Epidemiology and microbiological investigations of community-acquired pneumonia in children admitted at the emergency department of a university hospital.
Epidemiology and microbiological investigations of community-acquired pneumonia in children admitted at the emergency department of a university hospital.
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DOI：
10.1016/j.jcv.2014.05.006
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发表时间：
2014-08
期刊：
影响因子：
--
通讯作者：
Pozzetto B
中科院分区：
文献类型：
--
作者：
Cantais A;Mory O;Pillet S;Verhoeven PO;Bonneau J;Patural H;Pozzetto B
儿童社区获得性肺炎应全身应用抗菌药物。在85例CAP患儿中检测到大量细菌和病毒。超过60%的CAP患儿表现出单纯的病毒感染。在>40%的儿童中观察到至少2种病毒的合并感染。数据表明，应重新审查儿童CAP中抗菌药物的使用。社区获得性肺炎（CAP）儿童的管理在很大程度上受到新的分子诊断测试的发展的影响，这些测试可以同时检测多种病原体。评价一种诊断方法，包括多重PCR检测，用于回顾医院儿童CAP的流行病学和病因学。所有年龄段的儿童咨询在圣艾蒂安大学医院急诊科，法国，在2012-2013年冬季期间被纳入。除细菌培养物外，还使用市售双重rt-PCR检测法检测了以下病原体：腺病毒、呼吸道合胞病毒、人偏肺病毒、博卡病毒、鼻病毒/肠道病毒、冠状病毒、流感病毒A和B、副流感病毒、肺炎支原体和嗜衣原体肺炎。85例CAP患者中，81例（95.3%）至少检出一种病原体，其中细菌性单纯感染4例（4.7%），病毒性单纯感染53例（62.4%），混合感染24例（28.2%）。在37例（43.5%）病例中观察到至少两种病毒的合并感染。在有记录的细菌感染病例中，平均年龄较高（P < 0.05）。单纯病毒感染亚组中，重症组平均年龄为2.0岁，轻、中度组平均年龄为3.8岁（P < 0.05）。这些发现强调了病毒源性CAP的巨大比例，多种病毒合并感染的数量高，细菌性CAP的数量低，特别是在5岁以下儿童中，并解决了重新评估该年龄组经验性抗菌治疗适应症的必要性。
Systematic antimicrobials are recommended in community-acquired pneumonia of child. A large panel of bacteria and viruses was detected in 85 children exhibiting CAP. More than 60% of children with CAP exhibited an exclusive viral infection. A co-infection with at least 2 viruses was observed in >40% of the children. Data suggest that the use of antimicrobials in child's CAP should be revisited. The management of children with community-acquired pneumonia (CAP) is largely influenced by the development of new molecular diagnostic tests that allow the simultaneous detection of a wide range of pathogens. Evaluation of a diagnostic approach including multiplex PCR assays for revisiting the epidemiology and etiology of CAP in children at hospital. Children of all ages consulting at the Emergency Department of the University hospital of Saint-Etienne, France, during the 2012–2013 winter period were included. In addition to bacterial cultures, the following pathogens were detected using biplex commercially-available rt-PCR tests: adenovirus, respiratory syncytial virus, human metapneumovirus, bocavirus, rhinovirus/enterovirus, coronavirus, influenza viruses A and B, parainfluenza viruses, Mycoplasma pneumoniae and Chlamydophila pneumonia. From 85 patients with CAP, at least one pathogen was identified in 81 cases (95.3%), including 4 bacterial exclusive infections (4.7%), 53 viral exclusive infections (62.4%) and 24 mixed infections (28.2%). Coinfection by at least two viruses was observed in 37 cases (43.5%). Mean age was higher in the case of documented bacterial infection (P < 0.05). In the subgroup of viral exclusive infection, the mean age of severe cases was 2.0 years vs 3.8 years in mild and moderate cases (P < 0.05). These findings highlight the huge proportion of CAP of viral origin, the high number of co-infection by multiple viruses and the low number of bacterial CAP, notably in children under 5 years, and address the need to re-evaluate the indications of empiric antimicrobial treatment in this age group.
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影响因子：
3.1
作者：
Bellau-Pujol S;Vabret A;Legrand L;Dina J;Gouarin S;Petitjean-Lecherbonnier J;Pozzetto B;Ginevra C;Freymuth F
通讯作者：
Freymuth F
影响因子：
3.6
作者：
Cevey-Macherel M;Galetto-Lacour A;Gervaix A;Siegrist CA;Bille J;Bescher-Ninet B;Kaiser L;Krahenbuhl JD;Gehri M
通讯作者：
Gehri M
影响因子：
9.4
作者：
Ginevra, C;Barranger, C;Grattard, F
通讯作者：
Grattard, F
影响因子：
6.4
作者：
Fry, Alicia M.;Lu, Xiaoyan;Olsen, Sonja J.
通讯作者：
Olsen, Sonja J.
影响因子：
10
作者：
Lahti, E.;Peltola, V.;Ruuskanen, O.
通讯作者：
Ruuskanen, O.