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2. Colonization Density of the Upper Respiratory Tract as a Predictor of Pneumonia—Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus, and Pneumocystis jirovecii

Author

PERCH Study Group, Park, Daniel E., Baggett, Henry C., Howie, Stephen R. C., Shi, Qiyuan, Watson, Nora L., Brooks, W. Abdullah, Knoll, Maria Deloria, Hammitt, Laura L., Kotloff, Karen L., Levine, Orin S., Madhi, Shabir A., Murdoch, David R., O'Brien, Katherine L., Scott, J. Anthony G., Thea, Donald M., Ahmed, Dilruba, Antonio, Martin, Baillie, Vicky L., DeLuca, Andrea N., Driscoll, Amanda J., Fu, Wei, Gitahi, Caroline W., Olutunde, Emmanuel, Higdon, Melissa M., Hossain, Lokman, Karron, Ruth A., Maiga, Abdoul Aziz, Maloney, Susan A., Moore, David P., Morpeth, Susan C., Mwaba, John, Mwenechanya, Musaku, Prosperi, Christine, Sylla, Mamadou, Thamthitiwat, Somsak, Zeger, Scott L., and Feikin, Daniel R.

Published
2017

3. Pertussis-Associated Pneumonia in Infants and Children From Low- and Middle-Income Countries Participating in the PERCH Study

Author

Pneumonia Etiology Research for Child Health (PERCH) Study Group, Barger-Kamate, Breanna, Knoll, Maria Deloria, Kagucia, E. Wangeci, Prosperi, Christine, Baggett, Henry C., Brooks, W. Abdullah, Feikin, Daniel R., Hammitt, Laura L., Howie, Stephen R. C., Levine, Orin S., Madhi, Shabir A., Scott, J. Anthony G., Thea, Donald M., Amornintapichet, Tussanee, Anderson, Trevor P., Awori, Juliet O., Baillie, Vicky L., Chipeta, James, DeLuca, Andrea N., Driscoll, Amanda J., Goswami, Doli, Higdon, Melissa M., Hossain, Lokman, Karron, Ruth A., Maloney, Susan, Moore, David P., Morpeth, Susan C., Mwananyanda, Lawrence, Ofordile, Ogochukwu, Olutunde, Emmanuel, Park, Daniel E., Sow, Samba O., Tapia, Milagritos D., Murdoch, David R., O'Brien, Katherine L., and Kotloff, Karen L.

Published
2016

5. Incidence of Pneumococcal Bacteremia Requiring Hospitalization in Rural Thailand

Author

Baggett, Henry C., Peruski, Leonard F., Olsen, Sonja J., Thamthitiwat, Somsak, Rhodes, Julia, Dejsirilert, Surang, Wongjindanon, Wanna, Dowell, Scott F., Fischer, Julie E., Areerat, Peera, Sornkij, Denchai, Jorakate, Possawat, Kaewpan, Anek, Prapasiri, Prabda, Naorat, Sathapana, Sangsuk, Leelawadee, Eampokalap, Boonchuay, Moore, Matthew R., Carvalho, Gloria, Beall, Bernard, Ungchusak, Kumnuan, and Maloney, Susan A.

Published
2009
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7. Density of Upper Respiratory Colonization With Streptococcus pneumoniae and Its Role in the Diagnosis of Pneumococcal Pneumonia Among Children Aged <5 Years in the PERCH Study

