The Aetiology of pneumonia from analysis of Lung aspirate and Pleural fluid samples: Findings from the PERCH study

Ebruke, Bernard E, Knoll, Maria Deloria, Haddix, Meredith, Akramuzzaman, SyedMohd, Prosperi, Christine, Feikin, Daniel R, Hammitt, Laura L, Levine, Orin S, O'Brien, Katherine L, R Murdoch, David, Brooks, W Abdullah, Scott, J Anthony G, Kotloff, Karen L, Madhi, Shabir A, Thea, Donald M, Baillie, Vicky L, Chisti, Mohammod Jobayer, Dione, Michel, J Driscoll, Amanda, Fancourt, Nicholas, Karron, Ruth A, Le, Tham T, Mohamed, Shebe, Moore, David P, C Morpeth, Susan, Mwaba, John, Mwansa, James, Shahid, Abu Sadat Mohammad Sayeem Bin, Sow, Samba O, Tapia, Milagritos D, Antonio, Martin and Howie, Stephen R C (2021) 'The Aetiology of pneumonia from analysis of Lung aspirate and Pleural fluid samples: Findings from the PERCH study'. Clinical Infectious Diseases, Vol 73, Issue 11, e3788-e3796.

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Abstract

BACKGROUND
An improved understanding of childhood pneumonia aetiology is required to inform prevention and treatment strategies. Lung aspiration is the gold standard specimen for pneumonia diagnostics. We report findings from analyses of lung and pleural aspirates collected in the Pneumonia Etiology Research for Child Health (PERCH) study.

METHODS
The PERCH study enrolled children aged 1-59 months hospitalized with World Health Organization defined severe or very severe pneumonia in 7 countries in Africa and Asia. Percutaneous trans-thoracic lung (LA) and pleural fluid (PF) aspiration was performed on a sample of pneumonia cases with radiological consolidation and/or pleural fluid in 4 countries. Venous blood and nasopharyngeal/oropharyngeal swabs were collected from all cases. Multiplex quantitative PCR and routine microbiologic culture were applied to clinical specimens.

RESULTS
Of 44 LAs performed within 3 days of admission on 622 eligible cases, 13 (30%) had a pathogen identified by either culture (5/44) or by PCR (11/29). A pathogen was identified in 12/14 (86%) PF specimens tested by either culture (9/14) or PCR (9/11). Bacterial pathogens were identified more frequently than viruses. All but one of the cases with a virus identified were co-infected with bacterial pathogens. Streptococcus pneumoniae (9/44 [20%]) and Staphylococcus aureus (7/14 [50%]) were the predominant pathogen identified in LA and PF, respectively.

CONCLUSIONS
Bacterial pathogens predominated in this selected subgroup of PERCH participants drawn from those with radiological consolidation or pleural fluid, with S. pneumoniae and S. aureus the leading pathogens identified.

Item Type:	Article
Subjects:	QU Biochemistry > Genetics > QU 550 Genetic techniques. PCR. Chromosome mapping QW Microbiology and Immunology > Bacteria > QW 142 Gram-positive bacteria (General) WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries WC Communicable Diseases > Infection. Bacterial Infections > Bacterial Infections > WC 202 Pneumonia (General or not elsewhere classified) WS Pediatrics > Diseases of Children and Adolescents > By System > WS 280 Respiratory system WS Pediatrics > By Age Groups > WS 430 Infancy
Faculty: Department:	Education
Digital Object Identifer (DOI):	https://doi.org/10.1093/cid/ciaa1032
Depositing User:	Paula Harding
Date Deposited:	06 Oct 2020 10:20
Last Modified:	10 Dec 2021 11:05
URI:	https://archive.lstmed.ac.uk/id/eprint/15762

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