Colonization Density of the Upper Respiratory Tract as a Predictor of Pneumonia-Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus, and Pneumocystis jirovecii.
Daniel E. Park,Henry C. Baggett,Howie Src,Qiyuan Shi,Nora L. Watson,Brooks Wa,Deloria Knoll M,Laura L. Hammitt,Laura L. Hammitt,Karen L. Kotloff,Orin S. Levine,Orin S. Levine,Shabir A. Madhi,David R. Murdoch,Katherine L. O'Brien,Scott Jag.,Donald M. Thea,Dilruba Ahmed,Martin Antonio,Martin Antonio,Martin Antonio,Vicky L. Baillie,Vicky L. Baillie,Andrea DeLuca,Amanda J. Driscoll,Wei Fu,Caroline W. Gitahi,Emmanuel Olutunde,Melissa M. Higdon,Lokman Hossain,Ruth A. Karron,Abdoul Aziz Maiga,Susan A. Maloney,David P. Moore,David P. Moore,Susan C. Morpeth,Susan C. Morpeth,Susan C. Morpeth,John Mwaba,Musaku Mwenechanya,Christine Prosperi,Mariam Sylla,Somsak Thamthitiwat,Scott L. Zeger,Daniel R. Feikin,Daniel R. Feikin +45 more
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There is evidence for an association between H. influenzae–confirmed pneumonia in children; the association may be particularly informative in epidemiologic studies and unlikely to be of diagnostic value in clinical settings.Abstract:
Background. There is limited information on the association between colonization density of upper respiratory tract colonizers and pathogen-specific pneumonia. We assessed this association for Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus, and Pneumocystis jirovecii. Methods. In 7 low- and middle-income countries, nasopharyngeal/oropharyngeal swabs from children with severe pneumonia and age-frequency matched community controls were tested using quantitative polymerase chain reaction (PCR). Differences in median colonization density were evaluated using the Wilcoxon rank-sum test. Density cutoffs were determined using receiver operating characteristic curves. Cases with a pathogen identified from lung aspirate culture or PCR, pleural fluid culture or PCR, blood culture, and immunofluorescence for P. jirovecii defined microbiologically confirmed cases for the given pathogens. Results. Higher densities of H. influenzae were observed in both microbiologically confirmed cases and chest radiograph (CXR)-positive cases compared to controls. Staphylococcus aureus and P. jirovecii had higher densities in CXR-positive cases vs controls. A 5.9 log10 copies/mL density cutoff for H. influenzae yielded 86% sensitivity and 77% specificity for detecting microbiologically confirmed cases; however, densities overlapped between cases and controls and positive predictive values were poor (<3%). Informative density cutoffs were not found for S. aureus and M. catarrhalis, and a lack of confirmed case data limited the cutoff identification for P. jirovecii. Conclusions. There is evidence for an association between H. influenzae colonization density and H. influenzae-confirmed pneumonia in children; the association may be particularly informative in epidemiologic studies. Colonization densities of M. catarrhalis, S. aureus, and P. jirovecii are unlikely to be of diagnostic value in clinical settings.read more
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Causes of severe pneumonia requiring hospital admission in children without HIV infection from Africa and Asia: the PERCH multi-country case-control study
Katherine L. O'Brien,Henry C. Baggett,W. Abdullah Brooks,Daniel R. Feikin,Laura L. Hammitt,Melissa M. Higdon,Stephen R. C. Howie,Maria Deloria Knoll,Karen L. Kotloff,Orin S. Levine,Shabir A. Madhi,David R. Murdoch,Christine Prosperi,J. Anthony G. Scott,Qiyuan Shi,Donald M. Thea,Zhenke Wu,Scott L. Zeger,Peter V. Adrian,Pasakorn Akarasewi,Trevor P. Anderson,Martin Antonio,Juliet O. Awori,Vicky L. Baillie,Charatdao Bunthi,James Chipeta,Mohammod Jobayer Chisti,Jane Crawley,Andrea DeLuca,Amanda J. Driscoll,Bernard E. Ebruke,Hubert P. Endtz,Nicholas Fancourt,Wei Fu,Doli Goswami,Michelle J. Groome,Meredith Haddix,Lokman Hossain,Yasmin Jahan,E Wangeci Kagucia,Alice Kamau,Ruth A. Karron,Sidi Kazungu,Nana Kourouma,Locadiah Kuwanda,Geoffrey Kwenda,Mengying Li,Eunice M. Machuka,Grant A. Mackenzie,Nasreen Mahomed,Susan A. Maloney,Jessica McLellan,Joanne L. Mitchell,David P. Moore,Susan C. Morpeth,Azwifarwi Mudau,Lawrence Mwananyanda,James Mwansa,Micah Silaba Ominde,Uma Onwuchekwa,Daniel E. Park,Julia Rhodes,Pongpun Sawatwong,Phil Seidenberg,Arifin Shamsul,Eric A. F. Simões,Seydou Sissoko,Somwe Wa Somwe,Samba O. Sow,Mamadou Sylla,Boubou Tamboura,Milagritos D. Tapia,Somsak Thamthitiwat,Aliou Toure,Nora L. Watson,Khalequ Zaman,Syed M. A. Zaman +76 more
TL;DR: Estimating causes of pneumonia in young African and Asian children, using novel analytical methods applied to clinical and microbiological findings, estimated that viruses accounted for 61·4% (95% credible interval [CrI] 57·3–65·6) of causes, whereas bacteria accounted for 27·3% (23·3-31·6).
Journal ArticleDOI
Childhood pneumonia in low-and-middle-income countries: An update.
