Community acquired pneumonia - a prospective UK study

Background-There are few data on paediatric community acquired pneumonia (P CAP) in the UK. Aims-To investigate the aetiology and most useful diagnostic tests for PCAP in the north east of England. Methods-A prospective study of hospital admissions with a diagnosis of PCAP . Results-A pathogen was isolated from 60% (81/136) of cases, and considered a definite or probable cause of their pneumonia in 51% (70/136). Fifty (37% ) had a virus implicated (65% respiratory syncytial virus) and 19 (14%) a b acterium (7% group A streptococcus, 4% Streptococcus pneumoniae), with one mixed infection. Of a subgroup (51 patients) in whom serum antipneumolysin antibody testing was performed, 6% had evidence of pneumococcal infection, and all were under 2 years old. The best diagnostic yield was from paired s erology (34%, 31/87), followed by viral immunofluorescence (33%, 32/98). Conclusion-Viral infection accounted for 71% of the cases diagnosed. Group A streptococcus was the most common bacterial infective agent, with a low i ncidence of both Mycoplasma pneumoniae and S pneumoniae. Pneumococcal pneum onia was the most common bacterial cause of pneumonia in children under 2 y ears but not in older children. Inflammatory markers and chest x ray featur es did not differentiate viral from bacterial pneumonia; serology and viral immunofluorescence were the most useful diagnostic tests.