Microbiology of Bronchoalveolar Lavage Fluid in Children With Acute Nonresponding or Recurrent Community-Acquired Pneumonia: Identification of Nontypeable Haemophilus influenzae as a Major Pathogen

Background. Precise etiologic diagnosis in pediatric community-acquired pneumonia (CAP) remains challenging. Methods. We conducted a retrospective study of CAP etiology in 2 groups of pediatric patients who underwent flexible bronchoscopy (FOB) with bronchoalveolar lavage (BAL); children with acute...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Clinical infectious diseases 2011-06, Vol.52 (12), p.1437-1444
Hauptverfasser: De Schutter, Iris, De Wachter, Elke, Crokaert, Françoise, Verhaegen, Jan, Soetens, Oriane, Piérard, Denis, Malfroot, Anne
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 1444
container_issue 12
container_start_page 1437
container_title Clinical infectious diseases
container_volume 52
creator De Schutter, Iris
De Wachter, Elke
Crokaert, Françoise
Verhaegen, Jan
Soetens, Oriane
Piérard, Denis
Malfroot, Anne
description Background. Precise etiologic diagnosis in pediatric community-acquired pneumonia (CAP) remains challenging. Methods. We conducted a retrospective study of CAP etiology in 2 groups of pediatric patients who underwent flexible bronchoscopy (FOB) with bronchoalveolar lavage (BAL); children with acute nonresponsive CAP (NR-CAP; n = 127) or recurrent CAP (Rec-CAP; n = 123). Procedural measures were taken to limit contamination risk and quantitative bacterial culture of BAL fluid (significance cutoff point, ≥10⁴ colony-forming units/mL) was used. Blood culture results, serological test results, nasopharyngeal secretion findings, and pleural fluid culture results were also assessed, where available. Results. An infectious agent was detected in 76.0% of cases. In 51.2% of infections, aerobic bacteria were isolated, of which 75.0%, 28.9%, and 13.3% were Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pneumoniae, respectively. Most (97.9%) of the H. influenzae strains were nontypeable (NTHi). H. influenzae was detected in 26.0% of NR-CAP cases and 51.2% of Rec-CAP cases, whereas Mycoplasma pneumoniae was the predominant pathogen in the NR-CAP group (accounting for 34.9% of cases) but not in the Rec-CAP group (19.3%). Viruses were found in 30.4% of cases, with respiratory syncytial virus, parainfluenzaviruses, and influenzaviruses detected most frequently. Mixed infections were found in 18.9% of NR-CAP cases and 30.1% of Rec-CAP cases. Conclusions. A variety of microorganisms were isolated with frequent mixed infection. NTHi was one of the major pathogens found, especially in association with recurrent CAP, possibly because of improved detection with the FOB with BAL procedure. This suggests that the burden of pediatric CAP could be reduced by addressing NTHi as a major causative pathogen.
doi_str_mv 10.1093/cid/cir235
format Article
fullrecord <record><control><sourceid>jstor_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7107807</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><jstor_id>23024437</jstor_id><oup_id>10.1093/cid/cir235</oup_id><sourcerecordid>23024437</sourcerecordid><originalsourceid>FETCH-LOGICAL-c487t-144bb5d637ca857e1e36cd4b0e9a1875820adb17f3107e1cc2362ee67ca292fd3</originalsourceid><addsrcrecordid>eNp9kU2LFDEQhhtR3HX14l3JRQShNen0R2YPwji47sKsLqJ4bKqT6pkM6aQ36QyM_8__ZZYZd_TiIVSgHt6n4M2y54y-ZXTG30mt0vMFrx5kp6ziTV5XM_Yw_Wkl8lJwcZI9CWFDKWOCVo-zk4LVhShFeZr9utbSu04741Y74nrywTsr1w7MFp0BT5awhRWSCxO1ItqSxVob5dGSH3pak7mME5LPznoMo7NK2xVxnnxFGX2CJrJwwxCtnnb5XN5G7VGRG4txcFbDOblSidG9ljBpZ-_0KWrajQidQXIJOLgx-WJI5t5EtD8BCQQC5Bo2yXMD09qt0D7NHvVgAj47zLPs-8XHb4vLfPnl09VivsxlKZopZ2XZdZWqeSNBVA0y5LVUZUdxBkw0lSgoqI41PWc0baUseF0g1gkvZkWv-Fn2fp87xm5AJdP1Hkw7ej2A37UOdPvvxup1u3LbtkmBgjYp4PUhwLvbiGFqBx0kGgMWXQytqGeCFrSiiXyzJ1M9IXjs7y2Mtne1t6n2dl97gl_-fdc9-qfnBLw6ABAkmN6DlTocuZInJaNHzsXx_8IXe24TJuePOZwWZckb_htE59Ls</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>869802050</pqid></control><display><type>article</type><title>Microbiology of Bronchoalveolar Lavage Fluid in Children With Acute Nonresponding or Recurrent Community-Acquired Pneumonia: Identification of Nontypeable Haemophilus influenzae as a Major