Microorganisms Associated With Pneumonia in Children

The GABRIEL Pneumonia Multicenter, Prospective, Case-Control Study

Thomas Bénet, Valentina Sánchez Picot, Mélina Messaoudi, Monidarin Chou, Tekchheng Eap, Jianwei Wang, Kunling Shen, Jean-William Pape, Vanessa Rouzier, Shally Awasthi, Nitin Pandey, Ashish Bavdekar, Sonali Sanghavi, Annick Robinson, Mala Rakoto-Andrianarivelo, Maryam Sylla, Souleymane Diallo, Pagbajabyn Nymadawa, Nymadawaagiin Naranbat, Graciela Russomando & 7 others Wilma Basualdo, Florence Komurian-Pradel, Hubert Endtz, Philippe Vanhems, Gláucia Paranhos-Baccalà, Global Approach to Biological Research, Infectious diseases and Epidemics in Low-income countries (GABRIEL) Network, Delia Goletti

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Abstract

Background: Pneumonia, the leading infectious cause of child mortality globally, mainly afflicts developing countries. This prospective observational study aimed to assess the microorganisms associated with pneumonia in children aged <5 years in developing and emerging countries.

Methods: A multicenter, case-control study by the GABRIEL (Global Approach to Biological Research, Infectious diseases and Epidemics in Low-income countries) network was conducted between 2010 and 2014 in Cambodia, China, Haiti, India (2 sites), Madagascar, Mali, Mongolia, and Paraguay. Cases were hospitalized children with radiologically confirmed pneumonia; controls were children from the same setting without any features suggestive of pneumonia. Nasopharyngeal swabs were collected from all subjects; 19 viruses and 5 bacteria were identified by reverse-transcription polymerase chain reaction. Associations between microorganisms and pneumonia were quantified by calculating the adjusted population attributable fraction (aPAF) after multivariate logistic regression analysis adjusted for sex, age, time period, other pathogens, and site.

Results: Overall, 888 cases and 870 controls were analyzed; ≥1 microorganism was detected in respiratory samples in 93.0% of cases and 74.4% of controls (P < .001). Streptococcus pneumoniae, Mycoplasma pneumoniae, human metapneumovirus, rhinovirus, respiratory syncytial virus (RSV), parainfluenza virus 1, 3, and 4, and influenza virus A and B were independently associated with pneumonia; aPAF was 42.2% (95% confidence interval [CI], 35.5%-48.2%) for S. pneumoniae, 18.2% (95% CI, 17.4%-19.0%) for RSV, and 11.2% (95% CI, 7.5%-14.7%) for rhinovirus.

Conclusions: Streptococcus pneumoniae, RSV, and rhinovirus may be the major microorganisms associated with pneumonia infections in children <5 years of age from developing and emerging countries. Increasing S. pneumoniae vaccination coverage may substantially reduce the burden of pneumonia among children in developing countries.

Original languageEnglish
Pages (from-to)604-612
Number of pages9
JournalClinical Infectious Diseases
Volume65
Issue number4
DOIs
Publication statusPublished - Aug 15 2017

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Case-Control Studies
Pneumonia
Streptococcus pneumoniae
Rhinovirus
Developing Countries
Respiratory Syncytial Viruses
Confidence Intervals
Paraguay
Mongolia
Metapneumovirus
Haiti
Cambodia
Viruses
Mali
Influenza B virus
Madagascar
Paramyxoviridae Infections
Child Mortality
Mycoplasma pneumoniae
Hospitalized Child

Keywords

  • Journal Article

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Microorganisms Associated With Pneumonia in Children : The GABRIEL Pneumonia Multicenter, Prospective, Case-Control Study. / Bénet, Thomas; Sánchez Picot, Valentina; Messaoudi, Mélina; Chou, Monidarin; Eap, Tekchheng; Wang, Jianwei; Shen, Kunling; Pape, Jean-William; Rouzier, Vanessa; Awasthi, Shally; Pandey, Nitin; Bavdekar, Ashish; Sanghavi, Sonali; Robinson, Annick; Rakoto-Andrianarivelo, Mala; Sylla, Maryam; Diallo, Souleymane; Nymadawa, Pagbajabyn; Naranbat, Nymadawaagiin; Russomando, Graciela; Basualdo, Wilma; Komurian-Pradel, Florence; Endtz, Hubert; Vanhems, Philippe; Paranhos-Baccalà, Gláucia; Global Approach to Biological Research, Infectious diseases and Epidemics in Low-income countries (GABRIEL) Network ; Goletti, Delia.

In: Clinical Infectious Diseases, Vol. 65, No. 4, 15.08.2017, p. 604-612.

