Community-acquired Pneumonia In Children Research Articles

Unique Features of Hospitalized Children with Alveolar Pneumonia Suggest Frequent Viral-Bacterial Coinfections.

The World Health Organization Pneumonia Expert Group (WHO-PEG) defined a standardized radiologic endpoint for childhood community-acquired alveolar pneumonia (RD-CAAP), as the most likely to be pneumococcal, not ruling out other bacteria or coinfecting viruses. We aimed to determine the characteristics associated with hospitalization among children <5 years old presenting to the pediatric emergency room (PER) with RD-CAAP. This study was a part of an ongoing prospective population-based surveillance on hospital visits for RD-CAAP. RD-CAAP was determined according to the WHO-PEG. The study was conducted in the prepneumococcal conjugate vaccine era (2004-2008). Of 24,432 episodes with chest radiographs, 3871)15.8%) were RD-CAAP: 2319 required hospitalization and 1552 were discharged (outpatients). Compared with outpatients, hospitalized children had lower temperature, peripheral white cell and absolute neutrophil counts and C reactive protein serum levels, but higher rates of hypoxemia, rhinorrhea, cough and respiratory virus detection. PER visits during the respiratory virus season presented a 1.83 times higher risk of hospitalization than visits during nonrespiratory season. Although RD-CAAP is most often a bacterial infection, the unique characteristics of those visiting the PER and subsequently hospitalized suggest a frequent involvement of respiratory viruses, potentially as viral-bacterial coinfections, compared with outpatients.

A single centre study of viral community-acquired pneumonia in children: No evidence of SARS-CoV-2 from October 2019 to March 2020

Pneumonia is an important cause of morbidity and mortality in children. We described viral aetiologies, with particular interest in detecting SARS-CoV-2, in hospitalized pneumonia children. Human rhinovirus was the most frequently detected agent. No children tested positive for SARS-CoV-2. Our findings suggest that SARS-CoV-2 infection is rare in children and it was not circulating in Rome before COVID-19 outbreak.

Altered chemokine profile in Refractory Mycoplasma pneumoniae pneumonia infected children.

Mycoplasma pneumoniae is one of the major pathogens causing community-acquired pneumonia in children. Although usually self-limited, Mycoplasma pneumoniae pneumonia (MPP) may lead to complicated morbidity that can even be life-threatening. Upon MPP infection, alveolar macrophage becomes attracted and activated and will induce subsequent cytokine and chemokine reaction. Refractory Mycoplasma pneumoniae pneumonia (RMPP) is manifested by clinical or radiological deterioration despite proper antibiotic therapy. RMPP is characterized with excessive inflammation and may need subsequent glucocorticoid treatment. The aim of this study was to investigate the change of plasma chemokines in non-refractory Mycoplasma pneumoniae pneumonia (NRMPP) and RMPP before and after antibiotic or methylprednisolone treatment. A total of 42 children with MPP were enrolled in this study. Plasma specimens were collected at admission and one to two weeks after antibiotic or methylprednisolone treatment with declined fever. Plasma specimens were then indicated to chemokines detection. Mycoplasma pneumoniae pneumonia altered the chemokine profile through the observation of decreased plasma M1 related chemokines (CCL2, CCL8 and CXCL10) and increased M2 related chemokines (CCL17 and CCL22) after treatment.When the patients were divided into RMPP and NRMPP groups and the chemokines before treatment were compared, the RMPP group showed higher CXCL10 but lower CCL3 and CCL11 than the NRMPP group. Unique changes in macrophage related chemokines is observed in the course of MPP infection. NRMPP and RMPP infection in children showed distinct manifestation in chemokine profiles.

Актуальные вопросы этиологии, диагностики и терапии внебольничной пневмонии у детей

Актуальные вопросы этиологии, диагностики и терапии внебольничной пневмонии у детей

Relationship between Serum Endocan Levels and Childhood Community-Acquired Pneumonia.