Pathogen</title><source>MEDLINE</source><source>JSTOR Archive Collection A-Z Listing</source><source>Oxford University Press Journals All Titles (1996-Current)</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Alma/SFX Local Collection</source><creator>De Schutter, Iris ; De Wachter, Elke ; Crokaert, Françoise ; Verhaegen, Jan ; Soetens, Oriane ; Piérard, Denis ; Malfroot, Anne</creator><creatorcontrib>De Schutter, Iris ; De Wachter, Elke ; Crokaert, Françoise ; Verhaegen, Jan ; Soetens, Oriane ; Piérard, Denis ; Malfroot, Anne</creatorcontrib><description>Background. Precise etiologic diagnosis in pediatric community-acquired pneumonia (CAP) remains challenging. Methods. We conducted a retrospective study of CAP etiology in 2 groups of pediatric patients who underwent flexible bronchoscopy (FOB) with bronchoalveolar lavage (BAL); children with acute nonresponsive CAP (NR-CAP; n = 127) or recurrent CAP (Rec-CAP; n = 123). Procedural measures were taken to limit contamination risk and quantitative bacterial culture of BAL fluid (significance cutoff point, ≥10⁴ colony-forming units/mL) was used. Blood culture results, serological test results, nasopharyngeal secretion findings, and pleural fluid culture results were also assessed, where available. Results. An infectious agent was detected in 76.0% of cases. In 51.2% of infections, aerobic bacteria were isolated, of which 75.0%, 28.9%, and 13.3% were Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pneumoniae, respectively. Most (97.9%) of the H. influenzae strains were nontypeable (NTHi). H. influenzae was detected in 26.0% of NR-CAP cases and 51.2% of Rec-CAP cases, whereas Mycoplasma pneumoniae was the predominant pathogen in the NR-CAP group (accounting for 34.9% of cases) but not in the Rec-CAP group (19.3%). Viruses were found in 30.4% of cases, with respiratory syncytial virus, parainfluenzaviruses, and influenzaviruses detected most frequently. Mixed infections were found in 18.9% of NR-CAP cases and 30.1% of Rec-CAP cases. Conclusions. A variety of microorganisms were isolated with frequent mixed infection. NTHi was one of the major pathogens found, especially in association with recurrent CAP, possibly because of improved detection with the FOB with BAL procedure. This suggests that the burden of pediatric CAP could be reduced by addressing NTHi as a major causative pathogen.</description><identifier>ISSN: 1058-4838</identifier><identifier>EISSN: 1537-6591</identifier><identifier>DOI: 10.1093/cid/cir235</identifier><identifier>PMID: 21628484</identifier><identifier>CODEN: CIDIEL</identifier><language>eng</language><publisher>Oxford: Oxford University Press</publisher><subject>Adolescent ; and Commentaries ; Antibiotics ; Antibodies, Bacterial - blood ; Bacteria - classification ; Bacteria - isolation &amp; purification ; Biological and medical sciences ; Blood - microbiology ; Bronchoalveolar Lavage Fluid - microbiology ; Child ; Child, Preschool ; Children ; Coinfection ; Community-Acquired Infections - drug therapy ; Community-Acquired Infections - epidemiology ; Community-Acquired Infections - microbiology ; Etiology ; Female ; Haemophilus influenzae ; Humans ; Infant ; Infections ; Infectious diseases ; Male ; Medical sciences ; Nasopharynx - microbiology ; Pathogens ; Pediatrics ; Pleural Effusion - microbiology ; Pneumology ; Pneumonia ; Pneumonia, Bacterial - drug therapy ; Pneumonia, Bacterial - epidemiology ; Pneumonia, Bacterial - microbiology ; Prevalence ; Recurrence ; Respiratory system : syndromes and miscellaneous diseases ; Retrospective Studies ; Viruses</subject><ispartof>Clinical infectious diseases, 2011-06, Vol.52 (12), p.1437-1444</ispartof><rights>Copyright © 2011 Oxford University Press on behalf of the Infectious Diseases Society of America</rights><rights>The Author 2011. