Comparison of the frequency of bacterial and viral infections among children with community-acquired pneumonia hospitalized across distinct severity categories: a prospective cross-sectional study

BMC Pediatrics

Research Article

Amanda C. Nascimento-Carvalho¹  Cristiana M. Nascimento-Carvalho²  Olli Ruuskanen³ 

[1] Bahiana School of Medicine, Bahiana Foundation for Science Development, Salvador, Bahia, Brazil;Department of Paediatrics, Federal University of Bahia School of Medicine, Salvador, Bahia, Brazil;Department of Paediatrics, Turku University and University Hospital, Turku, Finland;

关键词: Acute respiratory infection;    Lower respiratory tract infection;    Lung disease;    Respiratory viruses;    Severity assessment;   

DOI  :  10.1186/s12887-016-0645-3

 received in 2016-02-06, accepted in 2016-07-15,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundThe comparison of the frequencies of bacterial and viral infections among children with community-acquired pneumonia (CAP) admitted in distinct severity categories, in an original study, is lacking in literature to-date. We aimed to achieve this goal.MethodsChildren aged 2-59-months-old hospitalized with CAP were included in this prospective study in Salvador, Brazil. Clinical data and biological samples were collected to investigate 11 viruses and 8 bacteria. Severity was assessed by using the World Health Organization criteria.ResultsOne hundred eighty-one patients were classified as “non-severe” (n = 53; 29.3 %), “severe” (n = 111; 61.3 %), or “very severe” (n = 17; 9.4 %) CAP. Overall, aetiology was detected among 156 (86.2 %) cases; viral (n = 84; 46.4 %), bacterial (n = 26; 14.4 %) and viral-bacterial (n = 46; 25.4 %) infections were identified. Viral infection frequency was similar in severe/very severe and non-severe cases (46.1 % vs. 47.2 %; p = 0.9). Pneumococcal infection increased across “non-severe” (13.2 %), “severe” (23.4 %), and “very severe” (35.3 %) cases (qui-squared test for trend p = 0.04). Among patients with detected aetiology, after excluding cases with co-infection, the frequency of sole bacterial infection was different (p = 0.04) among the categories; non-severe (12.5 %), severe (29.3 %) or very severe (55.6 %). Among these patients, sole bacterial infection was independently associated with severity (OR = 4.4 [95 % CI:1.1–17.6]; p = 0.04) in a model controlled for age (OR = 0.7 [95 % CI:0.5–1.1]; p = 0.1).ConclusionsA substantial proportion of cases in distinct severity subgroups had respiratory viral infections, which did not differ between severity categories. Bacterial infection, particularly pneumococcal infection, was more likely among severe/very severe cases.

【 授权许可】

CC BY   
© The Author(s). 2016