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. 2017 Dec 20;17(1):787.
doi: 10.1186/s12879-017-2891-x.

Etiologic spectrum and occurrence of coinfections in children hospitalized with community-acquired pneumonia

Wujun Jiang  1 , Min Wu  1 , Jing Zhou  1 , Yuqing Wang  2 , Chuangli Hao  1 , Wei Ji  1 , Xinxing Zhang  1 , Wenjing Gu  1 , Xuejun Shao  3
Affiliations

Etiologic spectrum and occurrence of coinfections in children hospitalized with community-acquired pneumonia

Wujun Jiang et al. BMC Infect Dis. .

Abstract

Background: Co-infections are common in childhood community acquired pneumonia (CAP). However, their etiological pattern and clinical impact remains inconclusive.

Methods: Eight hundred forty-six consecutive children with CAP were evaluated prospectively for the presence of viral and bacterial pathogens. Nasopharyngeal aspirates were examined by direct immunofluorescence assay or polymerase chain reaction (PCR) for viruses. PCR of nasopharyngeal aspirates and enzyme-linked immunosorbent assays were performed to detect M. pneumoniae. Bacteria was detected in blood, bronchoalveolar lavage specimen, or pleural fluid by culture.

Results: Causative pathogen was identified in 70.1% (593 of 846) of the patients. The most commonly detected pathogens were respiratory syncytial virus (RSV) (22.9%), human rhinovirus (HRV) (22.1%), M. pneumoniae (15.8%). Coinfection was identified in 34.6% (293 of 846) of the patients. The majority of these (209 [71.3%] of 293) were mixed viral-bacterial infections. Age < 6 months (odds ratio: 2.1; 95% confidence interval: 1.2-3.3) and admission of PICU (odds ratio: 12.5; 95% confidence interval: 1.6-97.4) were associated with mix infection. Patients with mix infection had a higher rate of PICU admission.

Conclusions: The high mix infection burden in childhood CAP underscores a need for the enhancement of sensitive, inexpensive, and rapid diagnostics to accurately identify pneumonia pathogens.

Keywords: Children; Coinfection; Community-acquired pneumonia.

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Conflict of interest statement

Ethics approval and consent to participate

The study was approved by the Medical Ethics Committee of Children’s Hospital of Soochow University. The parents of all study participants gave written informed consent before study enrollment.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Pathogen detection among children with community acquired pneumonia requiring hospitalization. RSV indicates respiratory syncytial virus, HRV indicates human rhinovirus, MP indicates M. pneumoniae, Boca indicates bocavirus, PIV indicates parainfluenza 1–3, SP indicates S. pneumoniae
Fig. 2
Fig. 2
Monthly distributions of commonly detected pathogens were shown in Fig. 2. RSV indicates respiratory syncytial virus, HRV indicates human rhinovirus, MP indicates M. pneumoniae, Boca indicates bocavirus, PIV indicates parainfluenza 1–3, SP indicates S. pneumoniae
Fig. 3
Fig. 3
Distribution of pathogen coinfections associated with community acquired pneumonia, stratified by age. RSV indicates respiratory syncytial virus, HRV indicates human rhinovirus, MP indicates M. pneumoniae, HBoV indicates bocavirus, PIV indicates parainfluenza 1–3, SP indicates S, pneumoniae, ADV indicates adenovirus, InF indicates influenza virus A and B, hMPV indicates human metapneumovirus, HI indicates H. influenza
See this image and copyright information in PMC

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