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com. 2011</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c487t-144bb5d637ca857e1e36cd4b0e9a1875820adb17f3107e1cc2362ee67ca292fd3</citedby><cites>FETCH-LOGICAL-c487t-144bb5d637ca857e1e36cd4b0e9a1875820adb17f3107e1cc2362ee67ca292fd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.jstor.org/stable/pdf/23024437$$EPDF$$P50$$Gjstor$$H</linktopdf><linktohtml>$$Uhttps://www.jstor.org/stable/23024437$$EHTML$$P50$$Gjstor$$H</linktohtml><link.rule.ids>230,314,780,784,803,885,1584,27924,27925,58017,58250</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=24350310$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21628484$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>De Schutter, Iris</creatorcontrib><creatorcontrib>De Wachter, Elke</creatorcontrib><creatorcontrib>Crokaert, Françoise</creatorcontrib><creatorcontrib>Verhaegen, Jan</creatorcontrib><creatorcontrib>Soetens, Oriane</creatorcontrib><creatorcontrib>Piérard, Denis</creatorcontrib><creatorcontrib>Malfroot, Anne</creatorcontrib><title>Microbiology of Bronchoalveolar Lavage Fluid in Children With Acute Nonresponding or Recurrent Community-Acquired Pneumonia: Identification of Nontypeable Haemophilus influenzae as a Major Pathogen</title><title>Clinical infectious diseases</title><addtitle>Clin Infect Dis</addtitle><description>Background. Precise etiologic diagnosis in pediatric community-acquired pneumonia (CAP) remains challenging. Methods. We conducted a retrospective study of CAP etiology in 2 groups of pediatric patients who underwent flexible bronchoscopy (FOB) with bronchoalveolar lavage (BAL); children with acute nonresponsive CAP (NR-CAP; n = 127) or recurrent CAP (Rec-CAP; n = 123). Procedural measures were taken to limit contamination risk and quantitative bacterial culture of BAL fluid (significance cutoff point, ≥10⁴ colony-forming units/mL) was used. Blood culture results, serological test results, nasopharyngeal secretion findings, and pleural fluid culture results were also assessed, where available. Results. An infectious agent was detected in 76.0% of cases. In 51.2% of infections, aerobic bacteria were isolated, of which 75.0%, 28.9%, and 13.3% were Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pneumoniae, respectively. Most (97.9%) of the H. influenzae strains were nontypeable (NTHi). H. influenzae was detected in 26.0% of NR-CAP cases and 51.2% of Rec-CAP cases, whereas Mycoplasma pneumoniae was the predominant pathogen in the NR-CAP group (accounting for 34.9% of cases) but not in the Rec-CAP group (19.3%). Viruses were found in 30.4% of cases, with respiratory syncytial virus, parainfluenzaviruses, and influenzaviruses detected most frequently. Mixed infections were found in 18.9% of NR-CAP cases and 30.1% of Rec-CAP cases. Conclusions. A variety of microorganisms were isolated with frequent mixed infection. NTHi was one of the major pathogens found, especially in association with recurrent CAP, possibly because of improved detection with the FOB with BAL procedure. This suggests that the burden of pediatric CAP could be reduced by addressing NTHi as a major causative pathogen.</description><subject>Adolescent</subject><subject>and Commentaries</subject><subject>Antibiotics</subject><subject>Antibodies, Bacterial - blood</subject><subject>Bacteria - classification</subject><subject>Bacteria - isolation &amp; purification</subject><subject>Biological and medical sciences</subject><subject>Blood - microbiology</subject><subject>Bronchoalveolar Lavage Fluid - microbiology</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Coinfection</subject><subject>Community-Acquired Infections - drug therapy</subject><subject>Community-Acquired Infections - epidemiology</subject><subject>Community-Acquired Infections - microbiology</subject><subject>Etiology</subject><subject>Female</subject><subject>Haemophilus influenzae</subject><subject>Humans</subject><subject>Infant</subject><subject>Infections</subject><subject>Infectious diseases</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Nasopharynx - microbiology</subject><subject>Pathogens</subject><subject>Pediatrics</subject><subject>Pleural Effusion - microbiology</subject><subject>Pneumology</subject><subject>Pneumonia</subject><subject>Pneumonia, Bacterial - drug therapy</subject><subject>Pneumonia, Bacterial - epidemiology</subject><subject>Pneumonia, Bacterial - microbiology</subject><subject>Prevalence</subject><subject>Recurrence</subject><subject>Respiratory system : syndromes and miscellaneous diseases</subject><subject>Retrospective