Abstract
The cause of primary pneumonia was diagnosed in 157 of 198 children and 165 of 207 adults seen as inpatients or outpatients in a 12-month period. In childrenMycoplasma pneumoniae and pneumococcus were identified in 79 and 29 cases respectively. Twenty-nine of 53 cases of viral infection in children were caused by respiratory syncytial virus, two-thirds of the cases occurring in children under three years of age. No children died of pneumonia. In adults pneumococcus was the most common pathogen, accounting for 81 cases. The overall mortality in adults was 7.7%. A high mortality was found in patients withHaemophilus influenzae and other gram-negative bacilli infections, and in elderly patients with pneumococcal pneumonia. Coagglutination was more sensitive than counterimmuno-electrophoresis for the detection of pneumococcal antigen in respiratory samples (p<0.001). Counterimmunoelectrophoresis was the only useful technique for detection of pneumococcal antigen in urine specimens, concentration, overnight storage at 4 °C and specific staining significantly increasing positivity (p<0.001).
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Sullivan, R. J., Dowdle, W. R., Marine, W. M., Hierholzer, J. C. Adult pneumonia in a general hospital. Etiology and host risk factors. Archives of Internal Medicine 1972, 129: 935–942.
Macfarlane, J. T., Ward, M. J., Finch, R. G., Macrae, A. D. Hospital study of adult community-acquired pneumonia. Lancet 1982, ii: 255–258.
Chretien, J., Holland, W., Macklem, P., Murray, J., Woolcock, A. Acute respiratory infection in children. A global public-health problem. New England Journal of Medicine 1984, 310: 982–984.
Washington, J. A. Noninvasive diagnostic techniques for lower respiratory infections. In: Pennington, J. E. (ed.): Respiratory infections: diagnosis and management. Raven Press, New York, 1983, p. 41–54.
Fung, J. C., Tilton, R. C. Detection of bacterial antigens by counterimmunoelectrophoresis, coagglutination and latex agglutination. In: Lennette, E. H., Balows, A., Hausler, W. J., Truant, J. P. (ed.): Manual of clinical microbiology. American Society for Microbiology, Washington, DC, 1985, p. 883–890.
Austrian, R. The Quellung reaction, a neglected microbiologic technique. Mount Sinai Journal of Medicine 1976, 43: 699–709.
Ingram, D. L., Anderson, P., Smith, D. H. Counter-current immunoelectrophoresis in the diagnosis of systemic diseases caused byHaemophilus influenzae type b. Journal of Pediatrics 1972, 81: 1156–1159.
Rytel, M. W. Counterimmunoelectrophoresis in diagnosis of infectious disease. Hospital Practitioner 1975, 10: 75–82.
Anhalt, J. P., Yu, P. K. W. Counterimmunoelectrophoresis of pneumococcal antigens: improved sensitivity for the detection of types VII and XIV. Journal of Clinical Microbiology 1975, 2: 510–515.
Sever, J. L. Application of a microtechnique to viral serological investigations. Journal of Immunology 1962, 83: 320–329.
Wilkinson, H. W., Fikes, B. J., Cruce, D. D. Indirect immunofluorescence test for serodiagnosis of Legionnaires disease: evidence for serogroup diversity of Legionnaires disease bacterial antigens and for multiple specificity of human antibodies. Journal of Clinical Microbiology 1979, 9: 379–383.
Feizi, T., Maclean, H., Sommerville, R. G., Selwyn, J. G. Studies on an epidemic of respiratory disease caused byMycoplasma pneumoniae. British Medical Journal 1967, i: 457–460.
Foy, H. M., Kenny, G. E., McMahan, R., Mansy, A. M., Grayston, J. T. Mycoplasma pneumoniae pneumonia in an urban area. Journal of the American Medical Association 1970, 214: 1666–1672.
Loda, F. A., Clyde, W. A., Glezen, W. P., Senior, R. J., Scheaffer, C. J., Denny, F. W. Studies on the role of viruses, bacteria, andMycoplasma pneumoniae as causes of lower respiratory tract infections in children. Journal of Pediatrics 1968, 72: 161–176.
