Characteristics of Streptococcus pneumoniae and atypical bacterial infections in children 2-5 years of age with community-acquired pneumonia.
The characteristics of community-acquired pneumonia associated with Streptococcus pneumoniae infection were compared with those associated with atypical bacterial infection and with mixed S. pneumoniae-atypical bacterial infection in 196 children aged 2-5 years. S. pneumoniae infections were diagnosed in 48 patients (24.5%); atypical bacterial infections, in 46 (23.5%); and mixed infections, in 16 (8.2%). Although white blood cell counts and C-reactive protein levels were higher in patients with pneumococcal infections, no other clinical, laboratory, or radiographic characteristic was significantly correlated with the different etiologic diagnoses. There was no significant difference in the efficacy of the different treatment regimens followed by children with S. pneumoniae infection, whereas clinical failure occurred significantly more frequently among children with atypical bacterial or mixed infection who were not treated with a macrolide. This study shows the major role of both S. pneumoniae and atypical bacteria in the development of community-acquired pneumonia in young children, the limited role of clinical, laboratory, and radiological features in predicting etiology, and the importance of the use of adequate antimicrobial agents for treatment.
Esposito
Susanna
S
Pediatric Department I, Istituto Ricerca e Cura a Carattere Scientifico Maggiore Hospital, University of Milan, 20122 Milan, Italy.
Bosis
Samantha
S
Cavagna
Roberta
R
Faelli
Nadia
N
Begliatti
Enrica
E
Marchisio
Paola
P
Blasi
Francesco
F
Bianchi
Ciro
C
Principi
Nicola
N
D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000382:microbiology*; D005260:Female; D006801:Humans; D008297:Male; D011008:Pneumococcal Infections / Q000000981:diagnostic imaging / Q000276:immunology* / Q000378:metabolism / Q000503:physiopathology; D018410:Pneumonia, Bacterial / Q000000981:diagnostic imaging / Q000276:immunology* / Q000378:metabolism / Q000503:physiopathology; D011859:Radiography; D013296:Streptococcus pneumoniae