ABSTRACT
We conducted a prospective pilot study over a 1-year period in New Caledonia in preparation for the Pneumonia Research for Child Health (PERCH) project. The pathogens associated with hospitalized lower respiratory infections in children were identified through the use of culture of induced sputum and blood, urinary antigen detection, polymerase chain reaction (PCR) on respiratory specimens, and serology on paired sera. Respiratory viruses were detected on respiratory specimens by immunofluorescence and PCR, and by serology on paired sera. Pathogens were detected in 87.9% of the 108 hospitalized cases. Viruses represented 81.6% of the 152 pathogens detected. Respiratory syncytial virus and rhinovirus were the most frequent, accounting for 32.2% and 24.3% of the pathogens identified, respectively. Only 26.3% of 99 induced sputum specimens collected were determined to be of good quality, which may be a consequence of the collection method used.
Subject(s)
Child, Hospitalized/statistics & numerical data , Pneumonia/etiology , Respiratory Syncytial Viruses/isolation & purification , Respiratory Tract Infections/epidemiology , Adolescent , Antigens, Viral/urine , Bacteria/isolation & purification , Bacteria/pathogenicity , Bacterial Infections/blood , Bacterial Infections/epidemiology , Bacterial Infections/virology , Case-Control Studies , Child , Child, Preschool , Fluorescent Antibody Technique , Humans , Infant , New Caledonia/epidemiology , Picornaviridae Infections/blood , Picornaviridae Infections/epidemiology , Picornaviridae Infections/virology , Pilot Projects , Prospective Studies , Respiratory Syncytial Virus Infections/blood , Respiratory Syncytial Virus Infections/epidemiology , Respiratory Syncytial Virus Infections/virology , Respiratory Syncytial Viruses/pathogenicity , Respiratory Tract Infections/microbiology , Respiratory Tract Infections/virology , Rhinovirus/isolation & purification , Rhinovirus/pathogenicity , Serologic Tests , Specimen Handling/methods , Sputum/microbiology , Sputum/virologyABSTRACT
OBJECTIVE: To describe the aetiology of community-acquired pneumonia (CAP) in hospitalized adult patients in New Caledonia, a French archipelago in the South Pacific. METHODS: Confirmed CAP patients (n=137) were enrolled prospectively. Pathogens were detected by culture, molecular methods, serology on paired sera, immunofluorescence on nasopharyngeal swabs and antigen detection in urine. RESULTS: The aetiology of CAP was determined in 82 of 137 cases (59.8%), of which 31 exhibited two or more pathogens (37.8%). Hundred and seventeen pathogens were detected: Streptococcus pneumoniae was the most common one (41.0%), followed by influenza virus A (22.1%) and Haemophilus influenzae (10.2%). The frequency of atypical bacteria was low (6.0%). The most frequent and significant coinfection was S. pneumoniae with influenza A virus (P=0.004). Influenza virus was detected from nasopharyngeal swabs in four patients (15.4% of patients tested for influenza) and by PCR from pulmonary specimens in 15 patients (57.7%). CONCLUSIONS : Pneumoniae is the leading cause of CAP in New Caledonian adults. Viral-bacterial co-infections involving S. pneumoniae and influenza virus are very common during the winter. Such adult patients hospitalized with CAP are a clear sentinel group for surveillance of influenza. Vaccination against influenza and S. pneumoniae should be strengthened when risk factors are identified.