Email this article Clinical spectrum of pneumonia in children aged 1 month to 18 years by serum polymerase chain reaction, in a tertiary care centre in Bengaluru, Karnataka, India
Abstract
Background: Pneumonia accounts for 15% all deaths in children under 5 years of age, being the single largest infectious cause of deaths in children worldwide according to WHO. Establishing the exact etiological factor is a difficult task, as there are no definite clinical, radiological markers to differentiate between causative organisms. Hence by detecting the genetic material of causative organism by serum PCR (polymerase chain reaction) and correlating it with the clinical and radiological features can help in appropriate use with antibiotics.
Methods: It is a observational study conducted in department of paediatrics KIMS hospital Bangalore, India which included inpatients admitted with clinical and radiological features of pneumonia over a study period from February 2018-April2019 .In this study we excluded immunocompromised children . After obtaining informed written consent, detailed history and clinical examination was done. Investigations including complete hemogram, CXR were done. Under sterile precautions, blood samples for serum PCR and blood culture and sensitivity were obtained. Serum PCR was done for a panel of 33 respiratory pathogens.
Results: Etiological agents were identified in 63% of cases. Streptococcus pneumoniae was the most common causartive agent being detected in 50.6% of the cases. Staphylococcus aureus has been detected to be the second common organism 16%.
Conclusions: In our study Pneumococci was identified in 50.6% of cases. Multiplex serum PCR could be a useful rapid diagnostic tool to identify the etiological agents. Introduction of pneumococcal vaccine worldwide in government immunization schedule, nationwide will help to reduce the disease burden caused by Streptococcus pneumoniae.
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UNICEF. Pneumonia in children. Available at: https://data.unicef.org/topic/child-health/pneumonia Accessed 24 February 2020.
Troeger C. Estimates of the global, regional and national morbidity, mortality and etiologies of lower respiratory infections in 195 countries,1990-2016:a systematic analysis for the global burden of disease study. Lancet Infect Dis. 2018;18:1191-210.
Davis HD. Community-acquired pneumonia in children. Paediatr Child Health. 2003;8(10):616-9.
Turner RB, Lande AE, Chase P. Pneumonia in pediatric outpatients: Cause and clinical manifestations. J Pediatr. 1987;111:194-200.
Heiskanen-Kosma T, Korppi M, Jokinen C. Etiology of childhood pneumonia: Serologic results of a prospective, population based study. Pediatr Infect Dis J. 1998;17:986-91.
Isaacs D. Problems in determining the etiology of community-acquired childhood pneumonia. Pediatr Infect Dis J. 1989;8:143-8.
Cvitkovic Spik V, Beovic B, Pokorn M, Drole Torkar A, Vidmar D, Papst L, et al. Improvement of pneumococcal pneumonia diagnostics by the use of rt-PCR on plasma and respiratory samples. Scand J Infect Dis. 2013 Oct 1;45(10):731-7.
Moïsi JC, Moore M, Carvalho MDG, Sow SO. Enhanced Diagnosis of Pneumococcal Bacteremia Using Antigen- and Molecular-Based Tools on Blood Specimens in Mali and Thailand: A Prospective Surveillance Study. Am J Trop Med Hyg. 2016 Feb;94(2):267-75.
Harris M, Clark J, Coote N, Fletcher P, Harnden A, McKean M, et al. British Thoracic Society guidelines for the management of community acquired pneumonia in children: update 2011. Thorax. 2011 Oct 1;66(Suppl 2):ii1-23.
Bogeart D, De Groot R, Hermans PW. Streptococcus pneumoniae colonization: the key to pneumococcal disease. Lancet Infect Dis. 2004;4:144-54.
Bjarnason A, Westin J, Lindh M, Andersson LM, Kristinsson KG, Löve A, et al. Incidence, etiology, and outcomes of community-acquired pneumonia: a population-based study. In Open Forum Infect Dis. 2018;5:1-9.
