Pathogen screening and prognostic factors in children with severe ARDS of pulmonary origin

Phung, Thuy Thi Bich; Suzuki, Tadaki; Phan, Phuc Huu; Kawachi, Shoji; Furuya, Hiroyuki; Do, Huong Thu; Kageyama, Tsutomu; Ta, Tuan Anh; Dao, Nam Huu; Nunoi, Hiroyuki; Tran, Dien Minh; Le, Hai Thanh; Nakajima, Noriko

infections (Table 1) . We screened CMV infection as a possible cause of severe ARDS of pulmonary origin, as we have observed many immunocompetent infants with CMV-associated pneumonia in our hospital. 30 Ninety-two percent (23 of 25) of CMV-positive children were co-infected with other viruses, and most CMV infections were considered to be opportunistic infections that followed infection with another virus or CMV-persistent infection. 31 The most commonly detected bacteria and fungi were Klebsiella pneumoniae, followed by Acinetobacter baumannii and Candida albicans, which are generally considered to be opportunistic and nosocomial infections (Table 3) . Streptococcus pneumoniae, a representative pathogen of community-acquired pneumonia, was detected in two children with measles. Taken together, most cases of severe ARDS of pulmonary origin in the present study developed from viral pneumonia rather than from primary bacterial pneumonia. Only 18 (32%) patients had bacteremia or fungemia (Table 3 ).