Respiratory viruses, not bacterial infections, are the most commonly detected causes of community-acquired pneumonia in children, revealed a multicenter Etiology of Pneumonia in the Community (EPIC) study.
The EPIC study was a prospective, population-based study of community-acquired pneumonia hospitalizations among children in the United States that sought to address critical gaps in the knowledge about pneumonia. The study showed that the burden of pneumonia-related hospitalization is highest among children younger than 5-years of age.
The study involved children who were admitted with pneumonia, from January 2010 to June 2012, at Monroe Carell Jr. Children's Hospital at Vanderbilt, LeBonheur Children's Medical Center and University of Utah. A total of 2,638 children younger than 18 years of age were enrolled, with 2,358 of those children having pneumonia confirmed by chest X-ray. Researchers obtained nasal, throat and blood samples on all the children to unravel the cause of pneumonia, whether viral or bacterial.
The key findings of the study revealed that 81 percent of cases examined were caused by viral infections, while only 8 percent were caused by bacterial infections and 7 percent were both viral and bacterial. It was seen that RSV and human rhinovirus accounted for the leading viral causes of pneumonia among these children, followed by human metapneumovirus (HMPV), adenovirus, parainfluenza virus and coronavirus. These findings could be a catalyst for researchers to further investigate new and better ways to treat or prevent respiratory viruses, such as respiratory syncytial virus (RSV), which can lead to pneumonia. The study authors wrote, "Effective antiviral vaccines or treatments, particularly for RSV infection, could have a mitigating effect on pneumonia in children."
Study co-author Kathryn Edwards said, "What this tells us is that viruses are important causes of pneumonia. But it also tells us that with the routinely administered pneumococcal and haemophilus vaccines given to children, that we have virtually eliminated most bacteria as causes of pneumonia."
Study lead Derek Williams said, "Pneumonia is a leading cause of hospitalization and is nearly always treated with antibiotics, but results from the EPIC study indicate we could drastically reduce antibiotic use overall, and when we do use antibiotics, we could do a much better job of limiting the use of broad-spectrum antibiotics. Unfortunately, differentiating viral from bacterial causes of pneumonia is not always clear. We are now trying to unravel that mystery to better understand the best way to treat pneumonia, when to use antibiotics, what antibiotics to use, and how to prevent it."
The research is published in the 'New England Journal of Medicine'.