title: Aetiology of community-acquired pneumonia: serological results of a paediatric survey.
abstract: Serological methods are routinely used in the diagnosis of viral and atypical bacterial respiratory infections. Recently, they have also been applied to typical bacteria, such as Streptococcus pneumoniae. The aim of this study was to determine the aetiology of paediatric community-acquired pneumonia (CAP) in both ambulatory and hospitalized patients, by using antibody assays. During a 15-month prospective surveillance, paired sera were studied for antibodies to 14 microbes in 101 children with symptoms of acute infection and infiltrates compatible with pneumonia on chest radiographs. A potential causative agent was detected in 66 (65%) patients. Evidence of bacterial, viral and mixed viral-bacterial infection was demonstrated in 44%, 42% and 20% of the CAP cases, respectively. The most commonly found agents included Mycoplasma pneumoniae (27%), Pneumococcus (18%) and respiratory syncytial virus (17%). Human metapneumovirus (hMPV) was detected in 5 (5%) children. Pneumococcal infections were evenly distributed among the age groups studied. Our results confirm the role of S. pneumoniae in paediatric CAP at all ages, those of M. pneumoniae at >2 y of age and emphasize the emerging role of hMPV. The high proportion of mixed viral-bacterial infections highlights the need to treat all children with CAP with antibiotics.
authors.affiliation: Department of Paediatrics, School of Medicine DPMSC, University of Udine, Udine, Italy. max.don@libero.it
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Don
authors.forename: Lolita
authors.initials: L
authors.lastname: Fasoli
authors.forename: Mika
authors.initials: M
authors.lastname: Paldanius
authors.forename: Raija
authors.initials: R
authors.lastname: Vainionpää
authors.forename: Marjaana
authors.initials: M
authors.lastname: Kleemola
authors.forename: Riitta
authors.initials: R
authors.lastname: Räty
authors.forename: Maija
authors.initials: M
authors.lastname: Leinonen
authors.forename: Matti
authors.initials: M
authors.lastname: Korppi
authors.forename: Alfred
authors.initials: A
authors.lastname: Tenore
authors.forename: Mario
authors.initials: M
authors.lastname: Canciani
mesh_terms: D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000209:etiology* / Q000382:microbiology / Q000821:virology; D003625:Data Collection; D005260:Female; D006801:Humans; D007223:Infant; D007558:Italy; D008297:Male; D011014:Pneumonia / Q000209:etiology* / Q000382:microbiology / Q000821:virology; D018410:Pneumonia, Bacterial / Q000209:etiology / Q000382:microbiology; D011024:Pneumonia, Viral / Q000209:etiology / Q000821:virology; D011446:Prospective Studies; D012698:Serologic Tests