Author

Baggett, Henry C, Watson, Nora L, Deloria Knoll, Maria, Brooks, W Abdullah, Feikin, Daniel R, Hammitt, Laura L, Howie, Stephen R C, Kotloff, Karen L, Levine, Orin S, Madhi, Shabir A, Murdoch, David R, Scott, J Anthony G, Thea, Donald M, Antonio, Martin, Awori, Juliet O, Baillie, Vicky L, DeLuca, Andrea N, Driscoll, Amanda J, Duncan, Julie, Ebruke, Bernard E, Goswami, Doli, Higdon, Melissa M, Karron, Ruth A, Moore, David P, Morpeth, Susan C, Mulindwa, Justin M, Park, Daniel E, Paveenkittiporn, Wantana, Piralam, Barameht, Prosperi, Christine, Sow, Samba O, Tapia, Milagritos D, Zaman, Khalequ, Zeger, Scott L, O’Brien, Katherine L, O, K L, L, O S, K, M D, F, D R, D, A N, D, A J, Fancourt, Nicholas, Fu, Wei, H, L L, H, M M, Wangeci Kagucia, E, K, R A, Li, Mengying, P, D E, P, C, Wu, Zhenke, Z, S L, W, N L, Crawley, Jane, M, D R, B, W A, Endtz, Hubert P, Z, K, G, D, Hossain, Lokman, Jahan, Yasmin, Ashraf, Hasan, C H, S R, E, B E, A, M, McLellan, Jessica, Machuka, Eunice, Shamsul, Arifin, Zaman, Syed M A, Mackenzie, Grant, G S, J A, A, J O, M, S C, Kamau, Alice, Kazungu, Sidi, Ominde, Micah Silaba, K, K L, T, M D, S, S O, Sylla, Mamadou, Tamboura, Boubou, Onwuchekwa, Uma, Kourouma, Nana, Toure, Aliou, M, S A, M, D P, Adrian, Peter V, B, V L, Kuwanda, Locadiah, Mudau, Azwifarwi, Groome, Michelle J, Mahomed, Nasreen, B, H C, Thamthitiwat, Somsak, Maloney, Susan A, Bunthi, Charatdao, Rhodes, Julia, Sawatwong, Pongpun, Akarasewi, Pasakorn, T, D M, Mwananyanda, Lawrence, Chipeta, James, Seidenberg, Phil, Mwansa, James, wa Somwe, Somwe, Kwenda, Geoffrey, Anderson, Trevor P, and Mitchell, Joanne

Subjects
0301 basic medicine, Microbiology (medical), Male, medicine.medical_specialty, 030106 microbiology, Zambia, medicine.disease_cause, Mali, Polymerase Chain Reaction, 03 medical and health sciences, South Africa, 0302 clinical medicine, Internal medicine, Streptococcus pneumoniae, medicine, Humans, Colonization, 030212 general & internal medicine, Respiratory Tract Infections, Bacteriological Techniques, Bangladesh, Respiratory tract infections, business.industry, Case-control study, Child Health, Infant, Newborn, Infant, Pneumonia, Pneumococcal, medicine.disease, Thailand, Kenya, Bacterial Load, 3. Good health, Surgery, respiratory tract diseases, Pneumonia, Infectious Diseases, Specimen collection, Case-Control Studies, Child, Preschool, Pneumococcal pneumonia, Etiology, Female, Gambia, Supplement Article, business, Child, Hospitalized
Abstract

Previous studies suggested an association between upper airway pneumococcal colonization density and pneumococcal pneumonia, but data in children are limited. Using data from the Pneumonia Etiology Research for Child Health (PERCH) study, we assessed this potential association.PERCH is a case-control study in 7 countries: Bangladesh, The Gambia, Kenya, Mali, South Africa, Thailand, and Zambia. Cases were children aged 1-59 months hospitalized with World Health Organization-defined severe or very severe pneumonia. Controls were randomly selected from the community. Microbiologically confirmed pneumococcal pneumonia (MCPP) was confirmed by detection of pneumococcus in a relevant normally sterile body fluid. Colonization density was calculated with quantitative polymerase chain reaction analysis of nasopharyngeal/oropharyngeal specimens.Median colonization density among 56 cases with MCPP (MCPP cases; 17.28 × 106 copies/mL) exceeded that of cases without MCPP (non-MCPP cases; 0.75 × 106) and controls (0.60 × 106) (each P.001). The optimal density for discriminating MCPP cases from controls using the Youden index was6.9 log10 copies/mL; overall, the sensitivity was 64% and the specificity 92%, with variable performance by site. The threshold was lower (≥4.4 log10 copies/mL) when MCPP cases were distinguished from controls who received antibiotics before specimen collection. Among the 4035 non-MCPP cases, 500 (12%) had pneumococcal colonization density6.9 log10 copies/mL; above this cutoff was associated with alveolar consolidation at chest radiography, very severe pneumonia, oxygen saturation92%, C-reactive protein ≥40 mg/L, and lack of antibiotic pretreatment (all P.001).Pneumococcal colonization density6.9 log10 copies/mL was strongly associated with MCPP and could be used to improve estimates of pneumococcal pneumonia prevalence in childhood pneumonia studies. Our findings do not support its use for individual diagnosis in a clinical setting.