Diana Marangu,Heather J. Zar +1 more
TL;DR: Morbidity and mortality from childhood pneumonia has decreased but a considerable preventable burden remains, and widespread implementation of available, effective interventions and development of novel strategies are needed.
Journal ArticleDOI
Is Higher Viral Load in the Upper Respiratory Tract Associated With Severe Pneumonia? Findings From the PERCH Study
Daniel R. Feikin,Wei Fu,Daniel E. Park,Daniel E. Park,Qiyuan Shi,Melissa M. Higdon,Henry C. Baggett,Brooks Wa,Deloria Knoll M,Laura L. Hammitt,Laura L. Hammitt,Howie Src,Karen L. Kotloff,Orin S. Levine,Orin S. Levine,Shabir A. Madhi,Scott Jag.,Donald M. Thea,Peter V. Adrian,Peter V. Adrian,Martin Antonio,Martin Antonio,Martin Antonio,Juliet O. Awori,Vicky L. Baillie,Vicky L. Baillie,Andrea DeLuca,Amanda J. Driscoll,Bernard E. Ebruke,Doli Goswami,Ruth A. Karron,Mengying Li,Susan C. Morpeth,Susan C. Morpeth,Susan C. Morpeth,John Mwaba,James Mwansa,Christine Prosperi,Pongpun Sawatwong,Samba O. Sow,Tapia,Toni Whistler,K. Zaman,Scott L. Zeger,O' Brien Kl,David R. Murdoch +45 more
TL;DR: Although higher viral loads among pneumonia cases than controls for some viruses are found, the utility in using viral load of URT specimens to define viral pneumonia was equivocal and analysis was limited by lack of a gold standard for viral pneumonia.
Journal ArticleDOI
Association of C-Reactive Protein With Bacterial and Respiratory Syncytial Virus–Associated Pneumonia Among Children Aged <5 Years in the PERCH Study
Melissa M. Higdon,Tham T Le,Tham T Le,Katherine L. O'Brien,David R. Murdoch,David R. Murdoch,Christine Prosperi,Henry C. Baggett,W. Abdullah Brooks,W. Abdullah Brooks,Daniel R. Feikin,Daniel R. Feikin,Laura L. Hammitt,Laura L. Hammitt,Stephen R. C. Howie,Stephen R. C. Howie,Stephen R. C. Howie,Karen L. Kotloff,Orin S. Levine,Orin S. Levine,J. Anthony G. Scott,J. Anthony G. Scott,Donald M. Thea,Juliet O. Awori,Vicky L. Baillie,Vicky L. Baillie,Stephanie Cascio,Somchai Chuananon,Andrea DeLuca,Amanda J. Driscoll,Bernard E. Ebruke,Hubert P. Endtz,Hubert P. Endtz,Anek Kaewpan,Geoff Kahn,Angela Karani,Ruth A. Karron,David P. Moore,David P. Moore,Daniel E. Park,Daniel E. Park,Mohammed Ziaur Rahman,Rasheed Salaudeen,Rasheed Salaudeen,Phil Seidenberg,Phil Seidenberg,Somwe Wa Somwe,Mamadou Sylla,Milagritos D. Tapia,Scott L. Zeger,Maria Deloria Knoll,Shabir A. Madhi,Shabir A. Madhi,Nicholas Fancourt,Wei Fu,E Wangeci Kagucia,Mengying Li,Zhenke Wu,Nora L. Watson,Jane Crawley,Khalequ Zaman,Doli Goswami,Lokman Hossain,Yasmin Jahan,Hasan Ashraf,Martin Antonio,Jessica McLellan,Eunice M. Machuka,Arifin Shamsul,Syed M. A. Zaman,Grant A. Mackenzie,Susan C. Morpeth,Alice Kamau,Sidi Kazungu,Micah Silaba Ominde,Samba O. Sow,Boubou Tamboura,Uma Onwuchekwa,Nana Kourouma,Aliou Toure,Peter V. Adrian,Locadiah Kuwanda,Azwifarwi Mudau,Michelle J. Groome,Nasreen Mahomed,Somsak Thamthitiwat,Susan A. Maloney,Charatdao Bunthi,Julia Rhodes,Pongpun Sawatwong,Pasakorn Akarasewi,Lawrence Mwananyanda,James Chipeta,James Mwansa,Geoffrey Kwenda,Trevor P. Anderson,Joanne L. Mitchell +96 more
TL;DR: Elevated CRP was positively associated with confirmed bacterial pneumonia and negatively associated with RSV pneumonia in PERCH, suggesting CRP may be useful for distinguishing bacterial from RSV-associated pneumonia, although its role in discriminating against other respiratory viral- associated pneumonia needs further study.
Journal ArticleDOI
Metagenomic next-generation sequencing of samples from pediatric febrile illness in Tororo, Uganda.
Akshaya Ramesh,Sara Nakielny,Jennifer Hsu,Mary Kyohere,Oswald Byaruhanga,Charles F. A. de Bourcy,Rebecca Egger,Boris Dimitrov,Yun-Fang Juan,Jonathan Sheu,James H.-C. Wang,Katrina Kalantar,Charles Langelier,Theodore Ruel,Arthur Mpimbaza,Michael R. Wilson,Philip J. Rosenthal,Joseph L. DeRisi +17 more
TL;DR: The near complete genome of a highly divergent orthobunyavirus, tentatively named Nyangole virus, is identified from the serum of a child diagnosed with malaria and pneumonia, a Bwamba orthob UNavirus in the nasopharynx of a children with rash and sepsis, and the genomes of two novel human rhinovirus C species are reported.
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