Community-acquired pneumonia (CAP) is a potentially lethal lower respiratory tract infection for children. For this reason, early recognition and appropriate treatment is essential. In addition, we need to determine which patient will be hospitalized or not hospitalized. Here, we aimed to evaluate the plasma endocan level to determine whether it is effective in making the decision on hospitalization and the assessment of the response to treatment in patients with CAP. This prospective case-control study was conducted between November 2015 and May 2016 at Erciyes University School of Medicine. Fifty-three patients diagnosed as CAP with clinical and radiological findings were enrolled in the study. The patients were divided into various subgroups, such as inpatient, outpatient, complicated, non-complicated, dead patients, etc., and the levels of endocan were compared between the control group and those various groups. A total of 53 children with a diagnosis of CAP and 55 healthy children were enrolled in the study. Patients were divided into two groups: hospitalized patients and outpatients. There was no statistically significant difference between these groups' serum endocan levels on the 1st day and serum endocan levels on the 4th day (p=0.783, p=0.419). Serum endocan level had no significant value in predicting patients' hospitalization. On the other hand, high serum endocrine levels may be important in predicting the severity and prognosis of the disease.

The distribution characteristics of intestinal microbiota in children with community-acquired pneumonia under five Years of age

Pneumonia is the leading cause of morbidity and mortality in children under five years of age worldwide. Over the past decades, studies have shown that the upper respiratory pathogens are closely related to the occurrence of pneumonia. However, the co-occurrence of gut microbiome dysbiosis may have clinical manifestation in the prognosis of childhood pneumonia. The aim of the present study is to investigate the differences in gut microbial communities between children's diagnosed community-acquired pneumonia (CAP) under five compared to healthy controls in Inner Mongolia. Fecal samples were collected from children with CAP and healthy controls (<5 years old) and the genomic microbiome 16S rRNA was amplified using the hypervariable V4 region and subjected to MiSeq Illumina sequencing, and then analyzed for microbiota composition and phenotype. Finally functional profiling was performed by KEGG pathways analyses. Our results revealed a gut microbiota dysbiosis in children with CAP. Distinct gut microbiome composition and structure were associated with childhood CAP between two age categories compared to healthy controls. In addition, the phylogenic phenotype's prediction was found to be significantly different between the groups. The prominent genera in age group of 0–3 were Bifidobacterium and Enterococcus. On the contrary, Escherichia-Shigella, Prevotella, Faecalibacterium and Enterobacter were remarkably decreased in most of the fecal samples from CAP patients in age group of 0–3 compared to the control. At the genus level, the CAP children in the age group of 4-5 showed an increase in the abundance of Escherichia/Shigella, Bifidobacterium, Streptococcus and Psychrobacter and, a decrease in the abundance of Faecalibacterium, Bacteroides, Lachnospiraceae and Ruminococcus compared with the matched healthy controls. Moreover, CAP children in both age groups exhibited distinct profiles in the KEGG functional analysis. Our data revealed that the gut microbiota differ between CAP patients and health children and certain gut microbial species are associated with CAP. Further research to identify specific microbial species which may contribute to the development CAP are merited. In addition, rectification of microbiota dysbiosis may provide supplemental benefits for treatment of the childhood CAP.

Analysis of the consumption of antibacterial medications in community-acquired pneumonia in children

Objective: The study objective is to analyze the efficacy of antibacterial medication selection to treat community-acquired pneumonia (CAP) in children in an out-patient clinic and in a pulmonology department of an in-patient hospital.Methods: Retrospective descriptive study for 2009–2017 in day-patient departments of pediatric clinics and pediatric pulmonology departments of in-patient hospitals of Primorskiy territory (760 cases).Results: 50 % of children took antibiotics at pre-hospital stage (self-treatment). Penicillins were the most popular – 50.1 % (218 prescriptions), cephalosporins were used in 129 (29.7 %), macrolides – in 86 (18.8 %) of cases. The average duration of antibacterial treatment course of CAP was 10 days at pre-hospital stage. Both in the out-patient clinic and in the in-patient hospital, cephalosporins (58.4 and 58.3 %), macrolides (34.8 and 37.4 %) and aminoglycosides (6.3 and 3.4 %) were used more often.Conclusions: The positive dynamics in the protocols of antibiotic therapy of CAP should be noted. The improvement of regulatory framework has led to the increase of rational prescriptions. It is necessary to continue improving of clinical guidelines and implementing pulmonology hospitals of microbiological monitoring that will allow improving the quality of antibacterial treatment.

