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Master Thesis

Épidémiologie clinique et micro biologique des pneumonies aiguës communautaires de l’enfant en Guyane

Abstract : Background : Acute community-acquired pneumonia remains a major cause of child morbidity and mortality. The risk of emergence of new pathogens in French Guiana exists in this territory with high infectious potential. The objective of this study was to describe the epidemiological characteristics and current microbial ecology of pathogens responsible for pneumonia in children in this department. Materials and methods : It was a cross-sectional, descriptive, monocentric and retrospective study between January 1, 2015 and December 31, 2017 in the pediatric unit of the Andrée Rosemon Hospital in Cayenne, French Guiana. The studied population was aged 0 to 15 years and 3 months and hospitalized in this ward for acute community pneumonia. Results : 415 patients (mean age 3.62 years, median age 1.83 years) were included. A pathogen was found in 22.4% of patients, with 61.3% of bacteria, 43% of viruses and 14% of co-infections. The main pathogens were 31.2% RespitorySincithial Virus, 20.4% Streptococcus Pneumoniae, 11.8% Haemophilus Influenzae and 10.8% Mycoplasma pneumoniae. 89% of patients received an antibiotic therapy, the majority (56.2%) mono-antibiotic with amoxicillin and / or clavulanic acid (respectively 46.2% and 24.7%). The mean duration of hospitalization was 7.35 days, with a total antibiotic therapy duration of 10.4 days average (9.54 standard deviation). 4.1% of patients were admitted in intensive care. There were 4 deaths in intensive care unit, and 3 delayed deaths, or 1.7% of patients. Simple clinical and laboratory criteria are used to assess the risk of adverse outcomes that is increased in patients with community-acquired acute pneumonia with a bacterial origin and CRP>130 mg/L. Conclusion : This study showed epidemiological similarities between childhood pneumonia in French Guiana and other French regions. There was, however, a different distribution of major pathogens. It would be interesting to study the impact of vaccination which became mandatory in January 2018, on pneumonia in this territory with a low rate of optimal vaccination.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03245268
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Submitted on : Tuesday, June 1, 2021 - 4:33:36 PM
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Alexandre Cannesson. Épidémiologie clinique et micro biologique des pneumonies aiguës communautaires de l’enfant en Guyane. Médecine humaine et pathologie. 2019. ⟨dumas-03245268⟩

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