Infection by Streptococcus pneumoniae in children with or without radiologically confirmed pneumonia
Objective: Community‐acquired pneumonia is an important cause of morbidity in childhood, but the detection of its causative agent remains a diagnostic challenge. The authors aimed to evaluate the role of the chest radiograph to identify cases of community‐aquired pneumonia caused by typical bacteria...
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doaj-66d1de1603b4429e90273871e4320b062020-11-25T01:23:53ZporElsevierJornal de Pediatria (Versão em Português)2255-55362018-01-01941233010.1016/j.jpedp.2017.06.008Infection by Streptococcus pneumoniae in children with or without radiologically confirmed pneumoniaDafne C. Andrade0Igor C. Borges1Ana Luísa Vilas‐Boas2Maria S.H. Fontoura3César A. Araújo‐Neto4Sandra C. Andrade5Rosa V. Brim6Andreas Meinke7Aldina Barral8Olli Ruuskanen9Helena Käyhty10Cristiana M. Nascimento‐Carvalho11Universidade Federal da Bahia (UFBA), Faculdade de Medicina, Programa de Pós‐Graduação em Ciências da Saúde, Salvador, BA, BrasilUniversidade Federal da Bahia (UFBA), Faculdade de Medicina, Programa de Pós‐Graduação em Ciências da Saúde, Salvador, BA, BrasilUniversidade Federal da Bahia (UFBA), Faculdade de Medicina, Programa de Pós‐Graduação em Ciências da Saúde, Salvador, BA, BrasilUniversidade Federal da Bahia (UFBA), Faculdade de Medicina, Departamento de Pediatria, Salvador, BA, BrasilUniversidade Federal da Bahia (UFBA), Faculdade de Medicina, Departamento de Medicina Interna e Apoio Diagnóstico, Salvador, BA, BrasilUniversidade Federal da Bahia (UFBA), Complexo Hospitalar Professor Edgard Santos (Hupes), Salvador, BA, BrasilUniversidade Federal da Bahia (UFBA), Faculdade de Medicina, Departamento de Medicina Interna e Apoio Diagnóstico, Salvador, BA, BrasilValneva Austria GmbH, Campus Vienna Biocenter 3, Viena, ÁustriaUniversidade Federal da Bahia (UFBA), Faculdade de Medicina, Departamento de Patologia, Salvador, BA, BrasilTurku University and University Hospital, Department of Pediatrics, Turku, FinlândiaNational Institute for Health and Welfare, Helsinque, FinlândiaUniversidade Federal da Bahia (UFBA), Faculdade de Medicina, Programa de Pós‐Graduação em Ciências da Saúde, Salvador, BA, BrasilObjective: Community‐acquired pneumonia is an important cause of morbidity in childhood, but the detection of its causative agent remains a diagnostic challenge. The authors aimed to evaluate the role of the chest radiograph to identify cases of community‐aquired pneumonia caused by typical bacteria. Methods: The frequency of infection by Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis was compared in non‐hospitalized children with clinical diagnosis of community acquired pneumonia aged 2‐59 months with or without radiological confirmation (n = 249 and 366, respectively). Infection by S. pneumoniae was diagnosed by the detection of a serological response against at least one of eight pneumococcal proteins (defined as an increase ≥2‐fold in the IgG levels against Ply, CbpA, PspA1 and PspA2, PhtD, StkP‐C, and PcsB‐N, or an increase ≥1.5‐fold against PcpA). Infection by H. influenzae and M. catarrhalis was defined as an increase ≥2‐fold on the levels of microbe‐specific IgG. Results: Children with radiologically confirmed pneumonia had higher rates of infection by S. pneumoniae. The presence of pneumococcal infection increased the odds of having radiologically confirmed pneumonia by 2.8 times (95% CI: 1.8‐4.3). The negative predictive value of the normal chest radiograph for infection by S. pneumoniae was 86.3% (95% CI: 82.4‐89.7%). There was no difference on the rates of infection by H. influenzae and M. catarrhalis between children with community‐acquired pneumonia with and without radiological confirmation. Conclusions: Among children with clinical diagnosis of community‐acquired pneumonia submitted to chest radiograph, those with radiologically confirmed pneumonia present a higher rate of infection by S. pneumoniae when compared with those with a normal chest radiograph.http://www.sciencedirect.com/science/article/pii/S2255553617300770Bacterial infectionEtiologyLower respiratory tract infectionRadiological studySerological tests |
