virology-infectious-diseases-2019-posters-abstracts

A p r i l 2 2 - 2 3 , 2 0 1 9

A t h e n s , G r e e c e

Page 71

Archives of Clinical Microbiology

ISSN: 1989-8436

Virology and Infectious Diseases 2019

EuroSciCon Conference on

Virology and Infectious Diseases

hildhood community acquired pneumonia (CCAP) is a significant public health challenge in developing countries.

Determination of microbial etiology is critical to develop evidence-based treatment and vaccination policies. Due to

paucity of well-designed studies, it is generally believed that bacterial etiology dominates in unvaccinated children. Our

research group sought to address the following research gaps.

Etiology of Pneumonia:

In the community acquired pneumonia etiology study (CAPES), 4045 children with pneumonia

underwent blood and nasopharyngeal aspirate (NPA) culture, and NPA PCR for 26 species. Gram-negative bacilli

predominated in blood, followed by S. aureus, pneumococcus and Hib. Blood and NPA cultures were discordant in most

cases. Multiplex PCR revealed viruses in 46.5% children viz RSV, rhinovirus, PIV, HMPV, coronavirus, influenza virus, and

combinations. This confirmed that viruses dominate in NPA and S pneumoniae is not as frequent as expected.

Reliability of NPA for etiology:

In 222 children with severe pneumonia, we examined blood culture, NPA culture and

NPA viral PCR in all. Additionally lung aspirate, BAL, pleural fluid, sputum, and induced sputum were processed where

feasible. Etiology was assigned using a hierarchy of biological specimens and three distinct etiology assignment

models. Irrespective of the model used, viral etiology dominated and RSV was the most frequent organism. Gram-

negative bacteria outnumbered Gram-positive organisms and S pneumoniae was identified in very few children. This

confirmed that RSV and not bacteria is the dominant pathogen in pneumonia, even in the lungs or lower airways.

Bacterial vs Viral Etiology:

We did not find any differences in demographic characteristics, clinical features, and

radiographic findings in children with bacterial vs viral pneumonia. Although CRP and Procalcitonin were higher in

bacterial pneumonia, there was no clinically useful discriminatory level. However, IL-6>5000 pg/ml, IL-8>1000 pg/ml,

and their combination could reliably distinguish bacterial from viral etiology. Thus, systemic biomarkers can help to

establish etiology at the time of presentation itself.

Microbial etiology of childhood pneumonia in

developing countries

Joseph L Mathew

Postgraduate Institute of Medical Education and Research, India

Arch Clin Microbiol 2019, Volume:10

DOI: 10.4172/1989-8436-C1-018