European Journal of Pediatrics

, Volume 168, Issue 12, pp 1429–1436

Etiology of community-acquired pneumonia in hospitalized children based on WHO clinical guidelines

  • Manon Cevey-Macherel
  • Annick Galetto-Lacour
  • Alain Gervaix
  • Claire-Anne Siegrist
  • Jacques Bille
  • Béatrice Bescher-Ninet
  • Laurent Kaiser
  • Jean-Daniel Krahenbuhl
  • Mario Gehri
Original Paper

DOI: 10.1007/s00431-009-0943-y

Cite this article as:
Cevey-Macherel, M., Galetto-Lacour, A., Gervaix, A. et al. Eur J Pediatr (2009) 168: 1429. doi:10.1007/s00431-009-0943-y
  • 917 Downloads

Abstract

Community-acquired pneumonia (CAP) is a major cause of death in developing countries and of morbidity in developed countries. The objective of the study was to define the causative agents among children hospitalized for CAP defined by WHO guidelines and to correlate etiology with clinical severity and surrogate markers. Investigations included an extensive etiological workup. A potential causative agent was detected in 86% of the 99 enrolled patients, with evidence of bacterial (53%), viral (67%), and mixed (33%) infections. Streptococcus pneumoniae was accounted for in 46% of CAP. Dehydration was the only clinical sign associated with bacterial pneumonia. CRP and PCT were significantly higher in bacterial infections. Increasing the number of diagnostic tests identifies potential causes of CAP in up to 86% of children, indicating a high prevalence of viruses and frequent co-infections. The high proportion of pneumococcal infections re-emphasizes the importance of pneumococcal immunization.

Keywords

Community-acquired pneumoniaChildWHO guidelinesPneumococcal infectionAntibioticImmunization

Abbreviations

CAP

Community-acquired pneumonia

WHO

World Health Organization

CRP

C-reactive protein

PCT

Procalcitonin

NPA

Nasopharyngeal aspirates

BTS

British Thoracic Society

NS

Nasopharyngeal swabs

WBC

White blood cell

URS

Upper respiratory symptoms

hMPV

Human metapneumovirus

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Manon Cevey-Macherel
    • 1
    • 6
  • Annick Galetto-Lacour
    • 2
  • Alain Gervaix
    • 2
  • Claire-Anne Siegrist
    • 3
  • Jacques Bille
    • 4
  • Béatrice Bescher-Ninet
    • 5
  • Laurent Kaiser
    • 5
  • Jean-Daniel Krahenbuhl
    • 1
  • Mario Gehri
    • 1
  1. 1.Child and Adolescent DepartmentLausanne University HospitalLausanneSwitzerland
  2. 2.Child and Adolescent DepartmentUniversity Hospital of GenevaGenevaSwitzerland
  3. 3.Center for Vaccine and Neonatal Immunology, Departments of Pediatrics and Pathology-ImmunologyUniversity of GenevaGenevaSwitzerland
  4. 4.Institute of MicrobiologyUniversity of LausanneLausanneSwitzerland
  5. 5.Central Laboratory of Virology, Division of Infectious Diseases and Faculty of MedicineUniversity Hospital of GenevaGenevaSwitzerland
  6. 6.Pediatric DepartmentLausanne University HospitalLausanneSwitzerland