Published
2017
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8. Limited utility of polymerase chain reaction in induced sputum specimens for determining the causes of childhood pneumonia in resource-poor settings: findings from the Pneumonia Etiology Research for Child Health (PERCH) study

Author

Thea, Donald M., Seidenberg, Phil, Park, Daniel E., Mwananyanda, Lawrence, Fu, Wei, Shi, Qiyuan, Baggett, Henry C., Brooks, W. Abdullah, Feikin, Daniel R., Howie, Stephen R.C., Knoll, Maria Deloria, Kotloff, Karen L., Levine, Orin S., Madhi, Shabir A., O’Brien, Katherine L., Scott, J. Anthony G., Antonio, Martin, Awori, Juliet O., Baillie, Vicky L., DeLuca, Andrea N., Driscoll, Amanda J., Higdon, Melissa M., Hossain, Lokman, Jahan, Yasmin, Karron, Ruth A., Kazungu, Sidi, Li, Mengying, Moore, David P., Morpeth, Susan C., Ofordile, Ogochukwu, Prosperi, Christine, Sangwichian, Ornuma, Sawatwong, Pongpun, Sylla, Mamadou, Tapia, Milagritos D., Zeger, Scott L., Murdoch, David R., Hammitt, Laura L., O., K. L., L., O. S., K., M. D., F., D. R., D., A. N., D., A. J., Fancourt, Nicholas, F., W., H., L. L., H., M. M., Wangeci Kagucia, E., K., R. A., L., M., P., D. E., P., C., Wu, Zhenke, Z., S. L., Watson, Nora L., Crawley, Jane, M., D. R., W. A., B., Endtz, Hubert P., Khalequ, Zaman, Goswami, Doli, H., L., J., Y., Ashraf, Hasan, H., S. R. C., Ebruke, Bernard E., A., M., McLellan, Jessica, Machuka, Eunice, Shamsul, Arifin, Zaman, Syed M. A., Mackenzie, Grant, S., J. A. G., A., J. O., M., S. C., Kamau, Alice, K., S., Ominde, Micah Silaba, K., K. L., T., M. D., Sow, Samba O., S., M., Tamboura, Boubou, Onwuchekwa, Uma, Kourouma, Nana, Toure, Aliou, M., S. A., M., D. P., Adrian, Peter V., B., V. L., Kuwanda, Locadiah, Mudau, Azwifarwi, Groome, Michelle J., Mahomed, Nasreen, B., H. C., Thamthitiwat, Somsak, Maloney, Susan A., Bunthi, Charatdao, Rhodes, Julia, S., P., Akarasewi, Pasakorn, T., D. M., M., L., Chipeta, James, Mwansa, James, wa Somwe, Somwe, Kwenda, Geoffrey, Anderson, Trevor P., and Mitchell, Joanne

Subjects
Male, 0301 basic medicine, Pathology, Respiratory System, medicine.disease_cause, Gastroenterology, law.invention, 0302 clinical medicine, Community-acquired pneumonia, law, Nasopharynx, 030212 general & internal medicine, Respiratory system, Lung, Polymerase chain reaction, community-acquired pneumonia, Child Health, nasopharyngeal swab, Community-Acquired Infections, PCR, Infectious Diseases, Molecular Diagnostic Techniques, Child, Preschool, Viruses, Health Resources, Female, Supplement Article, medicine.symptom, Microbiology (medical), medicine.medical_specialty, Pneumonia, Viral, 030106 microbiology, Real-Time Polymerase Chain Reaction, 03 medical and health sciences, Internal medicine, Multiplex polymerase chain reaction, Pneumonia, Bacterial, medicine, Humans, Bacteria, business.industry, Infant, Newborn, Sputum, Infant, Cytomegalovirus, Pneumonia, medicine.disease, respiratory tract diseases, induced sputum, Etiology, pneumonia etiology, business, Child, Hospitalized
Abstract