collection |
DOAJ |
language |
Portuguese |
format |
Article |
sources |
DOAJ |
author |
Dafne C. Andrade Igor C. Borges Ana Luísa Vilas‐Boas Maria S.H. Fontoura César A. Araújo‐Neto Sandra C. Andrade Rosa V. Brim Andreas Meinke Aldina Barral Olli Ruuskanen Helena Käyhty Cristiana M. Nascimento‐Carvalho |
spellingShingle |
Dafne C. Andrade Igor C. Borges Ana Luísa Vilas‐Boas Maria S.H. Fontoura César A. Araújo‐Neto Sandra C. Andrade Rosa V. Brim Andreas Meinke Aldina Barral Olli Ruuskanen Helena Käyhty Cristiana M. Nascimento‐Carvalho Infection by Streptococcus pneumoniae in children with or without radiologically confirmed pneumonia Jornal de Pediatria (Versão em Português) Bacterial infection Etiology Lower respiratory tract infection Radiological study Serological tests |
author_facet |
Dafne C. Andrade Igor C. Borges Ana Luísa Vilas‐Boas Maria S.H. Fontoura César A. Araújo‐Neto Sandra C. Andrade Rosa V. Brim Andreas Meinke Aldina Barral Olli Ruuskanen Helena Käyhty Cristiana M. Nascimento‐Carvalho |
author_sort |
Dafne C. Andrade |
title |
Infection by Streptococcus pneumoniae in children with or without radiologically confirmed pneumonia |
title_short |
Infection by Streptococcus pneumoniae in children with or without radiologically confirmed pneumonia |
title_full |
Infection by Streptococcus pneumoniae in children with or without radiologically confirmed pneumonia |
title_fullStr |
Infection by Streptococcus pneumoniae in children with or without radiologically confirmed pneumonia |
title_full_unstemmed |
Infection by Streptococcus pneumoniae in children with or without radiologically confirmed pneumonia |
title_sort |
infection by streptococcus pneumoniae in children with or without radiologically confirmed pneumonia |
publisher |
Elsevier |
series |
Jornal de Pediatria (Versão em Português) |
issn |
2255-5536 |
publishDate |
2018-01-01 |
description |
Objective: Community‐acquired pneumonia is an important cause of morbidity in childhood, but the detection of its causative agent remains a diagnostic challenge. The authors aimed to evaluate the role of the chest radiograph to identify cases of community‐aquired pneumonia caused by typical bacteria.
Methods: The frequency of infection by Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis was compared in non‐hospitalized children with clinical diagnosis of community acquired pneumonia aged 2‐59 months with or without radiological confirmation (n = 249 and 366, respectively). Infection by S. pneumoniae was diagnosed by the detection of a serological response against at least one of eight pneumococcal proteins (defined as an increase ≥2‐fold in the IgG levels against Ply, CbpA, PspA1 and PspA2, PhtD, StkP‐C, and PcsB‐N, or an increase ≥1.5‐fold against PcpA). Infection by H. influenzae and M. catarrhalis was defined as an increase ≥2‐fold on the levels of microbe‐specific IgG.
Results: Children with radiologically confirmed pneumonia had higher rates of infection by S. pneumoniae. The presence of pneumococcal infection increased the odds of having radiologically confirmed pneumonia by 2.8 times (95% CI: 1.8‐4.3). The negative predictive value of the normal chest radiograph for infection by S. pneumoniae was 86.3% (95% CI: 82.4‐89.7%). There was no difference on the rates of infection by H. influenzae and M. catarrhalis between children with community‐acquired pneumonia with and without radiological confirmation.
Conclusions: Among children with clinical diagnosis of community‐acquired pneumonia submitted to chest radiograph, those with radiologically confirmed pneumonia present a higher rate of infection by S. pneumoniae when compared with those with a normal chest radiograph. |
topic |
Bacterial infection Etiology Lower respiratory tract infection Radiological study Serological tests |
url |
http://www.sciencedirect.com/science/article/pii/S2255553617300770 |
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