Article Dans Une Revue Journal of Clinical Virology Année : 2014

Epidemiology and microbiological investigations of community-acquired pneumonia in children admitted at the emergency department of a university hospital

Résumé

Background: 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. Objectives: Evaluation of a diagnostic approach including multiplex PCR assays for revisiting the epidemiology and etiology of CAP in children at hospital. Study design: 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. Results: 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). Conclusions: 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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hal-04901046 , version 1 (20-01-2025)

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Aymeric Cantais, Olivier Mory, Sylvie Pillet, Paul Verhoeven, Julie Bonneau, et al.. Epidemiology and microbiological investigations of community-acquired pneumonia in children admitted at the emergency department of a university hospital. Journal of Clinical Virology, 2014, 60 (4), pp.402-407. ⟨10.1016/j.jcv.2014.05.006⟩. ⟨hal-04901046⟩
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