Abstract：Objective To investigate the distribution of pathogens of children with community acquired pneumonia (CAP) from the Chongqing area. Methods Nasopharyngeal specimens and blood specimens of 1 613 children with CAP were collected between January 2014 and December 2014 for bacterial culture and detection of 7 respiratory viruses and antibodies against Mycoplasma pneumoniae (MP). Results The overall positive rate of bacteria was 50.22% (810 cases). Hemophilus parainfluenzae (40.8%), Streptococcus pneumonia (29.7%) and Moraxelle catarrhalis (7.3%) were the predominant ones. Among the viruses, the top detected virus was respiratory syncytial virus (RSV, 58.3%), followed by parainfluenza virus type3 (17.4%) and adenovirus (14.3%). A total of 481 cases (29.82%) were MP-positive. The co-infection rate was 32.18% (519 cases), and the mixed infections of bacteria and viruses were common (47.4%). Conclusions RSV and Hemophilus parainfluenzae are the major pathogens of CAP in children from the Chongqing area. MP is also an important pathogen. The co-infection of bacteria and viruses is prevalent.
PENG Yi,SHU Chang,FU Zhou et al. Pathogen detection of 1 613 cases of hospitalized children with community acquired pneumonia[J]. CJCP, 2015, 17(11): 1193-1199.
De Schutter I, De Wachter E, Crokaert F, et al. Microbiology of bronchoalveolar lavage fluid in children with acute nonresponding or recurrent community-acquired pneumonia: identification of nontypeable Haemophilus influenzae as a major pathogen[J]. Clin Infect Dis, 2011, 52(12): 1437-1444.
Wei L, Liu W, Zhang XA, et al. Detection of viral and bacterial pathogens in hospitalized children with acute respiratory illnesses, Chongqing, 2009-2013[J]. Medicine (Baltimore), 2015, 94(16): e742.
[8]
Sakwinska O, Bastic Schmid V, Berger B, et al. Nasopharyngeal microbiota in healthy children and pneumonia patients[J]. J Clin Microbiol, 2014, 52(5): 1590-1594.
[9]
Ubukata K, Chiba N, Morozumi M, et al. Longitudinal surveillance of Haemophilus influenzae isolates from pediatric patients with meningitis throughout Japan, 2000-2011[J]. J Infect Chemother, 2013, 19(1): 34-41.
Ferone EA, Berezin EN, Durigon GS, et al. Clinical and epidemiological aspects related to the detection of adenovirus or respiratory syncytial virus in infants hospitalized for acute lower respiratory tract infection[J]. J Pediatr(Rio J), 2014, 90(1): 42-49.
[17]
Hasan R, Rhodes J, Thamthitiwat S, et al. Incidence and etiology of acute lower respiratory tract infections in hospitalized children younger than 5 years in rural Thailand[J]. Pediatr Infect Dis J, 2014, 33(2): e45-e52.
[18]
Freitas FT. Sentinel surveillance of influenza and other respiratory viruses, Brazil, 2000-2010[J]. Braz J Infect Dis, 2013, 17(1): 62-68.
Wang SL, Chi CY, Kuo PH, et al. High-incidence of human adenoviral co-infections in Taiwan[J]. PLoS One, 2013, 8(9): e75208.
[21]
Fujimoto T, Matsushima Y, Shimizu H, et al. A molecular epidemiologic study of human adenovirus type 8 isolates causing epidemic keratoconjunctivitis in Kawasaki city, Japan in 2011[J]. Jpn J Infect Dis, 2012, 65(3): 260-263.
[22]
Xie L, Yu XF, Sun Z, et al. Two adenovirus serotype 3 outbreaks associated with febrile respiratory disease and pharyngoconjunctival fever in children under 15 years of age in Hangzhou, China, during 2011[J]. J Clin Microbiol, 2012, 50(6): 1879-1888.
[23]
Ronchi A, Doern C, Brock E, et al. Neonatal adenoviral infection: a seventeen year experience and review of the literature[J]. J Pediatr, 2014, 164(3): 529-535.
Tsou TP, Tan BF, Chang HY, et al. Community outbreak of adenovirus, Taiwan, 2011[J]. Emerg Infect Dis, 2012, 18(11): 1825-1832.
