Persistent pathogens as risk factors of community-acquired pneumonia and acute bronchitis in children

Abstract

The aim of this study was to determine the relationship between infection with “persistent” agents of children and the possibility of the development of inflammatory diseases of the respiratory tract such as community-acquired pneumonia and acute bronchitis on the basis of risk management concepts.Materials and methods. 701 children in age from 15 days to 16 years were examined in Nizhny Novgorod and the Nizhny Novgorod region with clinically and radiologically confirmed diagnosis: community-acquired pneumonia, acute bronchitis. This study was performed in the period from 2005 to 2014. The control group consisted of 127 healthy children of different ages. The detection of M. pneumoniae, Сytomegalovirus, Herpes simplex I/II C. pneumoniae was performed by PCR. The concept of risk determination was based on the determination of the absolute risk in the exposed and the no exposed groups, attributable risk, relative risk, the population attributable risk, as well as determining the standard errors for each type of risk and confidence interval.Results. Attributable risk, relative risk, population-attributable risk are statistically significant figures. Attributable risk of development of community-acquired pneumonia was 29,26%; 27,37%; 25,70%; 20,21% for the M. pneumoniae, C. pneumoniae, CMV, HSV I / II respectively. The relative risk was 1,43 for the M. pneumoniae; 1,38 – for C. pneumoniae and CMV; 1,28- for HSV I / II. The presence of persistent pathogens is resulting in increased incidence of communityacquired pneumonia throughout the population (population attributable risk): 4,75% for M. pneumoniae, 0,23% for C. pneumoniae, 5,59% for the CMV and 1,08% for the HSV I/II. Similar calculations were performed for patients with acute bronchitis. The statistical analysis allowed to exclude C. pneumoniae and HSV I / II of the risk factors for communityacquired pneumonia and acute bronchitis.Conclusion. The findings suggest the influence of M. pneumoniae and CMV in the development of communityacquired pneumonia and acute bronchitis in children. C. pneumoniae, and HSV I / II do not play a statistically significant role in the overall landscape of etiologic agents of community-acquired pneumonia and acute bronchitis.

Keywords

• persistent pathogens
• community-acquired pneumonia
• acute bronchitis
• medical and statistical evaluation