Community-acquired Pneumonia in Children in Lambarene, Gabon

Britta Lassmann Albert Schweitzer Hospital, Lambarene, Gabon; Institute for Tropical Medicine, Tübingen, Germany; Division of Infectious Diseases and Chemotherapy, and Department of Clinical Microbiology, University Hospital of Vienna, Vienna, Austria; Infectious Diseases Section, Yale University School of Medicine, New Haven, Connecticut

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Marc Poetschke Albert Schweitzer Hospital, Lambarene, Gabon; Institute for Tropical Medicine, Tübingen, Germany; Division of Infectious Diseases and Chemotherapy, and Department of Clinical Microbiology, University Hospital of Vienna, Vienna, Austria; Infectious Diseases Section, Yale University School of Medicine, New Haven, Connecticut

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Bonito Ninteretse Albert Schweitzer Hospital, Lambarene, Gabon; Institute for Tropical Medicine, Tübingen, Germany; Division of Infectious Diseases and Chemotherapy, and Department of Clinical Microbiology, University Hospital of Vienna, Vienna, Austria; Infectious Diseases Section, Yale University School of Medicine, New Haven, Connecticut

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Saadou Issifou Albert Schweitzer Hospital, Lambarene, Gabon; Institute for Tropical Medicine, Tübingen, Germany; Division of Infectious Diseases and Chemotherapy, and Department of Clinical Microbiology, University Hospital of Vienna, Vienna, Austria; Infectious Diseases Section, Yale University School of Medicine, New Haven, Connecticut

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Stefan Winkler Albert Schweitzer Hospital, Lambarene, Gabon; Institute for Tropical Medicine, Tübingen, Germany; Division of Infectious Diseases and Chemotherapy, and Department of Clinical Microbiology, University Hospital of Vienna, Vienna, Austria; Infectious Diseases Section, Yale University School of Medicine, New Haven, Connecticut

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Peter G. Kremsner Albert Schweitzer Hospital, Lambarene, Gabon; Institute for Tropical Medicine, Tübingen, Germany; Division of Infectious Diseases and Chemotherapy, and Department of Clinical Microbiology, University Hospital of Vienna, Vienna, Austria; Infectious Diseases Section, Yale University School of Medicine, New Haven, Connecticut

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Wolfgang Graninger Albert Schweitzer Hospital, Lambarene, Gabon; Institute for Tropical Medicine, Tübingen, Germany; Division of Infectious Diseases and Chemotherapy, and Department of Clinical Microbiology, University Hospital of Vienna, Vienna, Austria; Infectious Diseases Section, Yale University School of Medicine, New Haven, Connecticut

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Petra Apfalter Albert Schweitzer Hospital, Lambarene, Gabon; Institute for Tropical Medicine, Tübingen, Germany; Division of Infectious Diseases and Chemotherapy, and Department of Clinical Microbiology, University Hospital of Vienna, Vienna, Austria; Infectious Diseases Section, Yale University School of Medicine, New Haven, Connecticut

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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.

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