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Community-acquired Pneumonia in Children in Lambarene, Gabon

Community-acquired pneumonia (CAP) accounts for more than two million deaths per year in children < 5 years of age. Recognition of pathogens is vital for guiding antibiotic treatment. In Gabon, no epidemiologic data on childhood CAP were available to help guide antibiotic therapy. We conducted a prospective, hospital-based, cross-sectional survey at the Albert Schweitzer Hospital, Lambarene, Gabon, to assess the importance of atypical organisms (Chlamydia pneumoniae, Mycoplasma pneumoniae, Bordetella pertussis, and Legionella pneumophila) and Streptococcus pneumoniae in the etiology of CAP in children by means of real-time polymerase chain reaction, cell culture, and serology. Collectively, atypical bacteria accounted for 11% of cases with a special emphasis on B. pertussis, accounting for 6% of cases. Clinical differentiation of atypical from typical pneumonia in children remains challenging. Molecular diagnostic methods offer fast and highly sensitive diagnostic tools and would be able to help guide antimicrobial therapy in rural areas where follow-up is difficult.

Received May 15, 2007. Accepted for publication February 18, 2008.

^* Address correspondence to Britta Lassmann, Infectious Diseases Section, Department of Internal Medicine, Yale University School of Medicine, 300 Cedar Street, PO Box 208022, New Haven, CT 06520-8022. E-mail: britta.lassmann{at}yale.edu

Authors’ addresses: Britta Lassmann, Infectious Diseases Section, Department of Internal Medicine, Yale University School of Medicine, 300 Cedar Street, PO Box 208022, New Haven, CT 06520-8022; Medical Research Unit, Albert Schweitzer Hospital, BP 118, Lambarene, Gabon; and Department of Internal Medicine I, Division of Infectious Diseases and Chemotherapy, University Hospital Vienna, 1090 Vienna, Austria. Marc Poetschke and Saadou Issifou, Medical Research Unit, Albert Schweitzer Hospital, BP 118, Lambarene, Gabon. Petra Apfalter, Department of Clinical Microbiology, University Hospital Vienna, 1090 Vienna, Austria. Bonito Ninteretse, Department of Pediatrics, Albert Schweitzer Hospital, BP 118, Lambarene, Gabon. Stefan Winkler, Medical Research Unit, Albert Schweitzer Hospital, BP 118, Lambarene, Gabon and Department of Internal Medicine I, Division of Infectious Diseases and Chemotherapy, University Hospital Vienna, 1090 Vienna, Austria. Peter G. Kremsner, Medical Research Unit, Albert Schweitzer Hospital, BP 118, Lambarene, Gabon and Institute for Tropical Medicine, University Hospital Tübingen, Wilhelmstrasse 27, 72074 Tübingen, Germany. Wolfgang Graninger, Department of Internal Medicine I, Division of Infectious Diseases and Chemotherapy, University Hospital Vienna, 1090 Vienna, Austria.