ABSTRACT
Background: Atypical organisms are a common causative agent of pneumonia in children more than 3 years of age, causing around 10-30% of the cases. Though atypical pathogens are said to cause relatively milder form of pneumonia as compared to other bacterial and viral pathogens, severe manifestations can also occur. Early identification of these pathogens can help in starting treatment with macrolides, which can reduce the length of hospital stay and mortality. Hence in this study the prevalence of atypical organisms was identified by using serum Polymerase chain reaction (PCR).Methods: This was a prospective observational study conducted in children between 3 years to 18 years of age with clinical diagnosis of pneumonia admitted in wards and PICU in KIMS hospital. Authors excluded Immunocompromised children. Detailed history and clinical examination was done. Investigations - complete hemogram, Chest Xray, blood Culture and sensitivity and serum PCR was done for a sample size of 100 children.Results: In this study among the three atypical organisms, Legionella pneumoniae was identified in 2% of the cases by serum PCR.Conclusions: In this study among the three atypical pathogens authors could only identify Legionella pneumoniae. Prevalence of Legionella pneumoniae was 2%. While treating children aged 3 years to 18 years with pneumonia, a high degree of suspicion of atypical pathogens is required, especially in Legionella because of its high mortality rate. In such circumstances adding macrolides along with other antibiotics will be beneficial to the patients outcome and duration of hospital stay.
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.
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.