Preliminary results of the pilot pneumonia multicentric study in the GABRIEL network for etiological agents identification

Background and Aims. The final purpose of the Pilot Multi-centric Pneumonia Study (launched in 2010) is to provide information on the pneumonia etiology (viruses and bacterial) to improve case management of the pneumonia ill child. Methods. A hospital-based case-control study has been carried-out in 10 centers located in 9 countries over 3 continents. 826 cases and 791 controls out of 2,000 under 5 years of age were enrolled. Respiratory specimens and whole blood were collected from all pneumonia cases and controls to identify viruses or bacteria using real-time multiplex PCR assays. S. pneumoniae was serotyped in positive samples. Results. The main bacterial agent found in cases and control respiratory samples were S. pneumoniae (58% and 40%, respectively). S. aureus, H. influenzae b, M. pneumoniae and C. pneumoniae were less represented (18% to 0.1%). For the viral population, RSV was the principal agent found (26% in cases and only at 5% in controls). HMPV, PIV-3 and Influenza-A/B were found mainly in cases. Rhinoviruses were found equally in controls and cases (around 21%). The main S. pneumoniae serotypes represented were 6A/B; 14; 19A; 19F and 5. The viral and S. pneumoniae serotype populations were different in each country. These results while preliminary are nonetheless interesting. Conclusions. The objective of this study is to identify the etiologies of pneumonia among hospitalized children in developing and emergent countries. The results will improve individual care and propose appropriate public health policies. The results should permit a better implementation of targeted curative or preventive measures.