Résumé
Les étiologies des pneumopathies communautaires de l'enfant varient avec l'âgec. Les infections virales prédominent chez le nourrisson et le virus respiratoire syncytial en est toujours le principal agent responsable. Les étiologies bactériennes deviennent prédominantes entre 3 et 6 ans. L'émergence de Streptococcus pneumaoniae de sensibilité réduite à la pénicilline, la mise en cause de Haemophilus influenzae non typables et sécréteur de β-lactamase, et la place importante des germes atypiques Mycoplasma pneumoniae et Chlamydia pneumoniae sont à l'arigine de nouvelles réflexions thérapeutiques. La mortalité liée aux pneumopathies reste faible dans les pays industrialisés. Cependant, la morbidité semble augmenter et il est nécessaire de s'assurer de la guérison clinique et randiologique.
Abstract
Viruses, particularly syncitial respiratory virus, are the main aetiology of community-acquired lower respiratory tract infections in infants, while bacterial agents are more frequently responsible in children older than 3 years. Antimicrobial therapy must take into account the development of reduced susceptibility of penicillin to strains of Straptoccocus pneumoniae and Haemophilus influenzae with β-lactamase, and high frequency of Mycoplasma pneumoniae and Chlamydia pneumoniae infections. Although the mortality rate has remained low in France, the morbidity appeared to increase in recent years.
Keywords: pneumopathies aiguës, enfants, nourrissons, épidémiologie
Keywords: acute pneumonia, children, infants, epidemiology
Références
- 1.Victora CG, Fuchs SC, Flores JAC, Fonsecra W, Kirkwood B. Risk factors for pneumonia among children in a brazilian metropolitan Area. Pediatrics. 1994;93:977–985. [PubMed] [Google Scholar]
- 2.Campbell PW. New developments in pediatric pneumonia and empyema. Cur Opin Pediatr. 1995;7:278–282. doi: 10.1097/00008480-199506000-00006. [DOI] [PubMed] [Google Scholar]
- 3.Glenzen PW, Denny Fw. Epidemiology of acute lower respiratory disease in children. N Engl J Med. 1973;288:498–504. doi: 10.1056/NEJM197303082881005. [DOI] [PubMed] [Google Scholar]
- 4.Jokinen C, Heiskanen L, Juvonen H. Incidence of community-acquired pneumonia in the population of four municipalities in Eastern Finland. Am J Epidemiol. 1993;137:977–988. doi: 10.1093/oxfordjournals.aje.a116770. [DOI] [PubMed] [Google Scholar]
- 5.Nohynek H, Eskola J, Laine E. The causes of hospital treated acute lower respiratory tract infection in children. Am J Dis Child. 1991;145:618–622. doi: 10.1001/archpedi.1991.02160060036016. [DOI] [PubMed] [Google Scholar]
- 6.Marguet C, Raymond F, Le Roux P. Group de pneumologie et phtisiologie infantile de langue francaise. 23–24 septembre 1994. Étude clinique et épidémiologique des pneumopathies communautaires vues en milieu hospitalier, Nancy. [Google Scholar]
- 7.Guyer B, Strobino DM, Venture SJ, Singh GK. Vol. 96. 1995. Annual summary of vital statistics-1994; pp. 1029–1039. (Pediatrics). [PubMed] [Google Scholar]
- 8.Mertsola J, Ziegler T, Ruuskanen O, Vanto T, Koivikko A, Halonen P. Recurrent wheezy bronchitis and viral respiratory infections. Arch Dis Child. 1991;66:124–129. doi: 10.1136/adc.66.1.124. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 9.Campbell H, Byass P, Lamont AC. Assessment of clinical criteria for identification of severe acute lower respiratory tract infections in children. Lancet. 1989;i:297–299. doi: 10.1016/s0140-6736(89)91308-1. [DOI] [PubMed] [Google Scholar]
