Etiology and impact of coinfections in children hospitalized with community-acquired pneumonia

Vikki G. Nolan, Sandra Arnold, Anna M. Bramley, Krow Ampofo, Derek J. Williams, Carlos G. Grijalva, Wesley H. Self, Evan J. Anderson, Richard G. Wunderink, Kathryn M. Edwards, Andrew T. Pavia, Seema Jain, Jonathan Mccullers

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background Recognition that coinfections are common in children with community-acquired pneumonia (CAP) is increasing, but gaps remain in our understanding of their frequency and importance. Methods We analyzed data from 2219 children hospitalized with CAP and compared demographic and clinical characteristics and outcomes between groups with viruses alone, bacteria alone, or coinfections. We also assessed the frequency of selected pairings of codetected pathogens and their clinical characteristics. Results A total of 576 children (26%) had a coinfection. Children with only virus detected were younger, more likely to be black, and more likely to have comorbidities such as asthma, compared with children infected with typical bacteria alone. Children with virus-bacterium coinfections had a higher frequency of leukocytosis, consolidation on chest radiography, parapneumonic effusions, intensive care unit admission, and need for mechanical ventilation and an increased length of stay, compared with children infected with viruses alone. Virus-virus coinfections were generally comparable to single-virus infections, with the exception of the need for oxygen supplementation, which was higher during the first 24 hours of hospitalization in some virus-virus pairings. Conclusions Coinfections occurred in 26% of children hospitalized for CAP. Children with typical bacterial infections, alone or complicated by a viral infection, have worse outcomes than children infected with a virus alone.

Original languageEnglish (US)
Pages (from-to)179-188
Number of pages10
JournalJournal of Infectious Diseases
Volume218
Issue number2
DOIs
StatePublished - Jun 20 2018

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Hospitalized Child
Coinfection
Pneumonia
Viruses
Virus Diseases
Bacteria
Leukocytosis
Artificial Respiration
Bacterial Infections
Radiography
Intensive Care Units
Comorbidity
Length of Stay
Hospitalization
Thorax
Asthma
Demography
Oxygen

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Infectious Diseases

Cite this

Etiology and impact of coinfections in children hospitalized with community-acquired pneumonia. / Nolan, Vikki G.; Arnold, Sandra; Bramley, Anna M.; Ampofo, Krow; Williams, Derek J.; Grijalva, Carlos G.; Self, Wesley H.; Anderson, Evan J.; Wunderink, Richard G.; Edwards, Kathryn M.; Pavia, Andrew T.; Jain, Seema; Mccullers, Jonathan.

In: Journal of Infectious Diseases, Vol. 218, No. 2, 20.06.2018, p. 179-188.

Research output: Contribution to journalArticle

Nolan, VG, Arnold, S, Bramley, AM, Ampofo, K, Williams, DJ, Grijalva, CG, Self, WH, Anderson, EJ, Wunderink, RG, Edwards, KM, Pavia, AT, Jain, S & Mccullers, J 2018, 'Etiology and impact of coinfections in children hospitalized with community-acquired pneumonia', Journal of Infectious Diseases, vol. 218, no. 2, pp. 179-188. https://doi.org/10.1093/infdis/jix641
Nolan, Vikki G. ; Arnold, Sandra ; Bramley, Anna M. ; Ampofo, Krow ; Williams, Derek J. ; Grijalva, Carlos G. ; Self, Wesley H. ; Anderson, Evan J. ; Wunderink, Richard G. ; Edwards, Kathryn M. ; Pavia, Andrew T. ; Jain, Seema ; Mccullers, Jonathan. / Etiology and impact of coinfections in children hospitalized with community-acquired pneumonia. In: Journal of Infectious Diseases. 2018 ; Vol. 218, No. 2. pp. 179-188.
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