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Etiology of community-acquired pneumonia in children hospitalized in the period of 2009-2012.
MedLine Citation:
PMID:  25182260     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Aim:The aim of this study was to analyze etiology of childhood pneumonia in the region of Warsaw and to assess the efficacy and usefulness of standard diagnostic procedures used in search of etiology. Material and methods: 663 patients (323 girls and 340 boys) hospitalized due to pneumonia in the period of 2009-2012 were enrolled. Diagnostic procedures to determine the etiology were performed in 400/663 (60.3%) children. Type of diagnostic procedures depended on medical history, disease's course and patient's condition and included 336 blood cultures, 257 measurements of antibody titers against Chlamydophila pneumoniae and Mycoplasma pneumoniae, 12 measurements of antibody titers against Bordetella pertussis, 14 pleural fluid cultures (deriving from 9 patients). Using the BiNet network 51 specimens (45 blood specimens, 4 pleural fluid, 2 bacterial strains) were send to the KOROUN in order to perform molecular diagnostic in search of encapsulated bacteria. Results: Etiology of pneumonia was found in 9.7% (64/663) of all patients with diagnosed CAP, what accounted for 16% (64/400) of children in which the diagnostics was taken. The most frequent agent was atypical bacteria which was found in 14.75% (59/400) patients (in 26 patients - Chlamydophila pneumoniae, 11 - Mycoplasma pneumoniae, 22 - mixed infection). Bacterial etiology was confirmed in 1.25% (5/400) of patients (Streptococcus pneumoniae-3 patients, Streptococcus pyogenes i Bordetella pertussis - 1 patient each other). Efficacy of a single blood culture was very low - 0.6% (2/336). Pleural fluid culture was positive only in 1 of 9 drained patients (S. pyogenes). Thanks to the use of BiNet network (KOROUN) etiology of severe pneumonia in 3 patients has been determined. 2 of those patients suffered from invasive pneumococcal disease, which was not diagnosed with standard microbiological procedures (blood cultures). Conclusions:The methods currently used in the diagnosis of pneumonia is inadequate. It was possible to determine the etiology of only 10% of children hospitalized. The most common cause of pneumonia that seen were atypical infection (8.9%). The effectiveness of single blood culture in determining the etiology of pneumonia was very low and amounted to 0.6%. It is necessary to expand the diagnosis of childhood pneumonia upon the basis of molecular techniques and methods of serotyping.
Authors:
Teresa Jackowska; August Wrotek
Publication Detail:
Type:  JOURNAL ARTICLE    
Journal Detail:
Title:  Developmental period medicine     Volume:  18     ISSN:  1428-345X     ISO Abbreviation:  Dev Period Med     Publication Date:  2014  
Date Detail:
Created Date:  2014-9-3     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101636421     Medline TA:  Dev Period Med     Country:  -    
Other Details:
Languages:  POL     Pagination:  209-215     Citation Subset:  -    
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