The Etiology of Pneumonia From Analysis of Lung Aspirate and Pleural Fluid Samples: Findings From the Pneumonia Etiology Research for Child Health (PERCH) Study

Abstract Background An improved understanding of childhood pneumonia etiology is required to inform prevention and treatment strategies. Lung aspiration is the gold standard specimen for pneumonia diagnostics. We report findings from analyses of lung and pleural aspirates collected in the Pneumonia...

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Veröffentlicht in:Clinical infectious diseases Jg. 73; H. 11; S. e3788 - e3796
Hauptverfasser: Ebruke, Bernard E, Deloria Knoll, Maria, Haddix, Meredith, Zaman, Syed M A, Prosperi, Christine, Feikin, Daniel R, Hammitt, Laura L, Levine, Orin S, O’Brien, Katherine L, Murdoch, David R, Brooks, W Abdullah, Scott, J Anthony G, Kotloff, Karen L, Madhi, Shabir A, Thea, Donald M, Baillie, Vicky L, Chisti, Mohammod Jobayer, Dione, Michel, Driscoll, Amanda J, Fancourt, Nicholas, Karron, Ruth A, Le, Tham T, Mohamed, Shebe, Moore, David P, Morpeth, Susan C, Mwaba, John, Mwansa, James, Bin Shahid, Abu Sadat Mohammad Sayeem, Sow, Samba O, Tapia, Milagritos D, Antonio, Martin, Howie, Stephen R C
Format: Journal Article
Sprache:Englisch
Veröffentlicht: US Oxford University Press 06.12.2021
Schlagworte:
Animals
Bayes Theorem
Case-Control Studies
Child
Child Health
Child, Preschool
Developing Countries
Humans
Infant
Lung
Patient Acuity
Perches
Pneumonia - diagnosis
Pneumonia - etiology
Pneumonia - prevention & control
Risk Factors
Staphylococcus aureus
lung aspirate
etiology childhood
pneumonia
PERCH
pleural fluid aspirate
ISSN:1058-4838, 1537-6591, 1537-6591
Online-Zugang:Volltext
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Zusammenfassung:Abstract Background An improved understanding of childhood pneumonia etiology is required to inform prevention and treatment strategies. Lung aspiration is the gold standard specimen for pneumonia diagnostics. We report findings from analyses of lung and pleural aspirates collected in the Pneumonia Etiology Research for Child Health (PERCH) study. Methods The PERCH study enrolled children aged 1–59 months hospitalized with World Health Organization–defined severe or very severe pneumonia in 7 countries in Africa and Asia. Percutaneous transthoracic lung aspiration (LA) and pleural fluid (PF) aspiration was performed on a sample of pneumonia cases with radiological consolidation and/or PF in 4 countries. Venous blood and nasopharyngeal/oropharyngeal swabs were collected from all cases. Multiplex quantitative polymerase chain reaction (PCR) and routine microbiologic culture were applied to clinical specimens. Results Of 44 LAs performed within 3 days of admission on 622 eligible cases, 13 (30%) had a pathogen identified by either culture (5/44) or by PCR (11/29). A pathogen was identified in 12/14 (86%) PF specimens tested by either culture (9/14) or PCR (9/11). Bacterial pathogens were identified more frequently than viruses. All but 1 of the cases with a virus identified were coinfected with bacterial pathogens. Streptococcus pneumoniae (9/44 [20%]) and Staphylococcus aureus (7/14 [50%]) were the predominant pathogens identified in LA and PF, respectively. Conclusions Bacterial pathogens predominated in this selected subgroup of PERCH participants drawn from those with radiological consolidation or PF, with S. pneumoniae and S. aureus the leading pathogens identified. Lung aspiration (LA) and pleural fluid (PF) aspiration were performed on a subgroup of PERCH pneumonia cases with radiological consolidation or PF collection. Bacterial pathogens predominated (Streptococcus pneumoniae in LA, Staphylococcus aureus in PF), in contrast to overall PERCH findings.
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
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ISSN:1058-4838
1537-6591
1537-6591
DOI:10.1093/cid/ciaa1032