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Erschienen in: Wiener klinische Wochenschrift 21-22/2013

01.11.2013 | original article

Spectrum of pathogens of in-patient children and youths with community acquired pneumonia: a 3 year survey of a community hospital in Vienna, Austria

verfasst von: Herbert Kurz, MD, Hubert Göpfrich, MD, Klaus Huber, PhD, Walter Krugluger, MD, Friederike Asbott, MD, Leila Wabnegger, PhD, Petra Apfalter, MD, Christian Sebesta, MD

Erschienen in: Wiener klinische Wochenschrift | Ausgabe 21-22/2013

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Summary

Background

No actual data are available on the epidemiology and morbidity of community acquired pneumonia (CAP) in youths and children in Vienna, Austria.

Objective

The objective was to determine the epidemiology of CAP and morbidity of children hospitalized due to CAP in a tertiary care facility.

Methods

During three winter seasons youths and children hospitalized due to CAP were enrolled. Testing for viral and bacterial pathogens of pneumonia was performed in a routine clinical setting. Blood cultures were performed; respiratory viruses, Mycoplasma pneumoniae and Chlamydia pneumoniae were searched for by an established Real Time polymerase chain reaction (PCR) panel. Clinical signs and indices of inflammation were documented.

Results

Out of 279 children and youths with CAP a causative agent could be detected in 190 (68 %). Viruses and bacteria were diagnosed in 107 (57 %) and 58 patients (30 %), respectively. Co-infection was found in 20 patients (10 %), Mycoplasma pneumoniae or Clamydia pneumoniae in 16 cases (8 %).
In seven patients blood cultures were positive. C-reactive protein (CRP) was significantly higher in children with positive Streptococcus pneumoniae antigen (SPAG) than with viral infection and/or co-infection. Clinical parameters showed no statistically significant differences. C. pneumoniae and M. pneumoniae were only diagnosed in children and youths with 5 years and older.

