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http://www.journals.uchicago.edu/CID/journal/issues/v35n11/020684/brief/020684.abstract.html

Clinical Infectious Diseases    2002;35:1345-1352
© 2002 by the Infectious Diseases Society of America. All rights reserved.
1058-4838/2002/3511-0007$15.00

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Characteristics of Streptococcus pneumoniae and Atypical Bacterial Infections in Children 25 Years of Age with Community-Acquired Pneumonia

Susanna Esposito,¹ Samantha Bosis,¹ Roberta Cavagna,¹ Nadia Faelli,¹ Enrica Begliatti,¹ Paola Marchisio,¹ Francesco Blasi,² Ciro Bianchi,³ and Nicola Principi¹

¹Pediatric Department I and ²Institute of Respiratory Diseases, Istituto Ricerca e Cura a Carattere Scientifico Maggiore Hospital, University of Milan, Milan, and ³Wyeth-Lederle Vaccines, Rome, Italy

 

Received 15 May 2002; accepted 20 July 2002; electronically published 13 November 2002.

The characteristics of community-acquired pneumonia associated with Streptococcus pneumoniae infection were compared with those associated with atypical bacterial infection and with mixed S. pneumoniaeatypical bacterial infection in 196 children aged 25 years. S. pneumoniae infections were diagnosed in 48 patients (24.5%); atypical bacterial infections, in 46 (23.5%); and mixed infections, in 16 (8.2%). Although white blood cell counts and C-reactive protein levels were higher in patients with pneumococcal infections, no other clinical, laboratory, or radiographic characteristic was significantly correlated with the different etiologic diagnoses. There was no significant difference in the efficacy of the different treatment regimens followed by children with S. pneumoniae infection, whereas clinical failure occurred significantly more frequently among children with atypical bacterial or mixed infection who were not treated with a macrolide. This study shows the major role of both S. pneumoniae and atypical bacteria in the development of community-acquired pneumonia in young children, the limited role of clinical, laboratory, and radiological features in predicting etiology, and the importance of the use of adequate antimicrobial agents for treatment.

     Presented in part: 3rd International Symposium on Pneumococci and Pneumococcal Diseases, Anchorage, Alaska, May 2002.
     Financial support: Wyeth-Lederle Vaccines, Rome, Italy.

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