Cases of community-acquired pneumonia were most commonly the result of viral infections, particularly respiratory syncytial virus, among children and adolescents in a heavily vaccinated population, according to recent findings in the Pediatric Infectious Disease Journal.
“Our main objective was to identify the contribution of various microbiological species that causes pneumonia in previously healthy children and adolescents,” Are Stuwitz Berg, MD, of the department of pediatric and adolescent medicine at Akershus University Hospital in Norway, and colleagues wrote. “We found a high proportion of viral etiology and a low proportion of bacterial etiology in this prospective study of radiologically confirmed community-acquired pneumonia in a pediatric population with a high vaccination rate for pneumococci.”
In the prospective, observational study, researchers formed a cohort of 265 children and adolescents aged younger than 18 years with clinical and radiological signs of pneumonia. The researchers tested nasopharyngeal samples, paired sera and cultures from blood and pleura to determine the viral or bacterial causative pathogens. The study was conducted at a single pediatric center with in- and outpatients from 2012 to 2014.
The researchers wrote that 84.9% of the cohort had received pneumococcal vaccine. Causative pathogens were confirmed for 84.2% of study participants. Among them, single viral etiology was confirmed for 63.4% patients, atypical bacteria confirmed for 7.9%, and other mixed or single bacteria were confirmed for 12.8%. More than 40% of cases were caused by RSV among all age groups. While RSV was the dominant cause in children aged younger than 5 years, Mycoplasma pneumonia bacteria were the primary cause in children aged older than 5 years.
The researchers noted that cases of multiple viral causative pathogens among a single patient were higher in this study (24.5%) than other community-acquired pneumonia studies.
“We hope that our results may contribute to improved community-acquired pneumonia management guidelines and eventually reduce antibiotic overuse in areas where widespread pneumococcal vaccination is provided,” Berg and colleagues wrote. “The low pneumococcal burden may reflect the success of widespread pneumococcal vaccination, and the high viral burden points to the development of viral vaccines and therapy for future reduction in the substantial morbidity due to pneumonia in the pediatric population.” – by David Costill
Disclosure: The researchers report no relevant financial disclosures.