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Spectrum of pathogens of in-patient children and youths with community acquired pneumonia: a 3 year survey of a community hospital in Vienna, Austria

Das Keimspektrum bei stationär aufgenommenen Kindern und Jugendlichen mit „Community Acquired Pneumonia“ – eine Untersuchung über 3 Jahre in einem Schwerpunktkrankenhaus in Wien, Österreich

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Summary

Background

No actual data are available on the epidemiology and morbidity of community acquired pneumonia (CAP) in youths and children in Vienna, Austria.

Objective

The objective was to determine the epidemiology of CAP and morbidity of children hospitalized due to CAP in a tertiary care facility.

Methods

During three winter seasons youths and children hospitalized due to CAP were enrolled. Testing for viral and bacterial pathogens of pneumonia was performed in a routine clinical setting. Blood cultures were performed; respiratory viruses, Mycoplasma pneumoniae and Chlamydia pneumoniae were searched for by an established Real Time polymerase chain reaction (PCR) panel. Clinical signs and indices of inflammation were documented.

Results

Out of 279 children and youths with CAP a causative agent could be detected in 190 (68 %). Viruses and bacteria were diagnosed in 107 (57 %) and 58 patients (30 %), respectively. Co-infection was found in 20 patients (10 %), Mycoplasma pneumoniae or Clamydia pneumoniae in 16 cases (8 %).

In seven patients blood cultures were positive. C-reactive protein (CRP) was significantly higher in children with positive Streptococcus pneumoniae antigen (SPAG) than with viral infection and/or co-infection. Clinical parameters showed no statistically significant differences. C. pneumoniae and M. pneumoniae were only diagnosed in children and youths with 5 years and older.

Conclusions

Testing for pathogens in CAP in clinical routine achieves a high recovery rate. Blood cultures are rarely helpful, but the molecular testing for viruses seemed to be helpful to establish the diagnosis.

Zusammenfassung

Grundlagen

Es gibt keine aktuellen Daten über Epidemiologie und Morbidität von Kindern und Jugendlichen mit „Community Acquired Pneumonia“ (CAP) aus Wien, Österreich.

Ziel

Das Ziel der Studie war, Daten über Epidemiologie und Morbidität von Kindern zu gewinnen, die wegen CAP in einem Tertiärspital stationär aufgenommen waren.

Methodik

Während dreier Wintersaisonen wurden Kinder und Jugendliche in die Studie aufgenommen, die wegen CAP stationär waren. Im Rahmen der klinischen Routine wurden Tests auf Viren und Bakterien gemacht. Blutkulturen wurden abgenommen und mit Hilfe eines PCR Panels wurden respiratorische Viren, Mykoplasmen und Chlamydien gesucht. Symptome und Entzündungsparameter wurden dokumentiert.

Ergebnisse

Von 279 Kindern und Jugendlichen mit CAP wurde bei 190 (68 %) ein auslösendes Agens gefunden. Viren wurden bei 107 Patienten (57 %), Bakterien bei 58 (30 %) nachgewiesen, Koinfektionen bei 20 Patienten (10 %), Mykoplasmen oder Chlamydien in 16 (8 %) Fällen. Bei sieben Patienten war die Blutkultur positiv. C-reaktives Protein (CRP) war bei Kindern mit positivem Pneumokokken-Antigentest signifikant höher als bei jenen mit viralen Infekten und/oder Koinfektion. Klinische Parameter unterschieden sich nicht signifikant. Chlamydia pneumoniae und Mycoplasma pneumoniae wurden nur bei Kindern und Jugendlichen über 5 Jahre diagnostiziert.

Schlussfolgerungen

Die Suche nach Keimen bei CAP kann im klinischen Routinebetrieb eine hohe Ausbeute bringen. Blutkulturen sind kaum hilfreich, aber die molekulare Testung auf Viren lässt häufig eine Diagnose stellen.

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Conflict of interest

All Authors declare that there are no conflicts of interest, there was no funding.

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Authors and Affiliations

  1. Department of Paediatrics, SMZ Ost Danube Hospital Vienna, Langobardenstraße 122, 1220, Vienna, Austria

    Herbert Kurz MD & Hubert Göpfrich MD

  2. Department of Laboratory Medicine, Danube Hospital Vienna, Vienna, Austria

    Klaus Huber PhD & Walter Krugluger MD

  3. Department of Pathology, Danube Hospital Vienna, Vienna, Austria

    Friederike Asbott MD

  4. Department of Clinical Microbiology, Institute of Hygiene and Medical Microbiology; Medical University Vienna, Vienna, Austria

    Leila Wabnegger PhD & Petra Apfalter MD

  5. Department of Internal Medicine, Danube Hospital Vienna, Vienna, Austria

    Christian Sebesta MD

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  1. Herbert Kurz MD
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  2. Hubert Göpfrich MD
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  3. Klaus Huber PhD
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  4. Walter Krugluger MD
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  5. Friederike Asbott MD
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  6. Leila Wabnegger PhD
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  7. Petra Apfalter MD
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  8. Christian Sebesta MD
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Correspondence to Herbert Kurz MD.

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Kurz, H., Göpfrich, H., Huber, K. et al. Spectrum of pathogens of in-patient children and youths with community acquired pneumonia: a 3 year survey of a community hospital in Vienna, Austria. Wien Klin Wochenschr 125, 674–679 (2013). https://doi.org/10.1007/s00508-013-0426-z

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  • DOI: https://doi.org/10.1007/s00508-013-0426-z

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