vomiting and diarrhea, pneumonia, atelectasis, and interstitial infiltrate were significantly more frequent in newborns with nosocomial viral infection. There was a correlation between nosocomial viral infection and low values of C-reactive protein. Two patients with mixed infection from Group I died during the hospital stay. In conclusion, RSV was the most frequent virus in these patients. It was observed that, although the majority of viral lower respiratory tract infections had a favorable course, some patients presented a serious and prolonged clinical manifestation, especially when there was concomitant bacterial or fungal infection.

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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

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Incidence of respiratory viruses in preterm infants submitted to mechanical ventilation

Diniz

Vieira

Ceccon

et al. 2005

Rev. Inst. Med. trop. S. Paulo

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“…Bacterial pneumonia cannot be differentiated from viral pneumonia on the basis of clinical or chest radiographic ®ndings [1±3]. In young children, the most important problem is how to differentiate between pneumonia caused by respiratory viruses and Streptococcus pneumoniae [1,4]. In addition, mixed infections caused by viruses and bacteria, especially respiratory syncytial virus (RSV) and pneumococci (PNC), are common [5].…”

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confidence: 99%

Serum procalcitonin in pneumococcal pneumonia in children

Korppi

Remes

2001

Eur Respir J

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Serum procalcitonin in pneumococcal pneumonia in children. M. Korppi, S. Remes. #ERS Journals Ltd 2001. ABSTRACT: Serum procalcitonin (PCT), a marker of bacterial infection, was measured in children with pneumonia to examine whether PCT can be used to screen pneumococcal (PNC) from viral pneumonia.The number of patients was 132; mean age 3.0 yrs, and 64% were males. In all cases, pneumonia was radiologically con®rmed, being alveolar in 46 and interstitial in 86 cases. The aetiology of infection was studied by a panel of serological tests for PNC, for ®ve other respiratory bacteria and for seven common respiratory viruses. PNC infection was found in 25, mixed viral-PNC infections in 13 and viral infection in 17 cases.In general, serum PCT was not associated with the type or aetiology of pneumonia. PCT values were >1.0 mg . L -1 in 40% of PNC cases, as compared to 12±15% in viral or mixed cases, respectively (p<0.05). PCT values were signi®cantly higher in >2 yrs old children than in younger ones. The cut-off limits of 0.5 ng . mL -1 , 1.0 ng . mL -1 and 2.0 ng . mL -1 were tested for screening between PNC and viral pneumonia. The highest sensitivity of 55% was found at the 0.5 ng . mL -1 cut-off level, whereas the highest speci®city of 88% was reached at the level of 1.0 ng . mL -1 . The likelihood ratios, however, were far from optimal for both the positive and negative results.Although marginally higher in pneumococcal pneumonia than in viral pneumonia, serum procalcitonin cannot be used to discriminate between these two types of pneumonia. Community-acquired pneumonia is a common clinical problem in childhood. Bacterial pneumonia cannot be differentiated from viral pneumonia on the basis of clinical or chest radiographic ®ndings [1±3]. In young children, the most important problem is how to differentiate between pneumonia caused by respiratory viruses and Streptococcus pneumoniae [1,4]. In addition, mixed infections caused by viruses and bacteria, especially respiratory syncytial virus (RSV) and pneumococci (PNC), are common [5]. Leukocyte count, serum C-reactive protein (CRP) concentration or another nonspeci®c laboratory ®nding sometimes helps to differentiate between either bacterial or viral aetiology. In recent years, several studies have focused on the use of CRP in bacterial and viral respiratory infections in children, but the results have been inconsistent [6±8]. Therefore, most children with pneumonia are treated with antibiotics without knowledge of the causative agent.Procalcitonin (PCT) is a newly recognized marker of bacterial infection [9], it contributes to the differentiation between septic and other infections in neonates [10] and older paediatric patients [11]. In a panel of children in which the aetiology of infection was assessed [12], it was examined whether PCT can be applied for the discrimination between bacterial and especially pneumococcal pneumonia and viral aetiology of pneumonia. Material and methods Study subjectsIn the course of a prospective study in 1981±1982, 195 children wer...

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“…Based on signs of clinical deterioration during admission Hall et al [2] found only 1.2 %, while studies using antibody increase in serum or antigen detection in serum or urine find an incidence of up to 44 % [3,4]. Two randomized controlled studies have evaluated the efficacy of antibiotics in patients with RSV-LRTI and found that antibiotics are not beneficial [5,6].…”

mentioning

confidence: 99%