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Viruses would be even more likely to cause severe childhood pneumonia than bacteria

Artistic illustration of human respiratory syncytial virus, responsible for one-third of pneumonia. | Kateryna Kon / Shutterstock

Researchers have shown, after examining children with pneumonia, that bacteria are far from the main agents of the disease in them. This study will warn physicians about the need for an accurate diagnosis for effective healing.

Pneumonia is an infection of the lungs that begins with frequent coughing, difficulty breathing, wheezing, headache, muscle aches and chest pain, and sudden fever. These symptoms, which often deceive the patient at first because of the similarity with a simple flu, can disappear without treatment or on the contrary worsen, requiring in this case a hospitalization.


The disease can be caused by a broad spectrum of bacteria, viruses or fungi (more than thirty) which, multiplying in the lungs, will clog the pulmonary alveoli causing their inflammation and the production of pus, which is going to accumulate and damage them, reducing the amount of oxygen they can absorb. Bacteria have long been considered the main culprits for the majority of cases of severe pneumonia.

The disease affects more than 600,000 French people every year and causes the death of about 15,000 of them. Children are the most fragile, with more than a million deaths each year. The large number of pathogens that can cause pneumonia and the location of the infection in the lungs make diagnosis difficult.

But researchers conducted a multi-site study over two years using a new method in seven countries with severe pneumonia (Zambia, Gambia, Kenya, South Africa, Mali, Thailand and Bangladesh) to identify pathogens most likely to cause serious infections.

They performed on 4232 children, samples in the throat and nose, as well as various body fluids such as blood, or those caused by coughing.


More than 60% of children in the study were infected with a virus, while bacteria accounted for less than 30% of cases. The remaining 10% were due to fungi, tuberculosis, or various unidentified causes.

Human respiratory syncytial virus (RSV) alone accounted for almost one-third of infections, but the distribution of different pathogens varied between study sites and countries.

The results of this study could influence research into the development of pneumonia drugs and vaccines. The latter, which are mainly produced to target bacteria, are also partly responsible for the excessive use of antibiotics.

Highlighting pathogens causing the majority of pneumonia and using their new diagnostic method could lead to effective identification and direct use of the correct treatment.



Bibliography:

Causes of severe pneumonia requiring hospital admission in children without HIV infection from Africa and Asia: the PERCH multi-country case-control study
The Pneumonia Etiology Research for Child Health (PERCH)
Published:June 27, 2019
DOI:https://doi.org/10.1016/S0140-6736(19)30721-4

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