tetano
Editor, Senior Moderator
BMJ Open
. 2022 Jun 21;12(6):e057957.
doi: 10.1136/bmjopen-2021-057957.
Epidemiology of community-acquired pneumonia among hospitalised children in Indonesia: a multicentre, prospective study
Dewi Lokida[SUP] 1 [/SUP], Helmia Farida[SUP] 2 [/SUP], Rina Triasih[SUP] 3 [/SUP], Yan Mardian[SUP] 4 [/SUP], Herman Kosasih[SUP] 5 [/SUP], Adhella Menur Naysilla[SUP] 5 [/SUP], Arif Budiman[SUP] 1 [/SUP], Chakrawati Hayuningsih[SUP] 1 [/SUP], Moh Syarofil Anam[SUP] 2 [/SUP], Dwi Wastoro[SUP] 2 [/SUP], Mujahidah Mujahidah[SUP] 3 [/SUP], Setya Dipayana[SUP] 2 [/SUP], Amalia Setyati[SUP] 3 [/SUP], Abu Tholib Aman[SUP] 3 [/SUP], Nurhayati Lukman[SUP] 5 [/SUP], Muhammad Karyana[SUP] 6 [/SUP], Ahnika Kline[SUP] 7 [/SUP], Aaron Neal[SUP] 7 [/SUP], Chuen-Yen Lau[SUP] 8 [/SUP], Clifford Lane[SUP] 7 [/SUP]
Affiliations
Abstract
Objective: To identify aetiologies of childhood community-acquired pneumonia (CAP) based on a comprehensive diagnostic approach.
Design: 'Partnerships for Enhanced Engagement in Research-Pneumonia in Paediatrics (PEER-PePPeS)' study was an observational prospective cohort study conducted from July 2017 to September 2019.
Setting: Government referral teaching hospitals and satellite sites in three cities in Indonesia: Semarang, Yogyakarta and Tangerang.
Participants: Hospitalised children aged 2-59 months who met the criteria for pneumonia were eligible. Children were excluded if they had been hospitalised for >24 hours; had malignancy or history of malignancy; a history of long-term (>2 months) steroid therapy, or conditions that might interfere with compliance with study procedures.
Main outcomes measures: Causative bacterial, viral or mixed pathogen(s) for pneumonia were determined using microbiological, molecular and serological tests from routinely collected specimens (blood, sputum and nasopharyngeal swabs). We applied a previously published algorithm (PEER-PePPeS rules) to determine the causative pathogen(s).
Results: 188 subjects were enrolled. Based on our algorithm, 48 (25.5%) had a bacterial infection, 31 (16.5%) had a viral infection, 76 (40.4%) had mixed bacterial and viral infections, and 33 (17.6%) were unable to be classified. The five most common causative pathogens identified were Haemophilus influenzae non-type B (N=73, 38.8%), respiratory syncytial virus (RSV) (N=51, 27.1%), Klebsiella pneumoniae (N=43, 22.9%), Streptococcus pneumoniae (N=29, 15.4%) and Influenza virus (N=25, 13.3%). RSV and influenza virus diagnoses were highly associated with Indonesia's rainy season (November-March). The PCR assays on induced sputum (IS) specimens captured most of the pathogens identified in this study.
Conclusions: Our study found that H. influenzae non-type B and RSV were the most frequently identified pathogens causing hospitalised CAP among Indonesian children aged 2-59 months old. Our study also highlights the importance of PCR for diagnosis and by extension, appropriate use of antimicrobials.
Trail registration number: NCT03366454.
Keywords: epidemiology; infectious diseases; paediatrics.
. 2022 Jun 21;12(6):e057957.
doi: 10.1136/bmjopen-2021-057957.
Epidemiology of community-acquired pneumonia among hospitalised children in Indonesia: a multicentre, prospective study
Dewi Lokida[SUP] 1 [/SUP], Helmia Farida[SUP] 2 [/SUP], Rina Triasih[SUP] 3 [/SUP], Yan Mardian[SUP] 4 [/SUP], Herman Kosasih[SUP] 5 [/SUP], Adhella Menur Naysilla[SUP] 5 [/SUP], Arif Budiman[SUP] 1 [/SUP], Chakrawati Hayuningsih[SUP] 1 [/SUP], Moh Syarofil Anam[SUP] 2 [/SUP], Dwi Wastoro[SUP] 2 [/SUP], Mujahidah Mujahidah[SUP] 3 [/SUP], Setya Dipayana[SUP] 2 [/SUP], Amalia Setyati[SUP] 3 [/SUP], Abu Tholib Aman[SUP] 3 [/SUP], Nurhayati Lukman[SUP] 5 [/SUP], Muhammad Karyana[SUP] 6 [/SUP], Ahnika Kline[SUP] 7 [/SUP], Aaron Neal[SUP] 7 [/SUP], Chuen-Yen Lau[SUP] 8 [/SUP], Clifford Lane[SUP] 7 [/SUP]
Affiliations
- PMID: 35728910
- DOI: 10.1136/bmjopen-2021-057957
Abstract
Objective: To identify aetiologies of childhood community-acquired pneumonia (CAP) based on a comprehensive diagnostic approach.
Design: 'Partnerships for Enhanced Engagement in Research-Pneumonia in Paediatrics (PEER-PePPeS)' study was an observational prospective cohort study conducted from July 2017 to September 2019.
Setting: Government referral teaching hospitals and satellite sites in three cities in Indonesia: Semarang, Yogyakarta and Tangerang.
Participants: Hospitalised children aged 2-59 months who met the criteria for pneumonia were eligible. Children were excluded if they had been hospitalised for >24 hours; had malignancy or history of malignancy; a history of long-term (>2 months) steroid therapy, or conditions that might interfere with compliance with study procedures.
Main outcomes measures: Causative bacterial, viral or mixed pathogen(s) for pneumonia were determined using microbiological, molecular and serological tests from routinely collected specimens (blood, sputum and nasopharyngeal swabs). We applied a previously published algorithm (PEER-PePPeS rules) to determine the causative pathogen(s).
Results: 188 subjects were enrolled. Based on our algorithm, 48 (25.5%) had a bacterial infection, 31 (16.5%) had a viral infection, 76 (40.4%) had mixed bacterial and viral infections, and 33 (17.6%) were unable to be classified. The five most common causative pathogens identified were Haemophilus influenzae non-type B (N=73, 38.8%), respiratory syncytial virus (RSV) (N=51, 27.1%), Klebsiella pneumoniae (N=43, 22.9%), Streptococcus pneumoniae (N=29, 15.4%) and Influenza virus (N=25, 13.3%). RSV and influenza virus diagnoses were highly associated with Indonesia's rainy season (November-March). The PCR assays on induced sputum (IS) specimens captured most of the pathogens identified in this study.
Conclusions: Our study found that H. influenzae non-type B and RSV were the most frequently identified pathogens causing hospitalised CAP among Indonesian children aged 2-59 months old. Our study also highlights the importance of PCR for diagnosis and by extension, appropriate use of antimicrobials.
Trail registration number: NCT03366454.
Keywords: epidemiology; infectious diseases; paediatrics.