Studies</subject><subject>Viruses</subject><issn>1058-4838</issn><issn>1537-6591</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU2LFDEQhhtR3HX14l3JRQShNen0R2YPwji47sKsLqJ4bKqT6pkM6aQ36QyM_8__ZZYZd_TiIVSgHt6n4M2y54y-ZXTG30mt0vMFrx5kp6ziTV5XM_Yw_Wkl8lJwcZI9CWFDKWOCVo-zk4LVhShFeZr9utbSu04741Y74nrywTsr1w7MFp0BT5awhRWSCxO1ItqSxVob5dGSH3pak7mME5LPznoMo7NK2xVxnnxFGX2CJrJwwxCtnnb5XN5G7VGRG4txcFbDOblSidG9ljBpZ-_0KWrajQidQXIJOLgx-WJI5t5EtD8BCQQC5Bo2yXMD09qt0D7NHvVgAj47zLPs-8XHb4vLfPnl09VivsxlKZopZ2XZdZWqeSNBVA0y5LVUZUdxBkw0lSgoqI41PWc0baUseF0g1gkvZkWv-Fn2fp87xm5AJdP1Hkw7ej2A37UOdPvvxup1u3LbtkmBgjYp4PUhwLvbiGFqBx0kGgMWXQytqGeCFrSiiXyzJ1M9IXjs7y2Mtne1t6n2dl97gl_-fdc9-qfnBLw6ABAkmN6DlTocuZInJaNHzsXx_8IXe24TJuePOZwWZckb_htE59Ls</recordid><startdate>20110615</startdate><enddate>20110615</enddate><creator>De Schutter, Iris</creator><creator>De Wachter, Elke</creator><creator>Crokaert, Françoise</creator><creator>Verhaegen, Jan</creator><creator>Soetens, Oriane</creator><creator>Piérard, Denis</creator><creator>Malfroot, Anne</creator><general>Oxford University Press</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20110615</creationdate><title>Microbiology of Bronchoalveolar Lavage Fluid in Children With Acute Nonresponding or Recurrent Community-Acquired Pneumonia: Identification of Nontypeable Haemophilus influenzae as a Major Pathogen</title><author>De Schutter, Iris ; De Wachter, Elke ; Crokaert, Françoise ; Verhaegen, Jan ; Soetens, Oriane ; Piérard, Denis ; Malfroot, Anne</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c487t-144bb5d637ca857e1e36cd4b0e9a1875820adb17f3107e1cc2362ee67ca292fd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adolescent</topic><topic>and Commentaries</topic><topic>Antibiotics</topic><topic>Antibodies, Bacterial - blood</topic><topic>Bacteria - classification</topic><topic>Bacteria - isolation &amp; purification</topic><topic>Biological and medical sciences</topic><topic>Blood - microbiology</topic><topic>Bronchoalveolar Lavage Fluid - microbiology</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Children</topic><topic>Coinfection</topic><topic>Community-Acquired Infections - drug therapy</topic><topic>Community-Acquired Infections - epidemiology</topic><topic>Community-Acquired Infections - microbiology</topic><topic>Etiology</topic><topic>Female</topic><topic>Haemophilus influenzae</topic><topic>Humans</topic><topic>Infant</topic><topic>Infections</topic><topic>Infectious diseases</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Nasopharynx - microbiology</topic><topic>Pathogens</topic><topic>Pediatrics</topic><topic>Pleural Effusion - microbiology</topic><topic>Pneumology</topic><topic>Pneumonia</topic><topic>Pneumonia, Bacterial - drug therapy</topic><topic>Pneumonia, Bacterial - epidemiology</topic><topic>Pneumonia, Bacterial - microbiology</topic><topic>Prevalence</topic><topic>Recurrence</topic><topic>Respiratory system : syndromes and miscellaneous diseases</topic><topic>Retrospective Studies</topic><topic>Viruses</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>De Schutter, Iris</creatorcontrib><creatorcontrib>De Wachter, Elke</creatorcontrib><creatorcontrib>Crokaert, Françoise</creatorcontrib><creatorcontrib>Verhaegen, Jan</creatorcontrib><creatorcontrib>Soetens, Oriane</creatorcontrib><creatorcontrib>Piérard, Denis</creatorcontrib><creatorcontrib>Malfroot, Anne</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Clinical infectious diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>De Schutter, Iris</au><au>De Wachter, Elke</au><au>Crokaert, Françoise</au><au>Verhaegen, Jan</au><au>Soetens, Oriane</au><au>Piérard, Denis</au><au>Malfroot, Anne</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Microbiology of Bronchoalveolar Lavage Fluid in Children With Acute Nonresponding or Recurrent Community-Acquired Pneumonia: Identification of Nontypeable Haemophilus influenzae as a Major Pathogen</atitle><jtitle>Clinical infectious diseases</jtitle><addtitle>Clin Infect Dis</addtitle><date>2011-06-15</date><risdate>2011</risdate><volume>52</volume><issue>12</issue><spage>1437</spage><epage>1444</epage><pages>1437-1444</pages><issn>1058-4838</issn><eissn>1537-6591</eissn><coden>CIDIEL</coden><abstract>Background. Precise etiologic