Development and validation of a clinical prediction rule to distinguish bacterial from viral pneumonia in children

Moreno, Laura; Krishnan, Jerry A.; Durán, Pablo; Ferrero, Fernando

doi:10.1002/ppul.20364

Cited by 69 publications

(81 citation statements)

References 28 publications

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“…5,6,7,8 Bacterial pneumonia was defined as: a) suggestive chest X-rays and one or more clinical, microbiological or laboratory findings; b) non-suggestive radiological pattern but both clinical, laboratory and microbiological findings suggestive of bacterial pneumonia. Viral non-varicella pneumonia was defined as: a) suggestive radiological finding and one or more clinical, microbiological or laboratory findings; b) non-suggestive radiological viral but both clinical, laboratory and microbiological findings suggestive of viral pneumonia.…”

Section: Methodsmentioning

confidence: 99%

How frequent is varicella-associated pneumonia in children?

Hervás

Henales

Yeste

et al. 2010

Eur J Clin Microbiol Infect Dis

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Section: Methodsmentioning

confidence: 99%

How frequent is varicella-associated pneumonia in children?

Hervás

Henales

Yeste

et al. 2010

Eur J Clin Microbiol Infect Dis

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“…Acute viral respiratory infection in children under 5 niños menores de un año. 3 Estudios recientes demuestran en nuestro país una demanda creciente a las salas de emergencia o urgencias.…”

Section: Infección Respiratoria Aguda Viral En Niños Menores De 5 Añounclassified

“…4 En las mismas, la indicación de tratamiento antibiótico empírico a los niños menores de 5 años que consultan por signos de IRA es una práctica habitual. Si bien se han desarrollado reglas de predicción clínica de gran valor para diferenciar la etiología viral de bacteriana en niños con síntomas compatibles con neumonía, 5 muchas veces no es suficiente para determinar una conducta adecuada, especialmente en niños ambulatorios. El diagnóstico virológico es necesario para determinar la etiología de las IRA ya que los cuadros clínicos producidos por los distintos virus suelen ser similares.…”

Section: Infección Respiratoria Aguda Viral En Niños Menores De 5 Añounclassified

Infección respiratoria aguda viral en niños menores de 5 años. Estudio epidemiológico en dos centros de Buenos Aires, Argentina

Vidaurreta

Marcone

Ellis³

et al. 2011

Arch Argent Pediat

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Arch Argent Pediatr 2011;109(4):296-304 / 296 RESUMEN Introducción. Las infecciones respiratorias agudas (IRA) son la mayor causa de hospitalización en edades extremas de la vida. Objetivos. Identificar los agentes etiológicos de IRA viral en niños < 5 años hospitalizados y ambulatorios; describir estacionalidad y caracterís-ticas clínico-epidemiológicas de la enfermedad. Población y métodos. Estudio descriptivo, transversal y multicéntrico en dos centros privados de Buenos Aires, en niños con IRA alta y baja. Se registraron antecedentes, cuadros clínicos y estudios virológicos. Resultados. Se estudiaron 347 pacientes: 235 hospitalizados; 112 ambulatorios. Los hospitalizados fueron menores que los ambulatorios (8 vs. 19 meses, p <0,001), presentaron más frecuentemente bronquiolitis (74% hospitalizados vs. 24% ambulatorios) y neumonía (14% hospitalizados vs. 5% ambulatorios). Solo la edad se asoció significativamente a hospitalización (p= 0,01). Se identificó etiología viral en 81% de los hospitalizados y 57% de los ambulatorios. El virus más frecuente fue rinovirus seguido por virus respiratorio sincicial. Se observó circulación viral durante todo el año, especialmente en otoño e invierno. En pacientes hospitalizados, la mediana de hospitalización fue 3,5 días. Requirieron cuidados intensivos 25 (11%) pacientes, y 7 (3%) recibieron asistencia ventilatoria mecánica. No hubo letalidad. Conclusiones. Las técnicas de diagnóstico virológico permitieron identificar agentes etiológicos en la mayoría de los pacientes hospitalizados y en más de la mitad de los ambulatorios con IRA. La incorporación de RT-PCR para rinovirus, permitió la identificación de este agente etioló-gico. La circulación viral se observó a lo largo de todo el año. La bronquiolitis fue causa de internación en 174/201 (86,5%) niños con IRA y la neumonía en 33/39 (84,6%) niños. Palabras clave: virus respiratorios, infección respiratoria aguda, bronquiolitis, RT-PCR, rinovirus. SUMMARY Introduction. Acute respiratory infections (ARI)are a major cause of hospitalization particularly at the extreme ages of life. Objectives. To determine the viral diagnosis in children < 5 years old with ARI, seasonality, clinical and epidemiological characteristics. Population and methods. A cross-sectional, descriptive and multicenter study was performed. Respiratory samples from patients with ARI hospitalized or outpatients with < 5 days of respiratory symptoms from June 2008 to May 2009 were studied for respiratory viruses. Clinical and demographic data were recorded. Results. A total of 347 patients were enrolled: 234 hospitalized and 112 outpatients. Hospitalized patients were younger compared with outpatients (8 vs. 19 months, p <0.001) and presented more frequently bronchiolitis (74% hospitalized vs. 24% outpatients) and pneumonia (14% hospitalized vs. 5% outpatients). Age was statistically associated with hospitalization (p= 0.01). Viral diagnosis was achieved in 81% hospitalized and 57% of outpatients. Rhinovirus was the most frequent followed by respiratory sync...