Paisley, J. W., Lauer, B. A., McIntosh, K., Clode, M. E., Schachter, J., Rumack, C. Pathogens associated with acute lower respiratory tract infections in young children. Pediatric Infectious Disease 1984, 3: 14–19.
World Health Organization A programme for controlling acute respiratory infections in children: memorandum from a WHO meeting. Bulletin of the World Health Organization 1984, 62: 47–58.
Berman S., McIntosh, K. Selective primary health care: strategies for control of disease in the developing world. XXI: Acute respiratory infections. Reviews of Infectious Diseases 1985, 7: 674–691.
Shann, F., Gratten, M., Germer, S., Linnemann, V., Hazlett, D., Payne, R. Aetiology of pneumonia in children in Coroka Hospital, Papua New Guinea. Lancet 1984, ii: 537–541.
Mufson, M. A., Kruss, D. M., Wasil, R. E., Metzger, W. I. Capsular types and outcome of bacteremic pneumococcal disease in the antibiotic era. Archives of Internal Medicine 1974, 134: 505–510.
Garb, J. L., Brown, R. B., Garb, J. R., Tulhill, R. W. Differences in etiology of pneumonias in nursing home and community patients. Journal of the American Medical Association 1978, 240: 2169–2172.
Verghese, A., Berk, S. L. Bacterial pneumonia in the elderly. Medicine 1983, 62: 271–285.
White, R. J., Blainey, A. D., Joy Harrison, K., Clarke, S. K. R. Causes of pneumonia presenting to a district general hospital. Thorax 1981, 36: 566–570.
Berntsson, E., Lagergard, T., Strannegard, O., Trolifors, B. Etiology of community-acquired pneumonia in out-patients. European Journal of Clinical Microbiology 1986, 5: 446–447.
Mufson, M. A., Chang, V., Gill, W., Wood, S. C., Romansky, M. J., Chanock, R. M. The role of viruses, mycoplasmas, and bacteria in acute pneumonia in civilian adults. American Journal of Epidemiology 1967, 86: 526–544.
Schachter, J. Chlamydia psittaci: “reemergence” of a forgottoen pathogen. New England Journal of Medicine 1986, 315: 189–191.
Edwards, E. A., Coonrod, J. D. Coagglutination and counterimmunoelectrophoresis for detection of pneumococcal antigens in the sputum of pneumonia patients. Journal of Clinical Microbiology 1980, 11: 488–491.
Guzzeta, P., Toews, G. B., Robertson, K. J., Pierce, A. K. Rapid diagnosis of community-acquired bacterial pneumonia. American Review of Respiratory Disease 1983, 128: 461–464.
Coonrod, J. D., Rylko-Bauer, R. Latex agglutination in the diagnosis of pneumococcal infection. Journal of Clinical Microbiology 1976, 4: 168–174.
Van der Auwera, P., Andre, A., Buillard, G., Legrand, J. C., Gordts, B., Van Landuyt, H. Rapid diagnosis ofStreptococcus pneumoniae infectioons by antigen detection in urine, serum and CSF. Annales de Biologie Clinique 1985, 43: 397–406.
Ajello, G. W., Bolan, G. A., Hayes, P. S., Lehmann, D., Montgomery, J., Feeley, J. C., Perlino, C. A., Broome, C. V. Commercial latex agglutination tests for detection ofHaemophilus influenzae type b andStreptococcus pneumoniae antigens in patients with bacteremic pneumonia. Journal of Clinical Microbiology 1987, 25: 1388–1391.
Coonrod, J. D., Rytel, M. W. Detection of type specific pneumococcal antigens by counterimmunoelectrophorsis. I: Methodology and immunologic properties of pneumococcal antigens. Journal of Laboratory and Clinical Medicine 1973, 81: 770–777.
Coonrod, J. D. Physical and immunologic properties of pneumococcal capsular polysaccharide produced during human infection. Journal of Immunology 1974, 112: 2193–2201.
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Ausina, V., Coll, P., Sambeat, M. et al. Prospective study on the etiology of community-acquired pneumonia in children and adults in Spain. Eur. J. Clin. Microbiol. Infect. Dis. 7, 342–347 (1988). https://doi.org/10.1007/BF01962334
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DOI: https://doi.org/10.1007/BF01962334