The Effect of Selective and Mass Immunization Against Pneumococcal Infection on the Morbidity and Mortality due to Community-Acquired Pneumonia in Children Under 5 Years of Age

Background. It is required to perform estimation of epidemiological and cost efficacy (regarding morbidity rate) of mass routine vaccination against pneumococcal infection in Russian children and carried out earlier selective vaccination of children from high-risk groups on the basis of four-year experience. It is also important to estimate the rate of hospital admissions in this patient group, long-term and annual cycles, morbidity age and etiology structure, and mortality due to community-acquired pneumonia as one of the most common form of pneumococcal disease.The aimis to study the effect of selective and mass immunization against pneumococcal infection on the morbidity and mortality due to community-acquired pneumonia in children under 5 years of age. Methods.The analysis of communityacquired pneumonia morbidity (in 2003–2018) and mortality due to pneumonias (in 2003–2018) in children under the 14 years old in Perm was carried out. Serotypes of circulating pneumococcus, etiology of community-acquired pneumonias and immunization cost efficacy (direct expense on health care) were further studied. The analysis of study indexes was carried out following selective (vaccination of at-risk children in 2011–2014) and mass (vaccination of infants in 2015–2018) immunization strategies. Results. The morbidity rate of community-acquired pneumonias decreased by 4.0 times (from 267.0 to 66.7 for 1000) after performing selective vaccination (2011–2014) in at-risk children (frequently and chronically ill children). The morbidity rate of community-acquired pneumonias in non vaccinated children of the same group increased by 2.0 times (from 40.0 to 80.0 for 1000 non-vaccinated). The prophylactic efficacy index was 46.0. Whereby the antibacterial index among vaccinated frequently and chronically ill children was 0.11 on one child. This index has decreased by 2.6 times (from 0.11 to 0.04 on one child) in a year within the framework of prospective controlled randomized clinical study. The antibacterial index among non-vaccinated children of this group remained slightly the same: 0.09 and 0.12 respectively. During the selective vaccination the mortality rate among infants decreased by 2 times: long-term average index was 17.9 (2011–2014) against 35.2 (2003-2010) on 100 thousand children. Mass vaccination of infants against pneumococcal infection has reduced the incidence of community-acquired pneumonias among children under 2 years of age and has led to absence of multiple sites of pneumococcal infection in children’s organizations. It also has reduced the number of hospitalized children and achieved zero mortality due to pneumonias in infants by the third year of this immunization strategy implementation. The obtained results were achieved mainly due to circulation of 7 pneumococcal serotypes (6A, 6B, 9V, 14, 19A, 19F, 23F) in children under 5 years of age. The threshold level of vaccination against pneumococcal infection advancing morbidity and mortality due to pneumonias in children was specified. The strategy of mass vaccination of infants was cost-effective. Conclusion. The new data on epidemiological and cost efficacy of various immunization strategies against pneumococcal infection in children was obtained.

Analysis of cots for children treatment pneumonia in Bach Mai Ha Noi hospital from 10/2018 to 3/2019