- 10.Berman S, Simoes EAF. Respiratory rate and pneumonia in infancy. Arch Dis Child. 1991;66:81–84. doi: 10.1136/adc.66.1.81. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 11.Taylor JA, Del Becarra M, Done S, Winters W. Establishing clinically relevant standards for tachypnea in febrile children younger than 2 years. Arch Pediatr Adolesc Med. 1995;149:283–287. doi: 10.1001/archpedi.1995.02170150063011. [DOI] [PubMed] [Google Scholar]
- 12.Turner RB, Lande AE, Chase P, Hilton N, Weinberg D. Pneumonia in pediatric outpatients: cause and clinical maifestations. J Pediatr. 1987;111:194–200. doi: 10.1016/S0022-3476(87)80066-5. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 13.Isaacs D. Problems in determining the etiology of community-acquired childhood pneumonia. Pediatr Infect Dis J. 1989;8:143–148. [PubMed] [Google Scholar]
- 14.Gendrel D, Raymond J, Moulin F. Pneumonies communautaires de l'enfant : Importance des infections à Mycoplasma pneumoniae et efficacité des antibiotiques. Presse Med. 1996;25:793–797. [PubMed] [Google Scholar]
- 15.Swischuk L.E, Hayden CK. Viral vs bacterial pulmonary infections in children (Is roentgenographid differentiation possible?) Pediatr Radiol. 1986;16:278–284. doi: 10.1007/BF02386862. [DOI] [PubMed] [Google Scholar]
- 16.Avila MM, Carballal G, Rovaletti H, Ebekian B, Cusminsky M, Weissenbacher MR. Viral etiology in acute lower respiratory infections in children from a closed community. Am Rev Respir Dis. 1989;140:634–637. doi: 10.1164/ajrccm/140.3.634. [DOI] [PubMed] [Google Scholar]
- 17.Hickey RW, Bowman MJ, Smith GA. Utility of blood cultures in pediatric patients found to have pneumonia in the emergency department. Ann Emerg Med. 1996;27:774–776. doi: 10.1016/s0196-0644(96)70189-0. [DOI] [PubMed] [Google Scholar]
- 18.Grayston JT. Chlamydia pneumontae (TWAR) infections in children. Pediatr Infect Dis J. 1994;13:675–685. doi: 10.1097/00006454-199408000-00001. [DOI] [PubMed] [Google Scholar]
- 19.Korppi M, leinonen M, Mkel PH, Launiala K. Mixed infections common in children with respiratory adenovirus infection. Acta Paediatr Scand. 1991;80:413–417. doi: 10.1111/j.1651-2227.1991.tb11875.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 20.Kim PE, Musher DM, Glenzen WP, Rodriguez-Barradas MC, Nahm WK, Wright CE. Association of invasive pneumococcal disease with season, atmospheric conditions, air pollution, and the isolation of respiratory viruses. Clin Inf Dis. 1996;22:100–106. doi: 10.1093/clinids/22.1.100. [DOI] [PubMed] [Google Scholar]
- 21.Houlette F. EUR de médecine et pharmacie de Rouen; Philadelphia: 1995. Nouveaux visages des staphylococcies sévères de l'enfant : rôle de la varicelle. [Thèse] [Google Scholar]
- 22.Funkhouser A, Steinhoff MC, Ward J. Haemophilus influenzae disease and immunization in developing countries. Rev Infect Dis. 1991;13:S542–S554. doi: 10.1093/clinids/13.supplement_6.s542. [DOI] [PubMed] [Google Scholar]
- 23.Hol C, Van Dijke EE, Verduin CM, Verhoef J, Van Dijk H. Experimental evidence for moraxella-induced penicillin neutralization in pneumococcal pneumonia. J Infect Dis. 1994;170:1613–1616. doi: 10.1093/infdis/170.6.1613. [DOI] [PubMed] [Google Scholar]
- 24.Paganin F, Chanez P, Brousse C. Pneumonies communautaires dans la région de Montpellier. Presse Med. 1995;24:1341–1344. [PubMed] [Google Scholar]
- 25.Ruuskanen O, Nohynek H, Ziegler T. Pneumonia in childhood: Etiology and response to antimicrobial therapy. Eur J Clin Microbiol Infect Dis. 1992;11:217–223. doi: 10.1007/BF02098083. [DOI] [PubMed] [Google Scholar]
- 26.Wortis N. Pertussis deaths: report of 23 cases in the United States, 1992 and 1993. Pediatrics. 1996;97:607–612. [PubMed] [Google Scholar]