Epidemiologic, clinical, and serum markers may improve discrimination between bacterial and viral etiologies of childhood pneumonia

作者：Helmia Farida, Rina Triasih, Dewi Lokida, Yan Mardian, Gustiani Salim, Wahyu Nawang Wulan, Deni P. Butar-butar, Rizki Amalia Sari, Arif Budiman, Chakrawati Hayuningsih, Moh Syarofil Anam, Setya Dipayana, Mujahidah Mujahidah, Amalia Setyati, Abu Tholib Aman, Adhella Menur Naysilla, Nurhayati Lukman, Aly Diana, Muhammad Karyana, Ahnika Kline, Aaron Neal, H. Clifford Lane, Herman Kosasih, Chuen‐Yen Lau · 发表于：Frontiers in Medicine · 年份：2023 · DOI：10.3389/fmed.2023.1140100 · 被引用次数：10 · 研究领域：Pneumonia and Respiratory Infections、Respiratory viral infections research、Antibiotic Use and Resistance

Background Discrimination of bacterial and viral etiologies of childhood community-acquired pneumonia (CAP) is often challenging. Unnecessary antibiotic administration exposes patients to undue risks and may engender antimicrobial resistance. This study aimed to develop a prediction model using epidemiological, clinical and laboratory data to differentiate between bacterial and viral CAP. Methods Data from 155 children with confirmed bacterial or mixed bacterial and viral infection ( N = 124) and viral infection ( N = 31) were derived from a comprehensive assessment of causative pathogens [Partnerships for Enhanced Engagement in Research-Pneumonia in Pediatrics (PEER-PePPeS)] conducted in Indonesia. Epidemiologic, clinical and biomarker profiles (hematology and inflammatory markers) were compared between groups. The area under the receiver operating characteristic curve (AUROC) for varying biomarker levels was used to characterize performance and determine cut-off values for discrimination of bacterial and mixed CAP versus viral CAP. Diagnostic predictors of bacterial and mixed CAP were assessed by multivariate logistic regression. Results Diarrhea was more frequently reported in bacterial and mixed CAP, while viral infections more frequently occurred during Indonesia’s rainy season. White blood cell counts (WBC), absolute neutrophil counts (ANC), neutrophil-lymphocyte ratio (NLR), C-reactive protein (CRP), and procalcitonin (PCT) were significantly higher in bacterial and mi...