A study of the direct costs of treating pneumonia of children at Bach Mai hospital from October 2018 to March 2019 that the costs of hospital beds accounts shows for the highest proportion, then comes the cost of medicines and diagnostics. The cost of antibiotics is the highest in the cost of drugs, while the cost of diagnosis is the cost of testing. The cost of treatment is significantly related to the number of days of treatment, in addition, the severity or co-morbidity factors are affected only when considered individually. The support of health insurance can be up to more than 70% of the direct cost. The research results show that the cost of treatment in Viet Nam is lower than some countries in the region, the cost distribution is similar to that of some other domestic studies, but the cost of antibiotics has decreased significantly. Although drugs used at Bach Mai hospital are prescribing mainly generic medicines.&#x0D; Keywords&#x0D; Direct costs, pneumonia, children, Bach Mai hospital.&#x0D; References&#x0D; [1] Ministry of pulic health, Decision on Guidelines for the Management of Community-Based Pneumonia in children 2014 (in Vietnamese).[2] UNICEF Viet Nam, The top two fatal diseases for children in the Asia-Pacific region and Viet Nam, 2012 (in Vietnamese).[3] Nguyen Van Quang, Analysis of the cost of treating decompensated cirrhosis due to hepatitis C at Ho Chi Minh Tropical Hospital and Bach Mai Hospital in Ha Noi 2015 University graduation thesis in pharmacy (2017) (in Vietnamese).[4] Duc Anh Dang, Kah Kee Tan, Ki Hwan Kim, Cissy Kartasasmita, et al, Burden of hospitalized childhood community-acquired pneumonia: A retrospective cross-sectional study in Vietnam, Malaysia, Indonesia and the Republic of Korea, Human vaccin Immunother 14 (1) (2018) 95-105. https://doi.org/10.1080/21645515.2017.1375073.[5] Philip Ayieko, Ulla Griffiths, Angela Oloo Akumu, Mike English, The economic burden of inpatient paediatric care in Kenya: household and provider costs for Treatment of pneumonia, malaria and meningitis.; Cost Effectiveness and Resource Allocation 7(3) (2009) 1-13. https://doi.org/10.1186/1478-7547-7-3.[6] Nguyen Ngoc Tu, Analyze the direct cost of treating community-acquired pneumonia at Thai Nguyen tuberculosis and lung disease year 2015, Master's thesis in pharmacy (2017) (in Vietnamese).[7] Bui Thi Quyen, Analyze the cost of treating community-acquired pneumonia at the children's hospital in Nam Dinh province 2015, Grade 1 specialized pharmacist thesis (2016) (in Vietnamese).[8] Hamidah Hussain, Hugh Waters, Aamir J Khan, Saad B Omer, et al, Economic analysis of childhood pneumonia in Northern Pakistan, Heatlh policy plan 23(6) (2008) 438-444. https://doi.org/10.1093/heapol/czn033.&#x0D; &#x0D; &#x0D; &#x0D;

Efflux Pumps and These Inhibitors

In this era of multi-drug resistance, efflux pump is one of the major problems which is increasingly concerned by scientists. The structure and mechanism activity of the efflux pumps on both bacteria and eurakyotes that are gradually being clarified. Since then, efflux pump inhibitors have also been studied and initially applied in clinic, that makes an important contribution to preventing the outbreak of multi-resistant infections and cancers. Efflux pump inhibitors are often small synthetic molecules or plant metabolites that show great promise in inhibiting multi- resistant in both bacteria and cancerous cells.&#x0D; Keywords&#x0D; Efflux pump, EPI, bacteria, cancer, MRD.&#x0D; References&#x0D; [1] Ministry of pulic health, Decision on Guidelines for the Management of Community-Based Pneumonia in children 2014 (in Vietnamese).[2] UNICEF Viet Nam, The top two fatal diseases for children in the Asia-Pacific region and Viet Nam, 2012 (in Vietnamese).[3] Nguyen Van Quang, Analysis of the cost of treating decompensated cirrhosis due to hepatitis C at Ho Chi Minh Tropical Hospital and Bach Mai Hospital in Ha Noi 2015 University graduation thesis in pharmacy (2017) (in Vietnamese).[4] Duc Anh Dang, Kah Kee Tan, Ki Hwan Kim, Cissy Kartasasmita, et al, Burden of hospitalized childhood community-acquired pneumonia: A retrospective cross-sectional study in Vietnam, Malaysia, Indonesia and the Republic of Korea, Human vaccin Immunother 14 (1) (2018) 95-105. https://doi.org/10.1080/21645515.2017.1375073.[5] Philip Ayieko, Ulla Griffiths, Angela Oloo Akumu, Mike English, The economic burden of inpatient paediatric care in Kenya: household and provider costs for Treatment of pneumonia, malaria and meningitis.; Cost Effectiveness and Resource Allocation 7(3) (2009) 1-13. https://doi.org/10.1186/1478-7547-7-3.[6] Nguyen Ngoc Tu, Analyze the direct cost of treating community-acquired pneumonia at Thai Nguyen tuberculosis and lung disease year 2015, Master's thesis in pharmacy (2017) (in Vietnamese).[7] Bui Thi Quyen, Analyze the cost of treating community-acquired pneumonia at the children's hospital in Nam Dinh province 2015, Grade 1 specialized pharmacist thesis (2016) (in Vietnamese).[8] Hamidah Hussain, Hugh Waters, Aamir J Khan, Saad B Omer, et al, Economic analysis of childhood pneumonia in Northern Pakistan, Heatlh policy plan 23(6) (2008) 438-444. https://doi.org/10.1093/heapol/czn033. &#x0D; &#x0D; &#x0D; &#x0D;

