Etiology of community-acquired pneumonia in hospitalized children based on WHO clinical guidelines |
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| Authors: | Manon Cevey-Macherel Annick Galetto-Lacour Alain Gervaix Claire-Anne Siegrist Jacques Bille Béatrice Bescher-Ninet Laurent Kaiser Jean-Daniel Krahenbuhl Mario Gehri |
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| Affiliation: | (1) Child and Adolescent Department, Lausanne University Hospital, Lausanne, Switzerland;(2) Child and Adolescent Department, University Hospital of Geneva, Geneva, Switzerland;(3) Center for Vaccine and Neonatal Immunology, Departments of Pediatrics and Pathology-Immunology, University of Geneva, Geneva, Switzerland;(4) Institute of Microbiology, University of Lausanne, Lausanne, Switzerland;(5) Central Laboratory of Virology, Division of Infectious Diseases and Faculty of Medicine, University Hospital of Geneva, Geneva, Switzerland;(6) Pediatric Department, Lausanne University Hospital, Rue du Bugnon 51, 1011 Lausanne, Switzerland |
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| Abstract: | Community-acquired pneumonia (CAP) is a major cause of death in developing countries and of morbidity in developed countries. The objective of the study was to define the causative agents among children hospitalized for CAP defined by WHO guidelines and to correlate etiology with clinical severity and surrogate markers. Investigations included an extensive etiological workup. A potential causative agent was detected in 86% of the 99 enrolled patients, with evidence of bacterial (53%), viral (67%), and mixed (33%) infections. Streptococcus pneumoniae was accounted for in 46% of CAP. Dehydration was the only clinical sign associated with bacterial pneumonia. CRP and PCT were significantly higher in bacterial infections. Increasing the number of diagnostic tests identifies potential causes of CAP in up to 86% of children, indicating a high prevalence of viruses and frequent co-infections. The high proportion of pneumococcal infections re-emphasizes the importance of pneumococcal immunization. |
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