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Prospective surveillance for atypical pathogens in children with community-acquired pneumonia in Japan
Authors:Masahiro Bamba  Keiji Jozaki  Norio Sugaya  Shinya Tamai  Jun Ishihara  Takeo Kori  Hiroyuki Shiro  Yoshinao Takeuchi  Hideo Cho  Ayumi Nakao  Yuji Okano  Kazuhiro Kimura  Osamu Komiyama  Masato Nonoyama  Intetsu Kobayashi  Tatsuo Kato  Keisuke Sunakawa
Affiliation:(1) Department of Pediatrics, Yokosuka Kyosai Hospital, 1-16 Yonegahamadori, Yokosuka-shi, Kanagawa 238-8558, Japan;(2) Hiratsuka Kyosai Hospital, Hiratsuka, Japan;(3) Nippon Kokan Hospital, Kawasaki, Japan;(4) Yamato Municipal Hospital, Yamato, Japan;(5) Yokohama Municipal Citizen's Hospital, Yokohama, Japan;(6) Yokohama Rosai Hospital, Yokohama, Japan;(7) Kawasaki Municipal Hospital, Kawasaki, Japan;(8) Toyoko Hospital, St. Marianna University School of Medicine, Kawasaki, Japan;(9) Isehara Kyodo Hospital, Isehara, Japan;(10) Kitasato University School of Medicine, Sagamihara, Japan;(11) Mitsubishi Kagaku Bio-Clinical Laboratories, Tokyo, Japan;(12) Yokohama City Seibu Hospital, St. Marianna University School of Medicine, Yokohama, Japan
Abstract:A total of 141 children with community-acquired pneumonia (CAP) were studied prospectively to determine the causative microorganisms. Microbial investigations included examination of postnasal swabs, cultures, polymerase chain reaction (PCR), and serology. The atypical pathogens occurring most frequently were Mycoplasma pneumoniae (58 patients [41.1%]), Chlamydia pneumoniae (4 patients [2.8%]), and concurrent occurrence of both pathogens (1 patient [0.7%]). Patients aged under 4 years showed a relatively lower rate of atypical bacterial etiology compared with those aged 4 years or older. Major bacterial pathogens were detected in 89 patients (atypical pathogens were detected in 28 patients simultaneously), including Streptococcus pneumoniae in 34 patients, Haemophilus influenzae in 60, Moraxella catarrhalis in 48, and multiple pathogens in 42. In patients suspected of having atypical pneumonia, macrolides are recommended.
Keywords:Community-acquired pneumonia  Atypical pathogen  Chlamydia pneumoniae  Mycoplasma pneumoniae  Macrolides  Children
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