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Role of viral and bacterial pathogens in causing pneumonia among Western Australian children: a case-control study protocol.
BMJ Open. 2018 03 16; 8(3):e020646.BO

Abstract

INTRODUCTION

Pneumonia is the leading cause of childhood morbidity and mortality globally. Introduction of the conjugate Haemophilus influenzae B and multivalent pneumococcal vaccines in developed countries including Australia has significantly reduced the overall burden of bacterial pneumonia. With the availability of molecular diagnostics, viruses are frequently detected in children with pneumonia either as primary pathogens or predispose to secondary bacterial infection. Many respiratory pathogens that are known to cause pneumonia are also identified in asymptomatic children, so the true contribution of these pathogens to childhood community-acquired pneumonia (CAP) remains unclear. Since the introduction of pneumococcal vaccines, very few comprehensive studies from developed countries have attempted to determine the bacterial and viral aetiology of pneumonia. We aim to determine the contribution of bacteria and viruses to childhood CAP to inform further development of effective diagnosis, treatment and preventive strategies.

METHODS AND ANALYSIS

We are conducting a prospective case-control study (PneumoWA) where cases are children with radiologically confirmed pneumonia admitted to Princess Margaret Hospital for Children (PMH) and controls are healthy children identified from PMH outpatient clinics and from local community immunisation clinics. The case-control ratio is 1:1 with 250 children to be recruited in each arm. Nasopharyngeal swabs are collected from both cases and controls to detect the presence of viruses and bacteria by PCR; pathogen load will be assessed by quantitative PCR. The prevalence of pathogens detected in cases and controls will be compared, the OR of detection and population attributable fraction to CAP for each pathogen will be determined; relationships between pathogen load and disease status and severity will be explored.

ETHICS AND DISSEMINATION

This study has been approved by the human research ethics committees of PMH, Perth, Australia (PMH HREC REF 2014117EP). Findings will be disseminated at research conferences and in peer-reviewed journals.

Authors+Show Affiliations

Division of Paediatrics, Faculty of Health and Medical Sciences, School of Medicine, The University of Western Australia, Perth, Western Australia, Australia. Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Australia.Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Australia. Department of Infectious Diseases, Princess Margaret Hospital for Children, Perth, Australia.Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Australia.PathWest Laboratory Medicine WA, Perth, Australia.Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Australia. Faculty of Health and Medical Sciences, School of Biomedical Science, The University of Western Australia, Perth, Australia.Department of Infectious Diseases, Princess Margaret Hospital for Children, Perth, Australia.Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Australia. Faculty of Health and Medical Sciences, School of Biomedical Science, The University of Western Australia, Perth, Australia.Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Australia. Faculty of Health and Medical Sciences, School of Biomedical Science, The University of Western Australia, Perth, Australia.PathWest Laboratory Medicine WA, Perth, Australia.Department of Infectious Diseases, Princess Margaret Hospital for Children, Perth, Australia.Division of Paediatrics, Faculty of Health and Medical Sciences, School of Medicine, The University of Western Australia, Perth, Western Australia, Australia. Department of Infectious Diseases, Princess Margaret Hospital for Children, Perth, Australia.PathWest Laboratory Medicine WA, Perth, Australia.Faculty of Medicine, School of Women's and Children's Health, University of New South Wales, Sydney, Australia.Division of Paediatrics, Faculty of Health and Medical Sciences, School of Medicine, The University of Western Australia, Perth, Western Australia, Australia. Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Australia. Department of Infectious Diseases, Princess Margaret Hospital for Children, Perth, Australia. PathWest Laboratory Medicine WA, Perth, Australia.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29549211

