Prevalence and clinical significance of common respiratory pathogens in the upper respiratory tract of children with community-acquired pneumonia in Zunyi, China.

Abstract

To estimate the prevalence of common respiratory pathogens among children with community-acquired pneumonia (CAP) in Zunyi City, Guizhou, China, and to assess whether the presence of common respiratory pathogens in patients is associated with disease severity. This retrospective study assessed the prevalence of common respiratory viruses and bacteria in the upper respiratory tract of among infants and children aged 1 month to 5 years hospitalized with radiologically confirmed CAP between April 2017 and March 2018. Direct immunofluorescence assay and bacterial culture were used to identify viruses and bacteria in the upper airway specimens, respectively. The association between severe CAP and the presence of pathogens was determined using multivariate logistic regression models. Of the 685 patients enrolled, 583 cases had viral and/or bacterial pathogens detected, which included the presence of only viral pathogens, only bacterial pathogens, and mixed viral and bacterial pathogens in 34.3%, 29.7%, and 36.0% of cases, respectively. Respiratory syncytial virus (RSV) was the most common viral pathogen, with a prevalence rate of 39.9% (273/685). Haemophilus influenzae was the most commonly detected bacterial pathogen, with a prevalence rate of 15.3% (105/685). The presence of RSV (adjusted odds ratio [aOR], 1.9; 95% confidence interval [CI], 1.3-2.8) and Staphylococcus aureus (aOR, 13.7; 95% CI, 5.5-33.9) in children with CAP was associated with severe pneumonia. In a cohort of Zunyi infants and children hospitalized with CAP, RSV was the most common pathogen.