Community-Acquired Pneumonia in Children: the Challenges of Microbiological Diagnosis

Rodrigues, Charlene; Groves, H M

doi:10.1128/jcm.01318-17

Cited by 85 publications

(80 citation statements)

References 40 publications

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“…Sensitive and specific diagnostic tools to aid in the diagnosis of ARIs (particularly in differentiating bacterial and viral infections) in primary and urgent healthcare settings have been lacking [2,15]. Available methods, such as standalone C-reactive protein (CRP) measurement, procalcitonin measurement, and molecular (e.g.…”

Section: Introductionmentioning

confidence: 99%

“…Available methods, such as standalone C-reactive protein (CRP) measurement, procalcitonin measurement, and molecular (e.g. rapid antigen detection testing, PCR) and culturing methods are limited by issues including insufficient sensitivity and/or specificity (including an inability to distinguish between colonization and a true infection), excessive time for results to provide actionable data, poor reproducibility and/or a requirement for specialized (and potentially costly) equipment [2,15].…”

Section: Introductionmentioning

confidence: 99%

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FebriDx®: A Rapid Diagnostic Test for Differentiating Bacterial and Viral Aetiologies in Acute Respiratory Infections

Shirley

2019

Mol Diagn Ther

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FebriDx ® is a rapid, point-of-care diagnostic test that is designed to aid in the differentiation of bacterial and viral acute respiratory infections (ARIs), thus helping to guide decisions regarding the prescription of antibiotics in the outpatient setting. FebriDx carries a CE mark for use in the EU and is also approved in several other countries, including Canada, Saudi Arabia and Singapore. It is indicated for use in patients > 2 years old with symptoms consistent with a community-acquired ARI. The test involves the use of an immunoassay on a fingerstick blood sample to provide simultaneous, qualitative measurement of elevated levels of C-reactive protein (CRP) and myxovirus resistance protein A (MxA). In two prospective, multicentre studies in patients with acute upper respiratory tract infections, FebriDx was shown to be both sensitive and specific in identifying patients with a clinically significant infection and in differentiating between infections of bacterial and viral aetiology. The test is simple, requires no additional equipment and produces actionable results in ~ 10 min. As was demonstrated in a small, retrospective analysis, FebriDx results can help guide (improve) antibiotic prescribing decisions. Reducing the unnecessary or inappropriate prescription of antibiotics for ARIs of probable viral aetiology is important for antibiotic stewardship and can also reduce the unnecessary exposure of patients to the risk of antibiotic-related adverse events. FebriDx thus represents a useful diagnostic tool in the outpatient setting. FebriDx®: a summaryA simple, all-in-one, diagnostic test to assist in the diagnosis of bacterial or viral ARIs by measuring the host response to infection Based on a rapid immunoassay that provides simultaneous, qualitative measurement of elevated levels of CRP and MxA Sensitive and specific in identifying patients with a clinically significant infection and in differentiating between infections of bacterial and viral aetiology Produces actionable results in ~ 10 min which can be used to help guide antibiotic prescribing decisions turer of FebriDx was also offered an opportunity to review this article. Changes resulting from comments received were made on the basis of scientific and editorial merit.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

FebriDx®: A Rapid Diagnostic Test for Differentiating Bacterial and Viral Aetiologies in Acute Respiratory Infections

Shirley

2019

Mol Diagn Ther

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“…Polysaccharide-conjugated vaccines, based on isolated CPS antigens attached to carrier proteins, protect young children and the elderly from deadly bacterial pathogens including Haemophilus influenzae type b (Hib), Neisseria meningitides, and the encapsulated gram-positive bacterium Streptococcus pneumoniae. S. pneumoniae is the leading cause of life-endangering diseases such as pneumonia, septicemia, and meningitis (1), and a major cause of death in children under five in developing countries (2)(3)(4). More than 90 S. pneumoniae serotypes can be distinguished based on their CPS (5,6).…”

mentioning

confidence: 99%

Improving vaccines against Streptococcus pneumoniae using synthetic glycans

Kapłonek

Khan

Reppe

et al. 2018

Proc. Natl. Acad. Sci. U.S.A.