Summary Among children with chest radiograph–confirmed pneumonia, polymerase chain reaction demonstrated relatively few additional pathogens in induced sputum specimens compared with nasopharyngeal/oropharyngeal specimens., Background. Sputum examination can be useful in diagnosing the cause of pneumonia in adults but is less well established in children. We sought to assess the diagnostic utility of polymerase chain reaction (PCR) for detection of respiratory viruses and bacteria in induced sputum (IS) specimens from children hospitalized with severe or very severe pneumonia. Methods. Among children aged 1–59 months, we compared organism detection by multiplex PCR in IS and nasopharyngeal/oropharyngeal (NP/OP) specimens. To assess whether organism presence or density in IS specimens was associated with chest radiographic evidence of pneumonia (radiographic pneumonia), we compared prevalence and density in IS specimens from children with radiographic pneumonia and children with suspected pneumonia but without chest radiographic changes or clinical or laboratory findings suggestive of pneumonia (nonpneumonia group). Results. Among 4232 cases with World Health Organization–defined severe or very severe pneumonia, we identified 1935 (45.7%) with radiographic pneumonia and 573 (13.5%) with nonpneumonia. The organism detection yield was marginally improved with IS specimens (96.2% vs 92.4% for NP/OP specimens for all viruses combined [P = .41]; 96.9% vs 93.3% for all bacteria combined [P = .01]). After accounting for presence in NP/OP specimens, no organism was detected more frequently in the IS specimens from the radiographic pneumonia compared with the nonpneumonia cases. Among high-quality IS specimens, there were no statistically significant differences in organism density, except with cytomegalovirus, for which there was a higher quantity in the IS specimens from cases with radiographic pneumonia compared with the nonpneumonia cases (median cycle threshold value, 27.9 vs 28.5, respectively; P = .01). Conclusions. Using advanced molecular methods with IS specimens provided little additional diagnostic information beyond that obtained with NP/OP swab specimens.

Published
2017

9. The Predictive Performance of a Pneumonia Severity Score in Human Immunodeficiency Virus–negative Children Presenting to Hospital in 7 Low- and Middle-income Countries.

Author

Gallagher, Katherine E, Knoll, Maria D, Prosperi, Chrissy, Baggett, Henry C, Brooks, W Abdullah, Feikin, Daniel R, Hammitt, Laura L, Howie, Stephen R C, Kotloff, Karen L, Levine, Orin S, Madhi, Shabir A, Murdoch, David R, O'Brien, Katherine L, Thea, Donald M, Awori, Juliet O, Baillie, Vicky L, Ebruke, Bernard E, Goswami, Doli, Kamau, Alice, and Maloney, Susan A

Subjects
AGE distribution, HYPOXEMIA, BODY weight, HIV-positive persons, RESEARCH methodology, PNEUMONIA, SEX distribution, LOGISTIC regression analysis, SEVERITY of illness index, RESEARCH methodology evaluation, MIDDLE-income countries, LOW-income countries, CHILDREN, EVALUATION
Abstract

Background In 2015, pneumonia remained the leading cause of mortality in children aged 1–59 months. Methods Data from 1802 human immunodeficiency virus (HIV)–negative children aged 1–59 months enrolled in the Pneumonia Etiology Research for Child Health (PERCH) study with severe or very severe pneumonia during 2011–2014 were used to build a parsimonious multivariable model predicting mortality using backwards stepwise logistic regression. The PERCH severity score, derived from model coefficients, was validated on a second, temporally discrete dataset of a further 1819 cases and compared to other available scores using the C statistic. Results Predictors of mortality, across 7 low- and middle-income countries, were age <1 year, female sex, ≥3 days of illness prior to presentation to hospital, low weight for height, unresponsiveness, deep breathing, hypoxemia, grunting, and the absence of cough. The model discriminated well between those who died and those who survived (C statistic = 0.84), but the predictive capacity of the PERCH 5-stratum score derived from the coefficients was moderate (C statistic = 0.76). The performance of the Respiratory Index of Severity in Children score was similar (C statistic = 0.76). The number of World Health Organization (WHO) danger signs demonstrated the highest discrimination (C statistic = 0.82; 1.5% died if no danger signs, 10% if 1 danger sign, and 33% if ≥2 danger signs). Conclusions The PERCH severity score could be used to interpret geographic variations in pneumonia mortality and etiology. The number of WHO danger signs on presentation to hospital could be the most useful of the currently available tools to aid clinical management of pneumonia. [ABSTRACT FROM AUTHOR]

Published
2020
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11. Pertussis-Associated Pneumonia in Infants and Children From Low- and Middle-Income Countries Participating in the PERCH Study

