Clinico-microbiological study of severe pneumonia in below five years age of children

Abstract

Background: Pneumonia is the leading cause of childhood morbidity and mortality under five-year-old children globally. WHO developed and disseminated a simple case definition for identification and treatment of pneumonia, which could be used by field-workers in resource poor settings. Materials and Methods: This prospective and cross sectional study was conducted at Department of Pediatrics and Department of Microbiology, N.C. Medical College and Hospital, Israna, Panipat, India, over a period of one year from May 2018 to April 2019. Total 150 children below 5 years of age were included in the study. Results: Total 150 cases examined in the study out of which 46% children belonged to 0-1 year of age, 32.67% 1-2 years and 21.33% children from 2-5 years. Males were 66% and females 34%. 147 (98%) children had fever history, 150 (100%) children had cough, tachypnea and chest in drawing which were the most common symptom observed in the study, followed by inability to take food or refusal was observed in 61 (40.67%) children, hepato splenomegaly was observed in 33 (22%). Severity of the disease was recorded according to WHO classification, severe pneumonia was observed in 94 (62.67%) and very severe pneumonia was observed in 56 (37.33%) Blood cultures were positive in 22.67% children (22.67%) and nasopharyngeal aspirates were positive in 36.67% children. The most common organism isolated from blood and nasopharyngeal culture was Staphylococcus aureus (10.67%) followed by Streptococcus pneumoniae (4.67%). Conclusions: Streptococcus pneumoniae and Staphylococcus aureus predominate in blood culture and nasopharyngeal aspirates respectively. Our study highlights the use of blood culture and nasopharyngeal aspirates culture to confirm the bacterial pathogens of pneumonia.