Research output: Contribution to journalArticle

Bénet, T, Sánchez Picot, V, Messaoudi, M, Chou, M, Eap, T, Wang, J, Shen, K, Pape, J-W, Rouzier, V, Awasthi, S, Pandey, N, Bavdekar, A, Sanghavi, S, Robinson, A, Rakoto-Andrianarivelo, M, Sylla, M, Diallo, S, Nymadawa, P, Naranbat, N, Russomando, G, Basualdo, W, Komurian-Pradel, F, Endtz, H, Vanhems, P, Paranhos-Baccalà, G, Global Approach to Biological Research, Infectious diseases and Epidemics in Low-income countries (GABRIEL) Network & Goletti, D 2017, 'Microorganisms Associated With Pneumonia in Children: The GABRIEL Pneumonia Multicenter, Prospective, Case-Control Study', Clinical Infectious Diseases, vol. 65, no. 4, pp. 604-612. https://doi.org/10.1093/cid/cix378
Bénet, Thomas ; Sánchez Picot, Valentina ; Messaoudi, Mélina ; Chou, Monidarin ; Eap, Tekchheng ; Wang, Jianwei ; Shen, Kunling ; Pape, Jean-William ; Rouzier, Vanessa ; Awasthi, Shally ; Pandey, Nitin ; Bavdekar, Ashish ; Sanghavi, Sonali ; Robinson, Annick ; Rakoto-Andrianarivelo, Mala ; Sylla, Maryam ; Diallo, Souleymane ; Nymadawa, Pagbajabyn ; Naranbat, Nymadawaagiin ; Russomando, Graciela ; Basualdo, Wilma ; Komurian-Pradel, Florence ; Endtz, Hubert ; Vanhems, Philippe ; Paranhos-Baccalà, Gláucia ; Global Approach to Biological Research, Infectious diseases and Epidemics in Low-income countries (GABRIEL) Network ; Goletti, Delia. / Microorganisms Associated With Pneumonia in Children : The GABRIEL Pneumonia Multicenter, Prospective, Case-Control Study. In: Clinical Infectious Diseases. 2017 ; Vol. 65, No. 4. pp. 604-612.
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abstract = "Background: Pneumonia, the leading infectious cause of child mortality globally, mainly afflicts developing countries. This prospective observational study aimed to assess the microorganisms associated with pneumonia in children aged <5 years in developing and emerging countries.Methods: A multicenter, case-control study by the GABRIEL (Global Approach to Biological Research, Infectious diseases and Epidemics in Low-income countries) network was conducted between 2010 and 2014 in Cambodia, China, Haiti, India (2 sites), Madagascar, Mali, Mongolia, and Paraguay. Cases were hospitalized children with radiologically confirmed pneumonia; controls were children from the same setting without any features suggestive of pneumonia. Nasopharyngeal swabs were collected from all subjects; 19 viruses and 5 bacteria were identified by reverse-transcription polymerase chain reaction. Associations between microorganisms and pneumonia were quantified by calculating the adjusted population attributable fraction (aPAF) after multivariate logistic regression analysis adjusted for sex, age, time period, other pathogens, and site.Results: Overall, 888 cases and 870 controls were analyzed; ≥1 microorganism was detected in respiratory samples in 93.0{\%} of cases and 74.4{\%} of controls (P < .001). Streptococcus pneumoniae, Mycoplasma pneumoniae, human metapneumovirus, rhinovirus, respiratory syncytial virus (RSV), parainfluenza virus 1, 3, and 4, and influenza virus A and B were independently associated with pneumonia; aPAF was 42.2{\%} (95{\%} confidence interval [CI], 35.5{\%}-48.2{\%}) for S. pneumoniae, 18.2{\%} (95{\%} CI, 17.4{\%}-19.0{\%}) for RSV, and 11.2{\%} (95{\%} CI, 7.5{\%}-14.7{\%}) for rhinovirus.Conclusions: Streptococcus pneumoniae, RSV, and rhinovirus may be the major microorganisms associated with pneumonia infections in children <5 years of age from developing and emerging countries. Increasing S. pneumoniae vaccination coverage may substantially reduce the burden of pneumonia among children in developing countries.",
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T1 - Microorganisms Associated With Pneumonia in Children