Author

Barger-Kamate, Breanna, primary, Deloria Knoll, Maria, additional, Kagucia, E. Wangeci, additional, Prosperi, Christine, additional, Baggett, Henry C., additional, Brooks, W. Abdullah, additional, Feikin, Daniel R., additional, Hammitt, Laura L., additional, Howie, Stephen R. C., additional, Levine, Orin S., additional, Madhi, Shabir A., additional, Scott, J. Anthony G., additional, Thea, Donald M., additional, Amornintapichet, Tussanee, additional, Anderson, Trevor P., additional, Awori, Juliet O., additional, Baillie, Vicky L., additional, Chipeta, James, additional, DeLuca, Andrea N., additional, Driscoll, Amanda J., additional, Goswami, Doli, additional, Higdon, Melissa M., additional, Hossain, Lokman, additional, Karron, Ruth A., additional, Maloney, Susan, additional, Moore, David P., additional, Morpeth, Susan C., additional, Mwananyanda, Lawrence, additional, Ofordile, Ogochukwu, additional, Olutunde, Emmanuel, additional, Park, Daniel E., additional, Sow, Samba O., additional, Tapia, Milagritos D., additional, Murdoch, David R., additional, O'Brien, Katherine L., additional, and Kotloff, Karen L., additional

Published
2016
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12. High Prevalence of Cryptococcal Infection Among HIV-Infected Patients Hospitalized With Pneumonia in Thailand.

Author

Harris, Julie R., Lindsley, Mark D., Henchaichon, Sununta, Poonwan, Natteewan, Naorat, Sathapana, Prapasiri, Prabda, Chantra, Somrak, Ruamcharoen, Fuangrak, Chang, Loretta S., Chittaganpitch, Malinee, Mehta, Nanthawan, Peruski, Leonard, Maloney, Susan A., Park, Benjamin J., and Baggett, Henry C.

Subjects
INFECTION treatment, HIV infections, THERAPEUTICS, PNEUMONIA treatment, ANTIFUNGAL agents, CRYPTOCOCCALES, DISEASE prevalence
Abstract

Background. Cryptococcal meningitis (CM) is a major cause of death among HIV-infected patients. Cryptococcal antigenemia (CrAg+) in the absence of CM can represent early-stage cryptococcosis during which antifungal treatment might improve outcomes. However, patients without meningitis are rarely tested for cryptococcal infection. We evaluated Cryptococcus species as a cause of acute respiratory infection in hospitalized patients in Thailand and evaluated clinical characteristics associated with CrAg+ Methods. We tested banked serum samples from 704 human immunodeficiency virus (HIV)-infected and 730 HIV-uninfected patients hospitalized with acute respiratory infection from 2004 through 2009 in 2 rural provinces in Thailand for the presence of CrAg+. Retrospective chart reviews were conducted for CrAg+ patients to distinguish meningeal and nonmeningeal cryptococcosis and to identify clinical characteristics associated with CrAg+ in patients with and without evidence of CM. Results. CrAg+ was found in 92 HIV-infected patients (13.1%); only tuberculosis (19.3%) and rhinovirus (16.5%) were identified more frequently. No HIV-uninfected patients were CrAg+. Of 70 CrAg1 patients with medical charts available, 37 (52.9%) had no evidence of past or existing CM at hospitalization; 30 of those patients (42.9% of all CrAg1) had neither past nor existing CM, nor any alternate etiology of infection identified. Dyspnea was more frequent among CrAg+ patients without CM than among CrAg- patients (P = .0002). Conclusions. Cryptococcus species were the most common pathogens detected in HIV-infected patients hospitalized with acute respiratory infection in Thailand. Few clinical differences were found between antigenemic and nonantigenemic HIV-infected patients. Health care providers in Thailand should evaluate HIV-infected patients hospitalized with acute respiratory infection for cryptococcal antigenemia, even in the absence of meningitis. [ABSTRACT FROM AUTHOR]

Published
2012
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13. Cruise Ships: High-Risk Passengers and the Global Spread of New Influenza Viruses.

Author

Miller, Joy M., Tam, Theresa W. S., Maloney, Susan, Fukuda, Keiji, Cox, Nancy, Hockin, James, Kertesz, Daniel, Klimov, Alexander, and Cetron, Martin

Subjects
RESPIRATORY diseases, COMMUNICABLE diseases, PASSENGER ships, INFLUENZA complications, EPIDEMIOLOGY, INFECTIOUS disease transmission
Abstract

Deals with a study which analyzed the medical records of passengers with acute respiratory illnesses during their North American cruise vacations in 1997. Nationality of passengers at risk for complications of influenza virus infection; Epidemiological investigation conducted on the outbreak; Description of the outbreak.

Published
2000
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