Etiology of community-acquired pneumonia in 254 hospitalized children

Background, Childhood community-acquired pneumonia is a common illness, but there have been relatively few comprehensive studies of the viral and bact erial etiology in developed countries. The aim of the present investigation was to determine the etiology of community-acquired pneumonia in hospitali zed children by several laboratory methods. Methods. In a 3-year prospective study a nasopharyngeal aspirate for viral studies and acute and convalescent serum samples for viral and bacterial se rology were taken from 254 children with symptoms of acute infection and in filtrates compatible with pneumonia in the chest radiograph. The role of 17 microbes was investigated. Results. A potential causative agent was detected in 215 (85%) of the 254 p atients. Sixty-two percent of the patients had viral infection, 53% had bac terial infection and 30% had evidence of concomitant viral-bacterial infect ion. Streptococcus pneumoniae (37%), respiratory syncytial virus (29%) and rhinovirus (24%) were the most common agents associated with community-acqu ired pneumonia, Only one patient had a positive blood culture (S. pneumonia e) of 125 cultured. A dual viral infection was detected in 35 patients, and a dual bacterial infection was detected in 19 patients. Conclusions. The possible causative agent of childhood community-acquired p neumonia can be detected in most cases. Further studies are warranted to de termine what etiologic investigations would aid in the management of pneumo nia. With effective immunization for S, pneumoniae and respiratory syncytia l virus infections, more than one-half of the pneumonia cases in this study could have been prevented.