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Streptococcus pneumoniae remains a deadly disease in small children and the elderly even though conjugate and polysaccharide vaccines based on isolated capsular polysaccharides (CPS) are successful. The most common serotypes that cause infection are used in vaccines around the world, but differences in geographic and demographic serotype distribution compromises protection by leading vaccines. The medicinal chemistry approach to glycoconjugate vaccine development has helped to improve the stability and immunogenicity of synthetic vaccine candidates for several serotypes leading to the induction of higher levels of specific protective antibodies. Here, we show that marketed CPS-based glycoconjugate vaccines can be improved by adding synthetic glycoconjugates representing serotypes that are not covered by existing vaccines. Combination (coformulation) of synthetic glycoconjugates with the licensed vaccines Prevnar13 (13-valent) and Synflorix (10-valent) yields improved 15-and 13-valent conjugate vaccines, respectively, in rabbits. A pentavalent semisynthetic glycoconjugate vaccine containing five serotype antigens (sPCV5) elicits antibodies with strong in vitro opsonophagocytic activity. This study illustrates that synthetic oligosaccharides can be used in coformulation with both isolated polysaccharide glycoconjugates to expand protection from existing vaccines and each other to produce precisely defined multivalent conjugated vaccines. synthetic glycans | vaccine | Streptococcus pneumoniae C apsular polysaccharides (CPS) surround many deadly human pathogens. Polysaccharide-conjugated vaccines, based on isolated CPS antigens attached to carrier proteins, protect young children and the elderly from deadly bacterial pathogens including Haemophilus influenzae type b (Hib), Neisseria meningitides, and the encapsulated gram-positive bacterium Streptococcus pneumoniae. S. pneumoniae is the leading cause of life-endangering diseases such as pneumonia, septicemia, and meningitis (1), and a major cause of death in children under five in developing countries (2-4). More than 90 S. pneumoniae serotypes can be distinguished based on their CPS (5, 6). Currently available CPS-based pneumococcal vaccines contain the serotypes most frequently associated with invasive pneumococcal diseases (IPDs). Although the licensed 23-valent polysaccharide vaccine (Pneumovax 23) is not effective in younger children (3, 7), the conjugate vaccines Prevnar13 and Synflorix cover 13 and 10 serotypes, respectively, and are highly successful in all age groups (8). Nevertheless, serotype replacement due to vaccination and regional differences in dominant serotypes necessitate the expansion of existing vaccines to include additional serotypes. An additional weak point is that some serotype antigens, such as ST5 and ST1, that are present in existing vaccines undergo undesired chemical modification during production (9, 10); others have limited immunogenicity and lead to protective levels well below those required for herd immunity, such as SP3 (6).The p...

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“…The diagnostic challenge of childhood pneumonia lies in the broad range of presenting features. Children can present with pneumonia at different stages of illness and with clinical features that might be difficult to discriminate from other common paediatric conditions (33).…”

Section: Discussionmentioning

confidence: 99%

Medical management of pneumonia in children aged under 5 years in Alexandria, Egypt: mothers’ perspective

Fadl

Ashour

Muhammed

2020

East Mediterr Health J.

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Background: Pneumonia is among the top causes of morbidity and mortality among the under-fives worldwide.Objectives: A cross-sectional study was conducted to assess health-seeking behaviour and first medical management of pneumonia among children aged under 5 years in Alexandria, Egypt from the mothers' perspectives.Methods: Using a pre-designed questionnaire, we interviewed 507 mothers of pneumonic children aged under 5 years who had been admitted at 4 governmental children's hospitals. The study was conducted during August-November 2017.Results: We found that 57.2% of children received home treatment before seeking medical advice. Around 26% of mothers waited ≥ 2 days before seeking medical advice; insufficient knowledge about the disease was their main contention (89%). Factors significantly associated with the delay were: rural residence (P = 0.006); low income (P = 0.002); home treatment given before seeking medical advice (P < 0.001) and previous episodes of pneumonia (P = 0.002). Diagnosis of pneumonia had not been made by more than half of the first consulted sources (52.7%).Conclusion: There is an urgent need to improve mothers' knowledge and train physicians for appropriate management of pneumonia in children under 5 years.

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Community-Acquired Pneumonia in Children: the Challenges of Microbiological Diagnosis

Cited by 85 publications

References 40 publications

FebriDx®: A Rapid Diagnostic Test for Differentiating Bacterial and Viral Aetiologies in Acute Respiratory Infections

FebriDx®: A Rapid Diagnostic Test for Differentiating Bacterial and Viral Aetiologies in Acute Respiratory Infections

Improving vaccines against Streptococcus pneumoniae using synthetic glycans

Medical management of pneumonia in children aged under 5 years in Alexandria, Egypt: mothers’ perspective

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