Abstract
Community-acquired pneumonia (CAP) is well-recognized as a leading cause of disease
burden in children. This study aimed to identify the prevalence of coinfection and
associated factors in Vietnamese children ages 1 month to 5 years with viral pneumonia.
We performed a cross-sectional study of children who were diagnosed with severe viral
pneumonia. Demographic, clinical, and subclinical characteristics were compared between
children with viral alone and bacterial coinfection. Multivariate logistic regression
was used to determine which factors were associated with risk of coinfection. Of 202
children with severe viral pneumonia, the most common causative agent was respiratory
syncytial virus (respiratory syncytial virus [RSV]: 36.1%), followed by influenza
virus A (24.3%) and adenovirus (19.8%). Fifty-three children (26.2%) had bacterial
superinfection and/or coinfection with other viruses. Haemophilus influenza was the most common bacterium (9.4%), followed by Klebsiella pneumoniae and Pseudomonas aeruginosa (with 4.0%). In infants (toddlers), ages 12 to 24 months with severe viral pneumonia,
(odds ratio [OR] = 3.37, 95% confidence interval [CI]: 1.22–9.33), the higher concentrations
of procalcitonin (PCT; OR = 1.16; 95% CI: 1.00–1.34), and neutrophils (OR = 1.13;
95% CI: 1.04–1.22) were associated with a higher risk of coinfection. This study underlined
the pervasiveness of coinfections among young children with severe viral pneumonia.
Provision of effective antiviral treatment, especially for RSV, as well as the advancement
of sensitive and rapid diagnostic tools for screening pathogens of pneumonia, is critical
to reducing the burden of this disease.
Keywords
bacterial - viral - severe pneumonia - coinfection
