Aetiology of community-acquired pneumonia in children treated in hospital

Eur J Pediatr. 1993 Jan;152(1):24-30. doi: 10.1007/BF02072512.


Viral and bacterial antigen and antibody assays were prospectively applied to study the microbial aetiology of community-acquired pneumonia in 195 hospitalised children during a surveillance period of 12 months. A viral infection alone was indicated in 37 (19%), a bacterial infection alone in 30 (15%) and a mixed viral-bacterial infection in 32 (16%) patients. Thus, 46% of the 69 patients with viral infection and 52% of the 62 patients with bacterial infection had a mixed viral and bacterial aetiology. Respiratory syncytial virus (RSV) was identified in 52 patients and Streptococcus pneumoniae in 41 patients. The next common agents in order were non-classified Haemophilus influenzae (17 cases), adenoviruses (10 cases) and Chlamydia species (8 cases). The diagnosis of an RSV infection was based on detecting viral antigen in nasopharyngeal secretions in 79% of the cases. Pneumococcal infections were in most cases identified by antibody assays; in 39% they were indicated by demonstrating pneumococcal antigen in acute phase serum. An alveolar infiltrate was present in 53 (27%) and an interstitial infiltrate in 108 (55%) of the 195 patients. The remaining 34 patients had probable pneumonia. C-reactive protein (CRP), erythrocyte sedimentation rate and total white blood cell count were elevated in 25%, 40% and 36% of the patients, respectively. CRP was more often elevated in patients with bacterial infection alone than in those with viral or mixed viral-bacterial infections. No other correlation was seen between the radiological or laboratory findings and serologically identified viral, bacterial or mixed viral-bacterial infections.(ABSTRACT TRUNCATED AT 250 WORDS)

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Bacteria / isolation & purification
  • Bacterial Infections / complications
  • Bacterial Infections / microbiology
  • Child
  • Child, Preschool
  • Hospitalization
  • Humans
  • Infant
  • Lung / diagnostic imaging
  • Pneumonia / diagnostic imaging
  • Pneumonia / etiology
  • Pneumonia / microbiology*
  • Pneumonia, Viral / diagnostic imaging
  • Pneumonia, Viral / etiology
  • Pneumonia, Viral / microbiology
  • Prospective Studies
  • Radiography
  • Virus Diseases / complications
  • Virus Diseases / microbiology
  • Viruses / isolation & purification