[27]
Rojas LJ, Jaramillo CA, Mojica MF, et al. Molecular typing of adenovirus circulating in a Colombian paediatric population with acute respiratory infection[J]. Epidemiol Infect, 2012, 140(5): 818-822.
Nascimento-Carvalho CM, Cardoso MR, Barral A, et al. Seasonal patterns of viral and bacterial infections among children hospitalized with community-acquired pneumonia in a tropical region[J]. Scand J Infect Dis, 2010, 42(11-12): 839-844.
[30]
du Prel JB, Puppe W, Gröndahl B, et al. Are meteorological parameters associated with acute respiratory tract infections?[J]. Clin Infect Dis, 2009, 49(6): 861-868.
Rasmussen JN, Voldstedlund M, Andersen RL, et al. Increased incidence of Mycoplasma pneumoniae infections detected by laboratory-based surveillance in Denmark in 2010[J]. Eure Surveill, 2010, 15(45): 19708.
[33]
Chalker V, Stocki T, Mentasti M, et al. Increased incidence of Mycoplasma pneumoniae infection in England and Wales in 2010: multiocus variable number tandem repeat analysis typing and macrolide susceptibility[J]. Euro Surveill, 2011, 16(19): 19865.
[34]
Zhao H, Li S, Cao L, et al. Surveillance of Mycoplasma pneumoniae infection among children in Beijing from 2007 to 2012[J]. Chin Med J(Engl), 2014, 127(7): 1244-1248.
Martinez MA, Ruiz M, Zunino E, et al. Identification of P1 types and variants of Mycoplasma pneumoniae during an epidemic in Chile[J]. J Med Microbiol, 2010, 59(Pt 8): 925-929.
[45]
Kenri T, Okazaki N, Yamazaki T, et al. Genotyping analysis of Mycoplasma pneumoniae clinical strains in Japan between 1995 and 2005: type shift phenomenon of M.pneumoniae clinical strains[J]. J Med Microbiol, 2008, 57(Pt 4): 469-475.
Kannan TR, Hardy RD, Coalson JJ, et al. Fatal outcomes in family transmission of Mycoplasma pneumonia[J]. Clin Infect Dis, 2012, 54(2): 225-231.
[48]
Okada T, Morozumi M, Tajima T, et al. Rapid effectiveness of minocycline or doxycycline against macrolide-resistant Mycoplasma pneumonia infection in a 2011outbreak among Japanese children[J]. Clin Infect Dis, 2012, 55(12): 1642-1649.
[49]
Zhao F, Liu G, Wu J, et al. Surveillance of macrolide-resistant Mycoplasma pneumoniae in Beijing, China, from 2008 to 2012[J]. Antimicrob Agents Chemother, 2013, 57(3): 1521-1523.
[50]
ChangYT, YangYH, Chiang BL. The significance of a rapid cold hemagglutination test for detecting mycoplasma infections in children with asthma exacerbation[J]. J Microbiol Immunol Infect, 2006, 39(1): 28-32.
Ruuskanen O, Lahti E, Jennings LC, et al. Viral pneumonia[J]. Lancet, 2011, 377(9773): 1264-1275.
[54]
Liu WK, Liu Q, Chen de H, et al. Epidemiology of acute respiratory infections in children in Guangzhou: a three-year study[J]. PLoS One, 2014, 9(5): e96674.
[55]
Franz A, Adams O, Willems R, et al. Correlation of viral load of respiratory pathogens and co-infections with disease severity in children hospitalized for lower respiratory tract infection[J]. J Clin Virol, 2010, 48(4): 239-245.
Alicino C, ludici R, Alberti M, et al. The dangerous synergism between influenza and Streptococcus pneumoniae and innovative perspectives of vaccine prevention[J]. J Prev Med Hyg, 2011, 52(3): 102-106.
[58]
Stockman LJ, Reed C, Kallen AJ, et al. Respiratory syncytial virus and Staphylococcus aureus coinfection in children hospitalized with pneumonia[J]. Pediatr Infect Dis J, 2010, 29(11): 1048-1050.
