The contribution of viruses and bacteria to community-acquired pneumonia in vaccinated children: a case-control study.
The contribution of viruses and bacteria to community-acquired pneumonia in vaccinated children: a case-control study.
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DOI：
10.1136/thoraxjnl-2018-212096
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发表时间：
2019-03
期刊：
影响因子：
10
通讯作者：
Blyth CC
中科院分区：
文献类型：
--
作者：
Bhuiyan MU;Snelling TL;West R;Lang J;Rahman T;Granland C;de Gier C;Borland ML;Thornton RB;Kirkham LS;Sikazwe C;Martin AC;Richmond PC;Smith DW;Jaffe A;Blyth CC
与儿童肺炎有关的呼吸道病原体经常在健康儿童的上呼吸道中被检测到，因此很难确定它们对肺炎的影响。我们的目标是确定常见病原体对肺炎的贡献，调整无症状检测率，为未来的诊断、治疗和预防策略提供信息。在西澳大利亚州珀斯的18岁儿童中进行了一项病例对照研究。病例是因放射学确诊的肺炎而住院的儿童；对照组是从门诊和当地免疫诊所确诊的健康儿童。采集鼻咽拭子，用聚合酶链式反应(PCR)检测14种呼吸道病毒和6种细菌。对于每种病原体，用多元Logistic回归计算调整后的优势比(AOR；95% CI)，并估计肺炎的人群归因分数(95% CI)。2015年5月至2017年10月，入选病例230例，对照230例。在57%的病例和29%的对照组中至少发现一种呼吸道病毒(AOR：4.7；95%CI：2.8至7.8)。72%的病例和80%的对照组至少检测到一种细菌(AOR：0.7；95%CI：0.4至1.2)。呼吸道合胞病毒检测与肺炎的相关性最强(AOR：58.495%CI：15.6~217.5)。肺炎支原体是唯一与肺炎相关的细菌(AOR：14.5；95%CI：2.2~94.8)。呼吸道合胞病毒、人类偏肺病毒、流感、腺病毒和肺炎支原体分别占儿童肺炎住院总数的20.2%(95%CI：14.6~25.5)、9.8%(5.6%~13.7%)、6.2%(2.5%~9.7%)、4%(1.1%~7.1%)和7.2%(3.5%~10.8%)。呼吸道病毒，特别是RSV和HMPV，是澳大利亚儿童肺炎的主要因素。
Respiratory pathogens associated with childhood pneumonia are often detected in the upper respiratory tract of healthy children, making their contribution to pneumonia difficult to determine. We aimed to determine the contribution of common pathogens to pneumonia adjusting for rates of asymptomatic detection to inform future diagnosis, treatment and preventive strategies. A case–control study was conducted among children <18 years in Perth, Western Australia. Cases were children hospitalised with radiologically confirmed pneumonia; controls were healthy children identified from outpatient and local immunisation clinics. Nasopharyngeal swabs were collected and tested for 14 respiratory viruses and 6 bacterial species by Polymerase chain reaction (PCR). For each pathogen, adjusted odds ratio (aOR; 95% CI) was calculated using multivariate logistic regression and population-attributable fraction (95% CI) for pneumonia was estimated. From May 2015 to October 2017, 230 cases and 230 controls were enrolled. At least one respiratory virus was identified in 57% of cases and 29% of controls (aOR: 4.7; 95% CI: 2.8 to 7.8). At least one bacterial species was detected in 72% of cases and 80% of controls (aOR: 0.7; 95% CI: 0.4 to 1.2). Respiratory syncytial virus (RSV) detection was most strongly associated with pneumonia (aOR: 58.4; 95% CI: 15.6 to 217.5). Mycoplasma pneumoniae was the only bacteria associated with pneumonia (aOR: 14.5; 95% CI: 2.2 to 94.8). We estimated that RSV, human metapneumovirus (HMPV), influenza, adenovirus and Mycoplasma pneumoniae were responsible for 20.2% (95% CI: 14.6 to 25.5), 9.8% (5.6% to 13.7%), 6.2% (2.5% to 9.7%), 4% (1.1% to 7.1%) and 7.2% (3.5% to 10.8%) of hospitalisations for childhood pneumonia, respectively. Respiratory viruses, particularly RSV and HMPV, are major contributors to pneumonia in Australian children.
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DOI：
10.1183/09031936.00092410
发表时间：
2011-05
期刊：
The European respiratory journal
影响因子：
--
作者：
Bizzintino J;Lee WM;Laing IA;Vang F;Pappas T;Zhang G;Martin AC;Khoo SK;Cox DW;Geelhoed GC;McMinn PC;Goldblatt J;Gern JE;Le Souëf PN
通讯作者：
Le Souëf PN
DOI：
10.1001/jama.2015.12160
发表时间：
2015-10-13
期刊：
JAMA
影响因子：
--
作者：
Grijalva CG;Zhu Y;Williams DJ;Self WH;Ampofo K;Pavia AT;Stockmann CR;McCullers J;Arnold SR;Wunderink RG;Anderson EJ;Lindstrom S;Fry AM;Foppa IM;Finelli L;Bramley AM;Jain S;Griffin MR;Edwards KM
通讯作者：
Edwards KM
影响因子：
4.4
作者：
Blyth CC;Webb SA;Kok J;Dwyer DE;van Hal SJ;Foo H;Ginn AN;Kesson AM;Seppelt I;Iredell JR;ANZIC Influenza Investigators;COSI Microbiological Investigators
通讯作者：
COSI Microbiological Investigators
影响因子：
120.7
作者：
Berkley, James A.;Munywoki, Patrick;Ngama, Mwanajuma;Kazungu, Sidi;Abwao, John;Bett, Anne;Lassauniere, Ria;Kresfelder, Tina;Cane, Patricia A.;Venter, Marietjie;Scott, J. Anthony G.;Nokes, D. James
通讯作者：
Nokes, D. James
影响因子：
1.7
作者：
Moore, Hannah;Burgner, David;Lehmann, Deborah
通讯作者：
Lehmann, Deborah