Microorganisms Associated With Pneumonia in Children <5 Years of Age in Developing and Emerging Countries: The GABRIEL Pneumonia Multicenter, Prospective, Case-Control Study

被引：136

作者：

Benet, Thomas ^{[1
,2
]}

Picot, Valentina Sanchez ^{[1
]}

Messaoudi, Melina ^{[1
]}

Chou, Monidarin ^{[3
]}

Eap, Tekchheng ^{[4
]}

Wang, Jianwei ^{[5
,6
,7
]}

Shen, Kunling ^{[8
]}

Pape, Jean-William ^{[9
]}

Rouzier, Vanessa ^{[9
]}

Awasthi, Shally ^{[10
]}

Pandey, Nitin ^{[10
]}

Bavdekar, Ashish ^{[11
]}

Sanghavi, Sonali ^{[11
]}

Robinson, Annick ^{[12
]}

Rakoto-Andrianarivelo, Mala ^{[13
]}

Sylla, Maryam ^{[14
]}

Diallo, Souleymane ^{[15
]}

Nymadawa, Pagbajabyn ^{[16
]}

Naranbat, Nymadawaagiin ^{[16
,17
]}

Russomando, Graciela ^{[18
]}

Basualdo, Wilma ^{[19
]}

Komurian-Pradel, Florence ^{[1
]}

Endtz, Hubert ^{[1
,20
]}

Vanhems, Philippe ^{[1
,2
]}

Paranhos-Baccala, Glaucia ^{[1
]}

机构：

[1] INSERM, CNRS, ENS Lyon,U1111,UMR 5308,UCBL1, Emerging Pathogens Lab,Fdn Merieux,Ctr Int Rech I, Lyon, France

[2] Hosp Civils Lyon, Edouard Herriot Hosp, Infect Control & Epidemiol Unit, Lyon, France

[3] Univ Hlth Sci, Fac Pharm, Phnom Penh, Cambodia

[4] Natl Pediat Hosp, Dept Pneumol, Phnom Penh, Cambodia

[5] Chinese Acad Med Sci, Inst Pathogen Biol, Fdn Merieux, MOH Key Lab Syst Biol Pathogens, Beijing, Peoples R China

[6] Chinese Acad Med Sci, Inst Pathogen Biol, Fdn Merieux, Dr Christophe Merieux Lab, Beijing, Peoples R China

[7] Peking Union Med Coll, Beijing, Peoples R China

[8] Capital Med Univ, Beijing Childrens Hosp, Key Lab Major Dis Children & Natl Key Discipline, Minist Educ,Beijing Pediat Res Inst, Beijing, Peoples R China

[9] Ctr GHESKIO, Grp Haitien Etude Sarcome Kaposi & Infect Opportu, Port Au Prince, Haiti

[10] Chatrapati Shahu Ji Maharaj Med Univ, Lucknow, Uttar Pradesh, India

[11] KEM Hosp, Res Ctr, Pune, Maharashtra, India

[12] Hop Femme Mere Enfant, Antananarivo, Madagascar

[13] Ctr Infectiol Charles Merieux, Fdn Merieux, Antananarivo, Madagascar

[14] Gabriel Toure Hosp, Bamako, Mali

[15] Ctr Infectiol Charles Merieux, Bamako, Mali

[16] Mongolian Acad Med Sci, Ulaanbaatar, Mongolia

[17] Gyals Med Ctr, Ulaanbaatar, Mongolia

[18] Res Inst Hlth, Asuncion, Paraguay

[19] Hosp Pediat Ninos Acosta Nu, San Lorenzo, Paraguay

[20] Erasmus MC, Dept Med Microbiol & Infect Dis, Rotterdam, Netherlands

来源：

CLINICAL INFECTIOUS DISEASES | 2017年 / 65卷 / 04期

关键词：

pneumonia; child; case-control studies; etiology; developing countries; RESPIRATORY-TRACT INFECTIONS; COMMUNITY-ACQUIRED PNEUMONIA; INFLUENZAE TYPE-B; CHILDHOOD PNEUMONIA; STREPTOCOCCUS-PNEUMONIAE; BURDEN; DISEASE; EFFICIENCY; ETIOLOGY; YOUNGER;

D O I：

10.1093/cid/cix378

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Background. Pneumonia, the leading infectious cause of child mortality globally, mainly afflicts developing countries. This prospective observational study aimed to assess the microorganisms associated with pneumonia in children aged <5 years in developing and emerging countries. Methods. A multicenter, case-control study by the GABRIEL (Global Approach to Biological Research, Infectious diseases and Epidemics in Low-income countries) network was conducted between 2010 and 2014 in Cambodia, China, Haiti, India (2 sites), Madagascar, Mali, Mongolia, and Paraguay. Cases were hospitalized children with radiologically confirmed pneumonia; controls were children from the same setting without any features suggestive of pneumonia. Nasopharyngeal swabs were collected from all subjects; 19 viruses and 5 bacteria were identified by reverse-transcription polymerase chain reaction. Associations between microorganisms and pneumonia were quantified by calculating the adjusted population attributable fraction (aPAF) after multivariate logistic regression analysis adjusted for sex, age, time period, other pathogens, and site. Results. Overall, 888 cases and 870 controls were analyzed; >= 1 microorganism was detected in respiratory samples in 93.0% of cases and 74.4% of controls (P < .001). Streptococcus pneumoniae, Mycoplasma pneumoniae, human metapneumovirus, rhinovirus, respiratory syncytial virus (RSV), parainfluenza virus 1, 3, and 4, and influenza virus A and B were independently associated with pneumonia; aPAF was 42.2% (95% confidence interval [CI], 35.5%-48.2%) for S. pneumoniae, 18.2% (95% CI, 17.4%-19.0%) for RSV, and 11.2% (95% CI, 7.5%-14.7%) for rhinovirus. Conclusions. Streptococcus pneumoniae, RSV, and rhinovirus may be the major microorganisms associated with pneumonia infections in children <5 years of age from developing and emerging countries. Increasing S. pneumoniae vaccination coverage may substantially reduce the burden of pneumonia among children in developing countries.

引用

页码：604 / 612

页数：9

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Microorganisms Associated With Pneumonia in Children &lt;5 Years of Age in Developing and Emerging Countries: The GABRIEL Pneumonia Multicenter, Prospective, Case-Control Study

Microorganisms Associated With Pneumonia in Children <5 Years of Age in Developing and Emerging Countries: The GABRIEL Pneumonia Multicenter, Prospective, Case-Control Study