Department of Paediatrics, SMZ Ost Danube Hospital Vienna, Langobardenstraße 122, 1220, Vienna, Austria,
Wien Klin Wochenschr. 2013 Nov;125(21-22):674-9. doi: 10.1007/s00508-013-0426-z. Epub 2013 Oct 1.
No actual data are available on the epidemiology and morbidity of community acquired pneumonia (CAP) in youths and children in Vienna, Austria.
The objective was to determine the epidemiology of CAP and morbidity of children hospitalized due to CAP in a tertiary care facility.
During three winter seasons youths and children hospitalized due to CAP were enrolled. Testing for viral and bacterial pathogens of pneumonia was performed in a routine clinical setting. Blood cultures were performed; respiratory viruses, Mycoplasma pneumoniae and Chlamydia pneumoniae were searched for by an established Real Time polymerase chain reaction (PCR) panel. Clinical signs and indices of inflammation were documented.
Out of 279 children and youths with CAP a causative agent could be detected in 190 (68 %). Viruses and bacteria were diagnosed in 107 (57 %) and 58 patients (30 %), respectively. Co-infection was found in 20 patients (10 %), Mycoplasma pneumoniae or Clamydia pneumoniae in 16 cases (8 %). In seven patients blood cultures were positive. C-reactive protein (CRP) was significantly higher in children with positive Streptococcus pneumoniae antigen (SPAG) than with viral infection and/or co-infection. Clinical parameters showed no statistically significant differences. C. pneumoniae and M. pneumoniae were only diagnosed in children and youths with 5 years and older.
Testing for pathogens in CAP in clinical routine achieves a high recovery rate. Blood cultures are rarely helpful, but the molecular testing for viruses seemed to be helpful to establish the diagnosis.
在奥地利维也纳,尚无有关社区获得性肺炎(CAP)在青少年和儿童中的流行病学和发病率的实际数据。
目的是确定 CAP 的流行病学以及在三级医疗机构因 CAP 住院的儿童的发病率。
在三个冬季季节中,因 CAP 住院的青少年和儿童均被纳入研究。在常规临床环境中进行肺炎的病毒和细菌病原体检测。进行血培养;通过已建立的实时聚合酶链反应(PCR)检测试剂盒检测呼吸道病毒、肺炎支原体和肺炎衣原体。记录临床体征和炎症指标。
在 279 名患有 CAP 的儿童和青少年中,190 名(68%)可检测到病原体。在 107 名(57%)和 58 名患者(30%)中分别诊断出病毒和细菌感染。20 名患者(10%)存在合并感染,16 名患者(8%)检测出肺炎支原体或肺炎衣原体。在 7 名患者的血培养中呈阳性。与病毒感染和/或合并感染相比,具有阳性肺炎链球菌抗原(SPAG)的儿童的 C 反应蛋白(CRP)显著更高。临床参数无统计学差异。仅在 5 岁及以上的儿童和青少年中诊断出 C. pneumoniae 和 M. pneumoniae。
在临床常规中检测 CAP 的病原体可获得较高的恢复率。血培养很少有帮助,但病毒的分子检测似乎有助于确立诊断。