diagnosis in pediatric community-acquired pneumonia (CAP) remains challenging. Methods. We conducted a retrospective study of CAP etiology in 2 groups of pediatric patients who underwent flexible bronchoscopy (FOB) with bronchoalveolar lavage (BAL); children with acute nonresponsive CAP (NR-CAP; n = 127) or recurrent CAP (Rec-CAP; n = 123). Procedural measures were taken to limit contamination risk and quantitative bacterial culture of BAL fluid (significance cutoff point, ≥10⁴ colony-forming units/mL) was used. Blood culture results, serological test results, nasopharyngeal secretion findings, and pleural fluid culture results were also assessed, where available. Results. An infectious agent was detected in 76.0% of cases. In 51.2% of infections, aerobic bacteria were isolated, of which 75.0%, 28.9%, and 13.3% were Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pneumoniae, respectively. Most (97.9%) of the H. influenzae strains were nontypeable (NTHi). H. influenzae was detected in 26.0% of NR-CAP cases and 51.2% of Rec-CAP cases, whereas Mycoplasma pneumoniae was the predominant pathogen in the NR-CAP group (accounting for 34.9% of cases) but not in the Rec-CAP group (19.3%). Viruses were found in 30.4% of cases, with respiratory syncytial virus, parainfluenzaviruses, and influenzaviruses detected most frequently. Mixed infections were found in 18.9% of NR-CAP cases and 30.1% of Rec-CAP cases. Conclusions. A variety of microorganisms were isolated with frequent mixed infection. NTHi was one of the major pathogens found, especially in association with recurrent CAP, possibly because of improved detection with the FOB with BAL procedure. This suggests that the burden of pediatric CAP could be reduced by addressing NTHi as a major causative pathogen.</abstract><cop>Oxford</cop><pub>Oxford University Press</pub><pmid>21628484</pmid><doi>10.1093/cid/cir235</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 1058-4838
ispartof Clinical infectious diseases, 2011-06, Vol.52 (12), p.1437-1444
issn 1058-4838
1537-6591
language eng
recordid cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7107807
source MEDLINE; JSTOR Archive Collection A-Z Listing; Oxford University Press Journals All Titles (1996-Current); EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection
subjects Adolescent
and Commentaries
Antibiotics
Antibodies, Bacterial - blood
Bacteria - classification
Bacteria - isolation & purification
Biological and medical sciences
Blood - microbiology
Bronchoalveolar Lavage Fluid - microbiology
Child
Child, Preschool
Children
Coinfection
Community-Acquired Infections - drug therapy
Community-Acquired Infections - epidemiology
Community-Acquired Infections - microbiology
Etiology
Female
Haemophilus influenzae
Humans
Infant
Infections
Infectious diseases
Male
Medical sciences
Nasopharynx - microbiology
Pathogens
Pediatrics
Pleural Effusion - microbiology
Pneumology
Pneumonia
Pneumonia, Bacterial - drug therapy
Pneumonia, Bacterial - epidemiology
Pneumonia, Bacterial - microbiology
Prevalence
Recurrence
Respiratory system : syndromes and miscellaneous diseases
Retrospective Studies
Viruses
title Microbiology of Bronchoalveolar Lavage Fluid in Children With Acute Nonresponding or Recurrent Community-Acquired Pneumonia: Identification of Nontypeable Haemophilus influenzae as a Major Pathogen
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-24T03%3A11%3A35IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-jstor_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Microbiology%20of%20Bronchoalveolar%20Lavage%20Fluid%20in%20Children%20With%20Acute%20Nonresponding%20or%20Recurrent%20Community-Acquired%20Pneumonia:%20Identification%20of%20Nontypeable%20Haemophilus%20influenzae%20as%20a%20Major%20Pathogen&rft.jtitle=Clinical%20infectious%20diseases&rft.au=De%20Schutter,%20Iris&rft.date=2011-06-15&rft.volume=52&rft.issue=12&rft.spage=1437&rft.epage=1444&rft.pages=1437-1444&rft.issn=1058-4838&rft.eissn=1537-6591&rft.coden=CIDIEL&rft_id=info:doi/10.1093/cid/cir235&rft_dat=%3Cjstor_pubme%3E23024437%3C/jstor_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=869802050&rft_id=info:pmid/21628484&rft_jstor_id=23024437&rft_oup_id=10.1093/cid/cir235&rfr_iscdi=true