DENVER — Pediatric community-acquired pneumonia is frequently associated with rhinoviruses, particularly type A, according to data presented here at the 2013 Interscience Conference on Antimicrobial Agents and Chemotherapy.
“Identification of etiology is critical for the definition of the best antimicrobial therapy for [community-acquired pneumonia (CAP)],” Susanna Esposito, MD, of the University of Milan, and colleagues wrote. “The main aim of this study was to evaluate whether nasopharyngeal pneumococcal colonization can be considered the expression of a mixed infection in children with alveolar CAP and detected [respiratory syncytial virus] or [rhinovirus].”
The study included 126 children positive for RSV and 134 positive for rhinovirus. Nasopharyngeal swabs were collected from all of the participants.
Researchers found Streptococcus pneumoniae in 51.6% of participants with RSV and 61.9% with rhinovirus. The different strains of rhinovirus present were: A (51.6%), B (9.3%) and C (39.1%). Types A78 (n=17), A12 (n=9) and C2 (n=5) were the most frequently detected. Participants with alveolar CAP had higher bacterial load mean values compared with those without (RSV, P=.04; rhinovirus, P=.03).
“Our findings suggest that in children with RSV or [rhinovirus] infection alveolar CAP was significantly associated with a higher nasopharyngeal pneumococcal load than non-alveolar CAP,” researchers wrote. “On the basis of these results, or data support the hypothesis that alveolar CAP in [S. pneumoniae]-colonized children with RSV or [rhinovirus] infection may indicate a mixed infection and require antibiotic administration when the bacterial load is high. Some of the pneumococcal serotypes included in PCV13 were detected more frequently in patients with alveolar CAP. These data increase our knowledge on the frequency and clinical relevance of mixed infection in pediatrics.”
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Disclosure: The researchers report no relevant financial disclosures.