ETIOLOGY OF PNEUMONIA IN HOSPITALIZED CHILDREN

One-hundred-and-thirty-two children with clinical and radiological evi dence of bronchopneumonia/pneumonia were studied over a 1-year period for isolation/detection of bacterial and viral aetiological pathogens. Throat swab, nasopharyngeal aspirate (NPA), and lung aspirate were st udied for bacterial and viral cultures. NPA was also subjected to late x agglutination test (LA) for H. influenzae and S. pneumoniae; and imm unofluorescent technique (IFAT) and enzyme immunoassay (EIA) for respi ratory syncytial virus (RSV). Blood culture for bacterial pathogens, a nd LA of blood and urine was also undertaken. Haemophilus influenzae w as the commonest organism (15 per cent) isolated as the sole pathogen followed by RSV (14 per cent), Klebsiella (13 per cent) and S. pneumon iae (12 per cent), E. coli was the commonest organism (50 per cent) in infants <3 months and was closely followed by RSV (44 per cent), Kleb siella (25 per cent), and S. pneumoniae (18 per cent), Isolation rate of E. coli gradually declined with age. RSV (47 per cent) and H. influ enzae (31 per cent) were the commonest organisms between 7 and 24 mont hs. S. pneumoniae and Staph, aureus were common bacterial pathogens id entified in all age groups with maximum isolation of 20 and 40 per cen t, respectively, in children more than 5 years. Isolation of E. coli, Klebsiella and Staph. aureus was highest from NPA culture, while as S. pneumoniae and H. influenzae were most often detected by LA. Out of 1 2 cases from whom a lung aspirate was collected, bacterial pathogen co uld be isolated in six cases (50 per cent). Detection of RSV by EIA wa s higher than by culture or IFAT. Most of the organisms were resistant to chloramphenicol except for H. influenzae. All the isolates of S. p neumoniae were sensitive to all the antibiotics. Bacterial pathogens w ere isolated/detected in 74 per cent of cases and RSV was the aetiolog ical agent in 49 per cent of cases investigated for viral aetiology. H igher detection rate of RSV is attributed to selection of cases in win ter months during a period of suspected epidemic of RSV.