Necrotizing pneumonia caused by nanC-carrying serotypes is associated with pneumococcal haemolytic uraemic syndrome in children

R. P. Janapatla, M. H. Hsu, Y. C. Hsieh, H. Y. Lee, T. Y. Lin, C. H. Chiu

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Streptococcus pneumoniae infection is a leading cause of morbidity and mortality worldwide. One of the most severe complications of invasive pneumococcal disease (IPD) is haemolytic uraemic syndrome (HUS). This study was undertaken to determine the risk factors and role of pneumococcal neuraminidases in HUS in children with IPD. Eighteen cases of HUS and 54 patients with IPD without HUS were identified. The controls were patients with culture-confirmed IPD without HUS. Clinical and laboratory characteristics of the two groups of patients were compared. Bacterial isolates from both groups were serotyped, sequence typed and examined for their carriage of three neuraminidase genes. Necrotizing pneumonia and serotype 3 infection were significantly associated with HUS in children with IPD, suggesting that a severe pulmonary suppurating disease increase the risk of HUS. Serotype 14 was associated with necrotizing pneumonia but not HUS. Children with HUS were more likely to require surgery and had a longer duration of hospitalization. The study identified a significantly higher carriage of a neuraminidase gene, nanC, in the causative pneumococcal isolates from patients with HUS (89% versus 41%, p0.001). The sensitivity and specificity of nanC to predict HUS were 89% and 59%, respectively. In conclusion, necrotizing pneumonia, serotype 3 infection and neuraminidase gene nanC were associated with HUS in children with IPD. The result suggests that NanC could provide an additive effect to NanA and NanB in the overall activity of pneumococcal neuraminidases to expose Thomsen-Friedenreich antigen on various cells in patients with HUS.

Original languageEnglish
Pages (from-to)480-486
Number of pages7
JournalClinical Microbiology and Infection
Volume19
Issue number5
DOIs
Publication statusPublished - May 2013
Externally publishedYes

Fingerprint

Hemolytic-Uremic Syndrome
Neuraminidase
Serogroup
Necrotizing Pneumonia
Genes
Pneumococcal Infections
Infection
Lung Diseases
Hospitalization

Keywords

  • Haemolytic uraemic syndrome
  • Invasive pneumococcal disease
  • Necrotizing pneumonia
  • Neuraminidase
  • Streptococcus pneumoniae
  • Thomsen-Friedenreich antigen

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Necrotizing pneumonia caused by nanC-carrying serotypes is associated with pneumococcal haemolytic uraemic syndrome in children. / Janapatla, R. P.; Hsu, M. H.; Hsieh, Y. C.; Lee, H. Y.; Lin, T. Y.; Chiu, C. H.

In: Clinical Microbiology and Infection, Vol. 19, No. 5, 05.2013, p. 480-486.

Research output: Contribution to journalArticle

Janapatla, R. P. ; Hsu, M. H. ; Hsieh, Y. C. ; Lee, H. Y. ; Lin, T. Y. ; Chiu, C. H. / Necrotizing pneumonia caused by nanC-carrying serotypes is associated with pneumococcal haemolytic uraemic syndrome in children. In: Clinical Microbiology and Infection. 2013 ; Vol. 19, No. 5. pp. 480-486.
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abstract = "Streptococcus pneumoniae infection is a leading cause of morbidity and mortality worldwide. One of the most severe complications of invasive pneumococcal disease (IPD) is haemolytic uraemic syndrome (HUS). This study was undertaken to determine the risk factors and role of pneumococcal neuraminidases in HUS in children with IPD. Eighteen cases of HUS and 54 patients with IPD without HUS were identified. The controls were patients with culture-confirmed IPD without HUS. Clinical and laboratory characteristics of the two groups of patients were compared. Bacterial isolates from both groups were serotyped, sequence typed and examined for their carriage of three neuraminidase genes. Necrotizing pneumonia and serotype 3 infection were significantly associated with HUS in children with IPD, suggesting that a severe pulmonary suppurating disease increase the risk of HUS. Serotype 14 was associated with necrotizing pneumonia but not HUS. Children with HUS were more likely to require surgery and had a longer duration of hospitalization. The study identified a significantly higher carriage of a neuraminidase gene, nanC, in the causative pneumococcal isolates from patients with HUS (89{\%} versus 41{\%}, p0.001). The sensitivity and specificity of nanC to predict HUS were 89{\%} and 59{\%}, respectively. In conclusion, necrotizing pneumonia, serotype 3 infection and neuraminidase gene nanC were associated with HUS in children with IPD. The result suggests that NanC could provide an additive effect to NanA and NanB in the overall activity of pneumococcal neuraminidases to expose Thomsen-Friedenreich antigen on various cells in patients with HUS.",
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