Citation

Bhuiyan, Mejbah Uddin, et al. "Role of Viral and Bacterial Pathogens in Causing Pneumonia Among Western Australian Children: a Case-control Study Protocol." BMJ Open, vol. 8, no. 3, 2018, pp. e020646.
Bhuiyan MU, Snelling TL, West R, et al. Role of viral and bacterial pathogens in causing pneumonia among Western Australian children: a case-control study protocol. BMJ Open. 2018;8(3):e020646.
Bhuiyan, M. U., Snelling, T. L., West, R., Lang, J., Rahman, T., Borland, M. L., Thornton, R., Kirkham, L. A., Sikazwe, C., Martin, A. C., Richmond, P. C., Smith, D. W., Jaffe, A., & Blyth, C. C. (2018). Role of viral and bacterial pathogens in causing pneumonia among Western Australian children: a case-control study protocol. BMJ Open, 8(3), e020646. https://doi.org/10.1136/bmjopen-2017-020646
Bhuiyan MU, et al. Role of Viral and Bacterial Pathogens in Causing Pneumonia Among Western Australian Children: a Case-control Study Protocol. BMJ Open. 2018 03 16;8(3):e020646. PubMed PMID: 29549211.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Role of viral and bacterial pathogens in causing pneumonia among Western Australian children: a case-control study protocol. AU - Bhuiyan,Mejbah Uddin, AU - Snelling,Thomas L, AU - West,Rachel, AU - Lang,Jurissa, AU - Rahman,Tasmina, AU - Borland,Meredith L, AU - Thornton,Ruth, AU - Kirkham,Lea-Ann, AU - Sikazwe,Chisha, AU - Martin,Andrew C, AU - Richmond,Peter C, AU - Smith,David W, AU - Jaffe,Adam, AU - Blyth,Christopher C, Y1 - 2018/03/16/ PY - 2018/3/18/entrez PY - 2018/3/20/pubmed PY - 2018/9/8/medline KW - epidemiology KW - molecular diagnostics KW - respiratory infections SP - e020646 EP - e020646 JF - BMJ open JO - BMJ Open VL - 8 IS - 3 N2 - INTRODUCTION: Pneumonia is the leading cause of childhood morbidity and mortality globally. Introduction of the conjugate Haemophilus influenzae B and multivalent pneumococcal vaccines in developed countries including Australia has significantly reduced the overall burden of bacterial pneumonia. With the availability of molecular diagnostics, viruses are frequently detected in children with pneumonia either as primary pathogens or predispose to secondary bacterial infection. Many respiratory pathogens that are known to cause pneumonia are also identified in asymptomatic children, so the true contribution of these pathogens to childhood community-acquired pneumonia (CAP) remains unclear. Since the introduction of pneumococcal vaccines, very few comprehensive studies from developed countries have attempted to determine the bacterial and viral aetiology of pneumonia. We aim to determine the contribution of bacteria and viruses to childhood CAP to inform further development of effective diagnosis, treatment and preventive strategies. METHODS AND ANALYSIS: We are conducting a prospective case-control study (PneumoWA) where cases are children with radiologically confirmed pneumonia admitted to Princess Margaret Hospital for Children (PMH) and controls are healthy children identified from PMH outpatient clinics and from local community immunisation clinics. The case-control ratio is 1:1 with 250 children to be recruited in each arm. Nasopharyngeal swabs are collected from both cases and controls to detect the presence of viruses and bacteria by PCR; pathogen load will be assessed by quantitative PCR. The prevalence of pathogens detected in cases and controls will be compared, the OR of detection and population attributable fraction to CAP for each pathogen will be determined; relationships between pathogen load and disease status and severity will be explored. ETHICS AND DISSEMINATION: This study has been approved by the human research ethics committees of PMH, Perth, Australia (PMH HREC REF 2014117EP). Findings will be disseminated at research conferences and in peer-reviewed journals. SN - 2044-6055 UR - https://www.unboundmedicine.com/medline/citation/29549211/Role_of_viral_and_bacterial_pathogens_in_causing_pneumonia_among_Western_Australian_children:_a_case_control_study_protocol_ L2 - https://bmjopen.bmj.com/lookup/pmidlookup?view=long&pmid=29549211 DB - PRIME DP - Unbound Medicine ER -