A1 Vertaisarvioitu alkuperäisartikkeli tieteellisessä lehdessä
Etiology of Clinical Community-Acquired Pneumonia in Swedish Children Aged 1-59 Months with High Pneumococcal Vaccine Coverage-The TREND Study
Tekijät: Eklundh Annika, Rhedin Samuel, Ryd-Rinder Malin, Andersson Maria, Gantelius Jesper, Gaudenzi Giulia, Lindh Magnus, Peltola Ville, Waris Matti, Nauclér Pontus, Mårtensson Andreas, Alfvén Tobias
Kustantaja: MDPI
Julkaisuvuosi: 2021
Journal: Vaccines
Tietokannassa oleva lehden nimi: VACCINES
Lehden akronyymi: VACCINES-BASEL
Artikkelin numero: ARTN 384
Vuosikerta: 9
Numero: 4
Sivujen määrä: 12
eISSN: 2076-393X
DOI: https://doi.org/10.3390/vaccines9040384
Verkko-osoite: https://doi.org/10.3390/vaccines9040384
Rinnakkaistallenteen osoite: https://research.utu.fi/converis/portal/detail/Publication/56782269
(1) Immunization with pneumococcal conjugate vaccines has decreased the burden of community-acquired pneumonia (CAP) in children and likely led to a shift in CAP etiology. (2) The Trial of Respiratory infections in children for ENhanced Diagnostics (TREND) enrolled children 1-59 months with clinical CAP according to the World Health Organization (WHO) criteria at Sachs' Children and Youth Hospital, Stockholm, Sweden. Children with rhonchi and indrawing underwent "bronchodilator challenge". C-reactive protein and nasopharyngeal PCR detecting 20 respiratory pathogens, were collected from all children. Etiology was defined according to an a priori defined algorithm based on microbiological, biochemical, and radiological findings. (3) Of 327 enrolled children, 107 (32%) required hospitalization; 91 (28%) received antibiotic treatment; 77 (24%) had a chest X-ray performed; and 60 (18%) responded to bronchodilator challenge. 243 (74%) episodes were classified as viral, 11 (3%) as mixed viral-bacterial, five (2%) as bacterial, two (0.6%) as atypical bacterial and 66 (20%) as undetermined etiology. After exclusion of children responding to bronchodilator challenge, the proportion of bacterial and mixed viral-bacterial etiology was 1% and 4%, respectively. (4) The novel TREND etiology algorithm classified the majority of clinical CAP episodes as of viral etiology, whereas bacterial etiology was uncommon. Defining CAP in children <5 years is challenging, and the WHO definition of clinical CAP is not suitable for use in children immunized with pneumococcal conjugate vaccines.
Ladattava julkaisu This is an electronic reprint of the original article. |  |