Conclusions

Testing for pathogens in CAP in clinical routine achieves a high recovery rate. Blood cultures are rarely helpful, but the molecular testing for viruses seemed to be helpful to establish the diagnosis.
Literatur
1.
Zurück zum Zitat Michelow IC, Olsen K, Lozano J, et al. Epidemiology and clinical characteristics of community-acquired pneumonia in hospitalized children. Pediatr. 2004;113:701–7.CrossRef Michelow IC, Olsen K, Lozano J, et al. Epidemiology and clinical characteristics of community-acquired pneumonia in hospitalized children. Pediatr. 2004;113:701–7.CrossRef
2.
Zurück zum Zitat Cevey-Macherel M, Galetto-Lacour A, Gervaix A, et al. Etiology of community acquired pneumonia in hospitalized children based on WHO clinical guidelines. Eur J Pediatr. 2009;168:1429–36.PubMedCrossRef Cevey-Macherel M, Galetto-Lacour A, Gervaix A, et al. Etiology of community acquired pneumonia in hospitalized children based on WHO clinical guidelines. Eur J Pediatr. 2009;168:1429–36.PubMedCrossRef
3.
Zurück zum Zitat Fleming DM, Pannell RS, Elliot AJ, et al. Respiratory illness associated with influenza and respiratory syncytial virus infection. Arch Dis Child. 2005;90:741–6.PubMedCrossRef Fleming DM, Pannell RS, Elliot AJ, et al. Respiratory illness associated with influenza and respiratory syncytial virus infection. Arch Dis Child. 2005;90:741–6.PubMedCrossRef
4.
Zurück zum Zitat Monto AS, Fendrick AM, Sarnes MW. Respiratory illness caused by picornavirus infection: a review of clinical outcomes. Clin Ther. 2001;23:1615–27.PubMedCrossRef Monto AS, Fendrick AM, Sarnes MW. Respiratory illness caused by picornavirus infection: a review of clinical outcomes. Clin Ther. 2001;23:1615–27.PubMedCrossRef
5.
Zurück zum Zitat Boivin G, De Serres G, Côtė S, et al. Human metapneumovirus infections in hospitalized children. Emerg Infect Dis. 2003;9:634–40.PubMedCrossRef Boivin G, De Serres G, Côtė S, et al. Human metapneumovirus infections in hospitalized children. Emerg Infect Dis. 2003;9:634–40.PubMedCrossRef
6.
Zurück zum Zitat Mackie PL. The classification of viruses infecting the respiratory tract. Paediatr Respir Rev. 2003;4:84–90.PubMedCrossRef Mackie PL. The classification of viruses infecting the respiratory tract. Paediatr Respir Rev. 2003;4:84–90.PubMedCrossRef
7.
Zurück zum Zitat Weinberg GA. Parainfluenza viruses: an underappreciated cause of pediatric respiratory morbidity. Pediatr Infect Dis J. 2003;25:447–8.CrossRef Weinberg GA. Parainfluenza viruses: an underappreciated cause of pediatric respiratory morbidity. Pediatr Infect Dis J. 2003;25:447–8.CrossRef
8.
Zurück zum Zitat Mostafaie N, Huber KR, Sebesta C, et al. Diagnosis of infections with human herpes viruses in routine laboratory practice. Clin Chem Lab Med. 2009;47:1141–5.PubMedCrossRef Mostafaie N, Huber KR, Sebesta C, et al. Diagnosis of infections with human herpes viruses in routine laboratory practice. Clin Chem Lab Med. 2009;47:1141–5.PubMedCrossRef
9.
Zurück zum Zitat British T. BTS Guidelines for the management of community acquired pneumonia in childhood. Thorax. 2002 May;57(Suppl 1):i1–24. British T. BTS Guidelines for the management of community acquired pneumonia in childhood. Thorax. 2002 May;57(Suppl 1):i1–24.
11.
Zurück zum Zitat Ostapchuk M, Robers DM, Haddy R, et al. Community-acquired pneumonia in infants and children. Am Fam Physician. 2004;70:899–908.PubMed Ostapchuk M, Robers DM, Haddy R, et al. Community-acquired pneumonia in infants and children. Am Fam Physician. 2004;70:899–908.PubMed
12.
Zurück zum Zitat British thoracic society standards of care committee. British thoracic society guidelines for the management of community acquired pneumonia in childhood. Thorax. 2002;57 (suppl 1):i1–24. British thoracic society standards of care committee. British thoracic society guidelines for the management of community acquired pneumonia in childhood. Thorax. 2002;57 (suppl 1):i1–24.
13.
Zurück zum Zitat Apfalter P, Loidl M, Nadrchal R, et al. Isolation and continuous growth of Chlamydia pneumoniae from arterectomy specimens. Eur J Clin Microbiol Infect Dis. 2000;19:305–8.PubMedCrossRef Apfalter P, Loidl M, Nadrchal R, et al. Isolation and continuous growth of Chlamydia pneumoniae from arterectomy specimens. Eur J Clin Microbiol Infect Dis. 2000;19:305–8.PubMedCrossRef
14.
Zurück zum Zitat Kurz H, Göpfrich H, Wabnegger L, et al. Role of Chlamydophila pneumoniae in children hospitalized for community-acquired pneumonia in Vienna, Austria. Pediatr Pulmonol. 2009;44:873–6.PubMedCrossRef Kurz H, Göpfrich H, Wabnegger L, et al. Role of Chlamydophila pneumoniae in children hospitalized for community-acquired pneumonia in Vienna, Austria. Pediatr Pulmonol. 2009;44:873–6.PubMedCrossRef
15.
Zurück zum Zitat Nascimento-Carvalho CM, Ribeiro CT, Cardoso MR, et al. The role of respiratory viral infections among children hospitalized for community-acquired pneumonia in a developing country. Pediatr Infect Dis J. 2008;27:939–41.PubMedCrossRef Nascimento-Carvalho CM, Ribeiro CT, Cardoso MR, et al. The role of respiratory viral infections among children hospitalized for community-acquired pneumonia in a developing country. Pediatr Infect Dis J. 2008;27:939–41.PubMedCrossRef