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“…17 Leukocytes ≥ 12,000 cells/ mm 3 are not statistically different among groups, but the variable is not part of the score. 8 The however, they are closer to bacterial pneumonia scores.…”

Section: Increased Bands Immature Neutrophil Count In Patientsmentioning

confidence: 94%

Características clínico-radiológicas e hematológicas das pneumonias causadas pelo Mycoplasma pneumoniae

Vervloet¹,

Camargos²,

Soares³

et al. 2010

J. Pediatr. (Rio J.)

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Objective: To describe the clinical, hematological and radiographic characteristics of children hospitalized for Mycoplasma pneumoniae pneumonia. Method:The study population consisted of 190 children between 3 months and 16 years old, hospitalized for radiographically confirmed pneumonia. Patients were divided into two groups, to wit: 95 children with Mycoplasma pneumoniae pneumonia, as diagnosed using the enzyme-linked immunosorbent assay (ELISA) method; and 95 children with pneumonia caused by other etiologic agents. Using a validated scoring system, the clinical, hematological and radiographic findings of both groups were compared to differentiate Mycoplasma pneumoniae pneumonia (group 1) from pneumonia caused by other etiologic agents (group 2), itself divided into two groups, bacterial (n = 75) and viral (n = 20).Results: Mycoplasma pneumoniae pneumonia was found most often in girls (p < 0.01), older children (p < 0.01), and patients with dry cough (p < 0.01) and extrapulmonary manifestations (p < 0.01). The clinical, hematological and radiographic variables of Mycoplasma pneumoniae pneumonia (mean score = 6.95) scored between those found in bacterial (mean score = 8.27) and viral pneumonia (mean score = 0.90). Conclusion:Results suggest that the scoring system can contribute to the presumptive diagnosis of Mycoplasma pneumoniae pneumonia and help differentiate pneumonic status caused by other etiologic agents.J Pediatr (Rio J). 2010;86(6):480-487: Mycoplasma, Mycoplasma pneumoniae, pneumonia, radiography, children. No conflicts of interest declared concerning the publication of this article. Organization (WHO). 9 MP pneumonia was defined by the Mycoplasma pneumoniae pneumonia -Vervloet LA et al. Original article

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Development and validation of a clinical prediction rule to distinguish bacterial from viral pneumonia in children

Abstract: The BPS accurately identifies hospitalized children's risk of bacterial pneumonia, helping clinicians determine those not likely to benefit from antibiotic therapy.

Cited by 69 publications

References 28 publications

How frequent is varicella-associated pneumonia in children?

How frequent is varicella-associated pneumonia in children?

Infección respiratoria aguda viral en niños menores de 5 años. Estudio epidemiológico en dos centros de Buenos Aires, Argentina

Características clínico-radiológicas e hematológicas das pneumonias causadas pelo Mycoplasma pneumoniae

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