Low Co-infection Rate in Children With Community-Acquired Pneumonia in Spain

Otheo, Enrique; Rodríguez, Mario; Tagarro, Alfredo; Vázquez, Carmen; Coca, Ana; Martín, María Dolores; González-Sainz, Javier; Galán, Juan Carlos; Moreno, Santiago

Methods. From April 2012 until March 2015, hospitalized children with CAP were recruited in two hospitals of Madrid, Spain. An extensive microbiological work-up was performed, including: blood cultures, S. pneumoniae by PCR in blood, S. pneumoniae antigen in urine, paired serum for M. pneumoniae, C. pneumoniae and L. pneumophila, and PCR for 16 viruses, M. pneumoniae and C. pneumoniae in nasopharyngeal aspirate (NPA). Culture and S. pneumoniae antigen in pleural fluid was added if thoracentesis was performed. Organisms were considered the causative agents of pneumonia in the following situations: any bacteria in blood culture or S. pneumoniae by PCR in blood, urinary S. pneumoniae antigen plus C-reactive protein >100 mg/L and/or procalcitonin >1.5 ng/mL, seroconversion to any agent, presence of nucleic acids of M. pneumoniae, C. pneumoniae, RSV, hMPV, ADV, PIV or flu virus on NPA, and any bacteria on culture or S. pneumoniae antigen detection in pleural fluid. Following recent recommendations, rhinovirus, enterovirus, bocavirus and coronavirus were excluded as causality, if detected.