Etiology of childhood pneumonia: serologic results of a prospective, population-based study.
HEISKANEN-KOSMA, TARJA MD; KORPPI, MATTI MD; JOKINEN, CAMILLA MD; KURKI, SEIJA MD; HEISKANEN, LEENA MD; JUVONEN, HELVI MD; KALLINEN, SAKARI MD; STEN, MARJA MD; TARKIAINEN, AIRI MD; RONNBERG, PIRJO-RIITTA RN; KLEEMOLA, MARJAANA MD; MAKELA, P. HELENA MD; LEINONEN, MAIJA PHD
Pediatric Infectious Disease Journal.
17(11):986-991, November 1998.
Background. To investigate the etiology of pediatric community-acquired pneumonia, we conducted a prospective, population-based study covering the total population <15 years of age (n = 8851) in 4 municipalities in eastern Finland.
Materials and methods. The number of patients was 201; chest radiographs were available for all cases and paired sera for serologic assays were available for >90% of cases. The methods included assays for antibody response to 3 pneumococcal antigens, specific pneumococcal immune complex assays and conventional antibody tests for mycoplasmal, chlamydial and viral infections.
Results. Serologic evidence of specific microbial etiology was obtained in 133 (66%) of the pneumonia patients. Bacterial infection was diagnosed in 102 cases (51%) and viral infection in 51 cases (25%). Streptococcus pneumoniae was the most common agent (57 cases; 28%), followed by Mycoplasma pneumoniae (44; 22%), respiratory syncytial virus (43; 21%) and Chlamydia spp. (29; 14%). Haemophilus influenzae was identified in only 6% and Moraxella catarrhalis in only 3% of the children. More than one specific infection was found in 51 patients (25%). The proportion of pneumococcal cases varied from 24 to 36% by age. Mycoplasma infections were seen mostly in patients >=5 years and Chlamydia infections in patients >=10 years of age.
Conclusions. The results of our prospective, strictly population-based study confirm the importance of S. pneumoniae in the etiology of community-acquired pneumonia in children of all ages. M. pneumoniae and Chlamydia pneumoniae are important from the age of 5 years onwards.
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