DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20201642

A study to assess the prevalence of atypical organisms in pneumonia in children aged 1 month to 3 years by serum polymerase chain reaction in KIMS Hospital, Bangalore, India

H. S. Ramya, Anjana Gopi, Vivetha Elango

Abstract


Background: Atypical organisms are a common causative agent of pneumonia in children more than 3 years of age. Though atypical pathogens are said to cause relatively milder form of pneumonia severe manifestations can also occur.  Very few studies are available on the prevalence of atypical pneumonia in children less than 3 years. Hence in this study the prevalence of atypical organisms in pneumonia was identified by using serum Polymerase chain reaction (PCR).

Methods: This is a prospective observational study conducted in children between 1 month to 3 years of age with clinical diagnosis of pneumonia admitted in wards and PICU in KIMS hospital. Authors excluded Immuno compromised children. Detailed history and clinical examination was done. Investigations - complete hemogram, Chest X-ray, blood Culture and sensitivity and serum PCR was done for a sample size of 50 children.

Results: Among the three atypical organisms, Legionella pneumoniae was identified in 4% (2/50) cases by serum PCR.

Conclusions: In this study it was found that the prevalence of 4%. Legionella pneumonia can be fatal in 10% of cases. Hence atypical pathogens like Legionella should be kept in mind even in children less than 3 years when pneumonia is not responding to beta lactam antibiotics, in such cases macrolides to be considered.


Keywords


Atypical pneumonia, Legionella, Less than 3 years, Polymerase chain reaction

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References


Mathai E, Padmavathy K, Cherian T, Inba-malar U, Varki S. Mycoplasma pneumoniae antibodies in children with acute respiratory infection. Indian Pediatr. 2001;38:157-60.

Salaria M, Singh M. Atypical pneumonia in children. Indian Pediatr. 2002;39:259-66.

Daniel SA, Stylianakis A, Papoutsi AI, Zorbas A. Papa AE Larnbropoulos. Application of polymerase chain reaction for detection of Legionella pneumophila in serum PCR. J Clin Microbiol. 2016 Feb;54(2):401-11.

Daxboeck F, Khanakah G, Bauer C, Stadler M, Hofmann H, Stanek G. Detection of Mycoplasma pneumoniae in serum specimens from patients with mycoplasma pneumonia by PCR. Inter J Med Microbiol. 2005 Aug 22;295(4):279-85.

Witte L, Droemann D, Dalhoff K, Rupp K. Chlamydia pneumoniae is frequently detected in the blood after acute lung infection. Eur Resp J. 2011 37:712-4.

Hindiyeh M, Caroll KC. Laboratory diagnosis of atupical pneumonia. Semin Respir Infect. 2000 Jun;15:101-13.

Hicks LA, Rose CE, Fields BS, Drees ML, Engel JP, Jenkins PR, et al. Increased rainfall is associated with increased risk for legionellosis. Epidemiol Infect. 2007;135(5):811-7.

Cunha BA. Atypical pneumonias. In: Conn, RB, Borer, WZ, Snyder, JW, eds. Current Diagnosis 9. Philadelphia: WB Saunders; 1996.

Neil K, Berkelman R. Increasing Incidence of Legionellosis in the United States, 1990-2005: Changing Epidemiologic Trends. Clin Infect Dis. 2008;47(5):591-9.

Alexander NT, Fields BS, Hicks LA. Epidemiology of reported pediatric legionnaires' disease in the United States, 1980-2004. Washington D.C. Presented at 48th Interscience Conference on Antimicrobial Agents and Chemotherapy. 2008.