EPIDEMIOLOGICAL ASPECTS OF COMMUNITY-ACQUIRED PNEUMONIA IN CHILDREN AND ADOLESCENTS OF THE REPUBLIC OF DAGESTAN

Community-acquired pneumonia (AP) caused by infectious agents is a dangerous respiratory disease that can lead to death. This determines the relevance of the topic. Materials and methods. A descriptive epidemiological study was conducted: the analysis of the primary incidence of community-acquired pneumonia in children from 1 month of age up to 17 years. Results. The incidence of AP among children in 2014-2018 on the RD was 286.9 per 100 thousand children and adolescents. Among children aged 6 months up to 1 year, AP was detected in 599.9 per 100 thousand surveyed. The obtained data on the EAP show that this indicator throughout the country did not exceed the Russian level, as well as the level of AP morbidity in the North Caucasus Federal district. The analysis of infant mortality from respiratory diseases showed a decrease in its level from 0.5% in 2014 to 0.2% in 2018 in the whole RD, including in rural areas, there was a decrease in the mortality rate from pneumonia from 0.5% to 0.3%, in urban areas from 0.4% to 0.1% over the observed period. Conclusion. The established patterns may lead to the discovery of new diagnostic biomarkers of AP and bring us closer to its personalized therapy in children.

High expression of miR-222-3p in children with Mycoplasma pneumoniae pneumonia

ObjectivesMycoplasma pneumoniae is a leading cause of community-acquired pneumonia in children. However, its mechanism of pathogenesis is not fully understood, and microRNAs might play a role. This study aimed to explore the microRNA-222-3p (miR-222-3p) expression and its possible role in children with M.pneumoniae pneumonia (MPP).MethodsThirty-six children with MPP and twenty-seven age-matched controls from Children’s Hospital of Soochow University were enrolled in this study. MiR-222-3p and cluster of differentiation 4 (CD4) mRNA were detected using real-time PCR in children’s peripheral blood plasma samples. THP-1 cells and mice were stimulated with M.pneumoniae lipid-associated membrane proteins(LAMPs).ResultsChildren with MPP had significantly higher levels of miR-222-3p and lower levels of CD4 in peripheral blood plasma (P < 0.05). Additionally, Sixteen children with MPP complicated with pleural effusion had higher miR-222-3p levels than those without pleural effusion. MiR-222-3p or CD4 in THP-1 cells increased or decreased, respectively, in a dose dependent manner after LAMP stimulation. In LAMP-stimulated mice massive inflammatory cells infiltrates surrounded the bronchioles, and miR-222-3p increased in the bronchoalveolar lavage fluid. In conclusion, miR-222-3p was highly expressed in children with MPP, especially those with pleural effusion.ConclusionSmall sample studies showed that M.pneumoniae or its LAMPs could increase miR-222-3p and decrease CD4 in macrophages,both in vitro and vivo.Thus, miR-222-3p might be an MPP biomarker for the diagnosis and prognosis.

Lung Ultrasonography – A Paraclinical Investigation Promoter in Community-Acquired Pneumonia Diagnosis in Children

Abstract Lung ultrasonography is an excellent alternative to chest radiography, with better sensitivity, specificity, positive and negative predictive values and, finally, with better accuracy. The lung ultrasonography is proven to be useful in trying to reduce the request of chest radiography. In the opinion of most specialists, lung ultrasonography is recommended to be a valuable tool for the diagnosis of community-acquired pneumonia in children. Considering the fact that clinical examination remains essential because it suspects the diagnosis, the evolution does not require radiologic follow-up, also the pathologic findings at the clinical examination may change over the course of a day, the possibility of the clinician to maintain the objectivity is essential. For this goal to be possible, it would be ideal that the clinician himself performs the ultrasonography (in real-time).

