title: Characteristics of Streptococcus pneumoniae and atypical bacterial infections in children 2-5 years of age with community-acquired pneumonia.
abstract: 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.
authors.affiliation: Pediatric Department I, Istituto Ricerca e Cura a Carattere Scientifico Maggiore Hospital, University of Milan, 20122 Milan, Italy.
authors.forename: Susanna
authors.initials: S
authors.lastname: Esposito
authors.forename: Samantha
authors.initials: S
authors.lastname: Bosis
authors.forename: Roberta
authors.initials: R
authors.lastname: Cavagna
authors.forename: Nadia
authors.initials: N
authors.lastname: Faelli
authors.forename: Enrica
authors.initials: E
authors.lastname: Begliatti
authors.forename: Paola
authors.initials: P
authors.lastname: Marchisio
authors.forename: Francesco
authors.initials: F
authors.lastname: Blasi
authors.forename: Ciro
authors.initials: C
authors.lastname: Bianchi
authors.forename: Nicola
authors.initials: N
authors.lastname: Principi
mesh_terms: 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