T2 - The GABRIEL Pneumonia Multicenter, Prospective, Case-Control Study

AU - Bénet, Thomas

AU - Sánchez Picot, Valentina

AU - Messaoudi, Mélina

AU - Chou, Monidarin

AU - Eap, Tekchheng

AU - Wang, Jianwei

AU - Shen, Kunling

AU - Pape, Jean-William

AU - Rouzier, Vanessa

AU - Awasthi, Shally

AU - Pandey, Nitin

AU - Bavdekar, Ashish

AU - Sanghavi, Sonali

AU - Robinson, Annick

AU - Rakoto-Andrianarivelo, Mala

AU - Sylla, Maryam

AU - Diallo, Souleymane

AU - Nymadawa, Pagbajabyn

AU - Naranbat, Nymadawaagiin

AU - Russomando, Graciela

AU - Basualdo, Wilma

AU - Komurian-Pradel, Florence

AU - Endtz, Hubert

AU - Vanhems, Philippe

AU - Paranhos-Baccalà, Gláucia

AU - Global Approach to Biological Research, Infectious diseases and Epidemics in Low-income countries (GABRIEL) Network

AU - Goletti, Delia

PY - 2017/8/15

Y1 - 2017/8/15

N2 - Background: Pneumonia, the leading infectious cause of child mortality globally, mainly afflicts developing countries. This prospective observational study aimed to assess the microorganisms associated with pneumonia in children aged <5 years in developing and emerging countries.Methods: A multicenter, case-control study by the GABRIEL (Global Approach to Biological Research, Infectious diseases and Epidemics in Low-income countries) network was conducted between 2010 and 2014 in Cambodia, China, Haiti, India (2 sites), Madagascar, Mali, Mongolia, and Paraguay. Cases were hospitalized children with radiologically confirmed pneumonia; controls were children from the same setting without any features suggestive of pneumonia. Nasopharyngeal swabs were collected from all subjects; 19 viruses and 5 bacteria were identified by reverse-transcription polymerase chain reaction. Associations between microorganisms and pneumonia were quantified by calculating the adjusted population attributable fraction (aPAF) after multivariate logistic regression analysis adjusted for sex, age, time period, other pathogens, and site.Results: Overall, 888 cases and 870 controls were analyzed; ≥1 microorganism was detected in respiratory samples in 93.0% of cases and 74.4% of controls (P < .001). Streptococcus pneumoniae, Mycoplasma pneumoniae, human metapneumovirus, rhinovirus, respiratory syncytial virus (RSV), parainfluenza virus 1, 3, and 4, and influenza virus A and B were independently associated with pneumonia; aPAF was 42.2% (95% confidence interval [CI], 35.5%-48.2%) for S. pneumoniae, 18.2% (95% CI, 17.4%-19.0%) for RSV, and 11.2% (95% CI, 7.5%-14.7%) for rhinovirus.Conclusions: Streptococcus pneumoniae, RSV, and rhinovirus may be the major microorganisms associated with pneumonia infections in children <5 years of age from developing and emerging countries. Increasing S. pneumoniae vaccination coverage may substantially reduce the burden of pneumonia among children in developing countries.

AB - Background: Pneumonia, the leading infectious cause of child mortality globally, mainly afflicts developing countries. This prospective observational study aimed to assess the microorganisms associated with pneumonia in children aged <5 years in developing and emerging countries.Methods: A multicenter, case-control study by the GABRIEL (Global Approach to Biological Research, Infectious diseases and Epidemics in Low-income countries) network was conducted between 2010 and 2014 in Cambodia, China, Haiti, India (2 sites), Madagascar, Mali, Mongolia, and Paraguay. Cases were hospitalized children with radiologically confirmed pneumonia; controls were children from the same setting without any features suggestive of pneumonia. Nasopharyngeal swabs were collected from all subjects; 19 viruses and 5 bacteria were identified by reverse-transcription polymerase chain reaction. Associations between microorganisms and pneumonia were quantified by calculating the adjusted population attributable fraction (aPAF) after multivariate logistic regression analysis adjusted for sex, age, time period, other pathogens, and site.Results: Overall, 888 cases and 870 controls were analyzed; ≥1 microorganism was detected in respiratory samples in 93.0% of cases and 74.4% of controls (P < .001). Streptococcus pneumoniae, Mycoplasma pneumoniae, human metapneumovirus, rhinovirus, respiratory syncytial virus (RSV), parainfluenza virus 1, 3, and 4, and influenza virus A and B were independently associated with pneumonia; aPAF was 42.2% (95% confidence interval [CI], 35.5%-48.2%) for S. pneumoniae, 18.2% (95% CI, 17.4%-19.0%) for RSV, and 11.2% (95% CI, 7.5%-14.7%) for rhinovirus.Conclusions: Streptococcus pneumoniae, RSV, and rhinovirus may be the major microorganisms associated with pneumonia infections in children <5 years of age from developing and emerging countries. Increasing S. pneumoniae vaccination coverage may substantially reduce the burden of pneumonia among children in developing countries.

KW - Journal Article

U2 - 10.1093/cid/cix378

DO - 10.1093/cid/cix378

M3 - Article

VL - 65

SP - 604

EP - 612

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

SN - 1058-4838

IS - 4

ER -