16.
Zurück zum Zitat Espy MJ, Uhl JR, Mitchel PS, et al. Diagnosis of Herpes Simplex virus infections in the clinical laboratory by LightCycler PCR. J Clinical Mircrobiology. 2000;38:795–9. Espy MJ, Uhl JR, Mitchel PS, et al. Diagnosis of Herpes Simplex virus infections in the clinical laboratory by LightCycler PCR. J Clinical Mircrobiology. 2000;38:795–9.
17.
Zurück zum Zitat Charkaluk ML, Kalach N, Mvogo H, et al. Assessment of a rapid urinary antigen detection by an immonocrhormatographic test for diagnosis of pneumococcal infection in children. Diagn Microbiol Infect Dis. 2006;55:89–94.PubMedCrossRef Charkaluk ML, Kalach N, Mvogo H, et al. Assessment of a rapid urinary antigen detection by an immonocrhormatographic test for diagnosis of pneumococcal infection in children. Diagn Microbiol Infect Dis. 2006;55:89–94.PubMedCrossRef
18.
Zurück zum Zitat Flores JC, Moro MN, Berron S, et al. Usefulness of pneumococcal antigen detection in pleural effusion for the rapid diagnosis of infection by Streptococcus pneumonia. Eur J Pediatr. 2010;169:581–4.CrossRef Flores JC, Moro MN, Berron S, et al. Usefulness of pneumococcal antigen detection in pleural effusion for the rapid diagnosis of infection by Streptococcus pneumonia. Eur J Pediatr. 2010;169:581–4.CrossRef
19.
Zurück zum Zitat Abe T, Tokuda Y, Ishimatsu S, et al. Usefulness of initial blood cultures in patients admitted with pneumonia from an emergency department in Japan. J Infect Chemother. 2009;15:180–6.PubMedCrossRef Abe T, Tokuda Y, Ishimatsu S, et al. Usefulness of initial blood cultures in patients admitted with pneumonia from an emergency department in Japan. J Infect Chemother. 2009;15:180–6.PubMedCrossRef
20.
Zurück zum Zitat Kurz H, Göpfrich H. Epidemiology and morbidity of mycoplasma as causative agent for community-acquired pneumonia in hospitalized children in a Community Hospital in Vienna. Wien Med Wochenschr. 2010;161:180–3.PubMedCrossRef Kurz H, Göpfrich H. Epidemiology and morbidity of mycoplasma as causative agent for community-acquired pneumonia in hospitalized children in a Community Hospital in Vienna. Wien Med Wochenschr. 2010;161:180–3.PubMedCrossRef
21.
Zurück zum Zitat Don M, Valent F, Korppi M, et al. Differentiation of bacterial and viral community-acquired pneumonia in children. Pediatr Int. 2009;51:91–6.PubMedCrossRef Don M, Valent F, Korppi M, et al. Differentiation of bacterial and viral community-acquired pneumonia in children. Pediatr Int. 2009;51:91–6.PubMedCrossRef
22.
Zurück zum Zitat Pricipi N, Esposito S. Emerging role of Mycoplasma pneumoniae and Chlamydia pneumoniae in paediatric respiratory-tract infections. Lancet Infect Dis. 2001;1:334–44.CrossRef Pricipi N, Esposito S. Emerging role of Mycoplasma pneumoniae and Chlamydia pneumoniae in paediatric respiratory-tract infections. Lancet Infect Dis. 2001;1:334–44.CrossRef
23.
Zurück zum Zitat Block S, Hedrick J, Hammerschlag MR, et al. Mycoplasma pneumoniae and Chlamydia pneumoniae in pediatric community-acquired pneumonia: comparative efficacy and safety of clarithromycin vs. erythromycin ethylsuccinate. J Pediatr Infect Dis. 1995;14:471–7.CrossRef Block S, Hedrick J, Hammerschlag MR, et al. Mycoplasma pneumoniae and Chlamydia pneumoniae in pediatric community-acquired pneumonia: comparative efficacy and safety of clarithromycin vs. erythromycin ethylsuccinate. J Pediatr Infect Dis. 1995;14:471–7.CrossRef
24.
Zurück zum Zitat Bradley JS, Byington CL, Shah SS, et al. The management of community-acquired pneumonia in infants and children older than 3 months of age: clinical practice guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America. Clin Infect Dis. 2011;53:e25–76.PubMedCrossRef Bradley JS, Byington CL, Shah SS, et al. The management of community-acquired pneumonia in infants and children older than 3 months of age: clinical practice guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America. Clin Infect Dis. 2011;53:e25–76.PubMedCrossRef
25.
Zurück zum Zitat Ambroggio L, Taylor JA, Tabb LP, et al. Comparative effectiveness of empiric b-lactam monotherapiy and b-Lactam-Macrolide combination Therapy in Children Hospitalized with Community-Acquired Pneumonia. J Pediatr. 2012;161:1097–103.PubMedCrossRef Ambroggio L, Taylor JA, Tabb LP, et al. Comparative effectiveness of empiric b-lactam monotherapiy and b-Lactam-Macrolide combination Therapy in Children Hospitalized with Community-Acquired Pneumonia. J Pediatr. 2012;161:1097–103.PubMedCrossRef
Metadaten
Titel
Spectrum of pathogens of in-patient children and youths with community acquired pneumonia: a 3 year survey of a community hospital in Vienna, Austria
verfasst von
Herbert Kurz, MD
Hubert Göpfrich, MD
Klaus Huber, PhD
Walter Krugluger, MD
Friederike Asbott, MD
Leila Wabnegger, PhD
Petra Apfalter, MD
Christian Sebesta, MD
Publikationsdatum
01.11.2013
Verlag
Springer Vienna
Erschienen in
Wiener klinische Wochenschrift / Ausgabe 21-22/2013
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI
https://doi.org/10.1007/s00508-013-0426-z

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