Etiology of community-acquired pneumonia in hospitalized children in Northern Taiwan

Chih Jung Chen, Pen Yi Lin, Ming Han Tsai, Chung Guei Huang, Kuo Chien Tsao, Kin Sun Wong, Luan Yin Chang, Cheng Hsun Chiu, Tzou Yien Lin, Yhu Chering Huang

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

BACKGROUND: Pneumonia is the leading reason for hospitalization in children. The heptavalent pneumococcal conjugate vaccine was introduced in Taiwan in October 2005. There has been no comprehensive study of the etiology of childhood community-acquired pneumonia (CAP), either in the pre- or postpneumococcal conjugate vaccine era, in Taiwan. METHODS: From August 2001 to July 2002, consecutive children admitted to a teaching hospital with radiologically confirmed CAP were prospectively enrolled. The following were considered indicative of infection when positive: blood or pleural effusion bacterial culture or urinary Streptococcus pneumoniae antigen test (Binax NOW), direct immunofluorescent antigen test for Chlamydia species and viruses, virus isolation and identification and viral, mycoplasmal or chlamydial serologic tests. RESULTS: A total of 209 children were included, and 102 children (48.8%) were male. Patients' ages ranged from 7 months to 16 years with a median of 4 years and 3 months. The combined tests identified at least 1 etiologic agent in 85.6% of all cases, including typical bacterial pathogens in 88 cases (42.1%; 86 S. pneumoniae, 1 methicillin-resistant Staphylococcus aureus and 1 Mycobacterium tuberculosis), Mycoplasma pneumoniae in 77 cases (36.8%), Chlamydia species in 24 cases (11.5%), viral etiology in 86 cases (41.1%) and mixed viral-bacterial infections in 69 cases (33%). Children with S. pneumoniae infection were significantly younger than those with Mycoplasma pneumoniae infection (P = 0.0055) or unknown etiology (P = 0.0140). CONCLUSION: S. pneumoniae, Mycoplasma pneumoniae and viruses were equally common etiologic agents of childhood CAP in Taiwan. Frequent coinfection increased the difficulty of both predicting the responsible organisms and choosing empiric antibiotics for the management of pediatric CAP.

Original languageEnglish
JournalPediatric Infectious Disease Journal
Volume31
Issue number11
DOIs
Publication statusPublished - Nov 2012
Externally publishedYes

Fingerprint

Hospitalized Child
Taiwan
Pneumonia
Mycoplasma pneumoniae
Streptococcus pneumoniae
Chlamydia
Viruses
Pneumococcal Infections
Antigens
Conjugate Vaccines
Serologic Tests
Virus Diseases
Pleural Effusion
Methicillin-Resistant Staphylococcus aureus
Infection
Coinfection
Mycobacterium tuberculosis
Bacterial Infections
Teaching Hospitals
Hospitalization

Keywords

  • children
  • community-acquired pneumonia
  • etiology
  • Taiwan

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Infectious Diseases
  • Microbiology (medical)

Cite this

Chen, C. J., Lin, P. Y., Tsai, M. H., Huang, C. G., Tsao, K. C., Wong, K. S., ... Huang, Y. C. (2012). Etiology of community-acquired pneumonia in hospitalized children in Northern Taiwan. Pediatric Infectious Disease Journal, 31(11). https://doi.org/10.1097/INF.0b013e31826eb5a7

Etiology of community-acquired pneumonia in hospitalized children in Northern Taiwan. / Chen, Chih Jung; Lin, Pen Yi; Tsai, Ming Han; Huang, Chung Guei; Tsao, Kuo Chien; Wong, Kin Sun; Chang, Luan Yin; Chiu, Cheng Hsun; Lin, Tzou Yien; Huang, Yhu Chering.

In: Pediatric Infectious Disease Journal, Vol. 31, No. 11, 11.2012.

Research output: Contribution to journalArticle

Chen, CJ, Lin, PY, Tsai, MH, Huang, CG, Tsao, KC, Wong, KS, Chang, LY, Chiu, CH, Lin, TY & Huang, YC 2012, 'Etiology of community-acquired pneumonia in hospitalized children in Northern Taiwan', Pediatric Infectious Disease Journal, vol. 31, no. 11. https://doi.org/10.1097/INF.0b013e31826eb5a7
Chen, Chih Jung ; Lin, Pen Yi ; Tsai, Ming Han ; Huang, Chung Guei ; Tsao, Kuo Chien ; Wong, Kin Sun ; Chang, Luan Yin ; Chiu, Cheng Hsun ; Lin, Tzou Yien ; Huang, Yhu Chering. / Etiology of community-acquired pneumonia in hospitalized children in Northern Taiwan. In: Pediatric Infectious Disease Journal. 2012 ; Vol. 31, No. 11.
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abstract = "BACKGROUND: Pneumonia is the leading reason for hospitalization in children. The heptavalent pneumococcal conjugate vaccine was introduced in Taiwan in October 2005. There has been no comprehensive study of the etiology of childhood community-acquired pneumonia (CAP), either in the pre- or postpneumococcal conjugate vaccine era, in Taiwan. METHODS: From August 2001 to July 2002, consecutive children admitted to a teaching hospital with radiologically confirmed CAP were prospectively enrolled. The following were considered indicative of infection when positive: blood or pleural effusion bacterial culture or urinary Streptococcus pneumoniae antigen test (Binax NOW), direct immunofluorescent antigen test for Chlamydia species and viruses, virus isolation and identification and viral, mycoplasmal or chlamydial serologic tests. RESULTS: A total of 209 children were included, and 102 children (48.8{\%}) were male. Patients' ages ranged from 7 months to 16 years with a median of 4 years and 3 months. The combined tests identified at least 1 etiologic agent in 85.6{\%} of all cases, including typical bacterial pathogens in 88 cases (42.1{\%}; 86 S. pneumoniae, 1 methicillin-resistant Staphylococcus aureus and 1 Mycobacterium tuberculosis), Mycoplasma pneumoniae in 77 cases (36.8{\%}), Chlamydia species in 24 cases (11.5{\%}), viral etiology in 86 cases (41.1{\%}) and mixed viral-bacterial infections in 69 cases (33{\%}). Children with S. pneumoniae infection were significantly younger than those with Mycoplasma pneumoniae infection (P = 0.0055) or unknown etiology (P = 0.0140). CONCLUSION: S. pneumoniae, Mycoplasma pneumoniae and viruses were equally common etiologic agents of childhood CAP in Taiwan. Frequent coinfection increased the difficulty of both predicting the responsible organisms and choosing empiric antibiotics for the management of pediatric CAP.",
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