The Usefulness of Lung Ultrasound for the Aetiological Diagnosis of Community-Acquired Pneumonia in Children

The aetiology of community-acquired pneumonia (CAP) is not easy to establish. As lung ultrasound (LUS) has already proved to be an excellent diagnostic tool for CAP, we analysed its usefulness for discriminating between the aetiologically different types of CAP in children. We included 147 children hospitalized because of CAP. LUS was performed in all patients at admission, and follow-up LUS was performed in most patients. LUS-detected consolidations in viral CAP were significantly smaller, with a median diameter of 15 mm, compared to 20 mm in atypical bacterial CAP (p = 0.05) and 30 mm in bacterial CAP (p < 0.001). Multiple consolidations were detected in 65.4% of patients with viral CAP and in 17.3% of patients with bacterial CAP (p < 0.001). Bilateral consolidations were also more common in viral CAP than in bacterial CAP (51.9% vs. 8.0%, p < 0.001). At follow-up, a regression of consolidations was observed in 96.6% of patients with bacterial CAP and in 33.3% of patients with viral CAP (p < 0.001). We found LUS to be especially suitable for differentiating bacterial CAP from CAP due to other aetiologies. However, LUS must be interpreted in light of clinical and laboratory findings.

Treatment Failure Rate of Penicillin Gas Empiric Therapy for Pediatric Community-Acquired Pneumonia in Children Admitted in Gov. Celestino Gallares Memorial Hospital

Treatment Failure Rate of Penicillin Gas Empiric Therapy for Pediatric Community-Acquired Pneumonia in Children Admitted in Gov. Celestino Gallares Memorial Hospital

Evaluation the Clinical Value of Xiyanping Injection in the Treatment of Community-acquired Pneumonia in Children

Evaluation the Clinical Value of Xiyanping Injection in the Treatment of Community-acquired Pneumonia in Children

2619. Clinical Characteristics and Etiology of Community-Acquired Pneumonia in Children: A Contemporary, Prospective, Multicenter Study in Ohio, 2015–2018

BackgroundWorldwide, pneumonia is the leading cause of death in children <5 years of age and the second most common reason for hospitalization in children in the United States and Europe. This study was designed to describe the clinical characteristics and etiology of community-acquired pneumonia (CAP) in children.MethodsWe conducted a prospective, multicenter, observational study of CAP among previously healthy children aged 2 months through 18 years in six children’s hospitals in Ohio. Blood, pleural fluid, and nasopharyngeal swabs were collected for pathogen detection by culture and/or molecular diagnostics. Patient clinical management including antibiotic therapy and respiratory support, followed the standard of care at each study site. Follow-up information regarding clinical outcomes was collected via a survey 6–8 weeks after enrollment.ResultsWe enrolled 441 children (n = 380, 86% hospitalized) with CAP from 2015 to 2018. Median age was 5 years (IQR: 2.1–8.9y). Intensive care and respiratory support were required for 15% and 49% of children, respectively. Consolidation and pleural effusion were identified in 26% and 21%, respectively. Among hospitalized children, 99% received antibiotics during hospitalization, and 91% continued antibiotic treatment at discharge. There were no children with any kind of sequelae or deaths from CAP, but 4.4% were readmitted within 30 days after discharge. Pathogens were identified in 64% patients; including pyogenic bacteria in 4%, atypical bacteria in 9%, and viruses in 56%. A total of 18 (4%) children had both bacterial (9 pyogenic and 9 mycoplasma) and viral pathogens. Among children with a virus detected (n = 245), 17% had more than one virus. The most commonly detected bacteria were M. pneumoniae (n = 39) and S. pneumoniae (n = 10). Rhinovirus was the most common virus detected (RV; n = 81, 28%), followed by respiratory syncytial virus (RSV; n = 75, 26%).ConclusionIn this multicenter cohort, the most commonly detected viruses in children with CAP were RV and RSV, and M. pneumoniae and S. pneumoniae among bacteria. Clinical outcomes in children with CAP were overall good, but there was a high burden of hospitalization and antibiotic use.DisclosuresOctavio Ramilo, MD, Bill & Melinda Gates Foundation: Research Grant; Janssen: Research Grant; Merck: Advisory Board; NIH: Research Grant; Ohio Children’s Hospital Association (OCHA): Research Grant; Pfizer: Advisory Board, Consultant, Lectures; Sanofi/Medimmune: Advisory Board.

Characteristics of Hospitalized Rhinovirus-Associated Community-Acquired Pneumonia in Children, Finland, 2003-2014.

Background: Rhinovirus (RV) is the most common cause of respiratory tract infections in children but, still, the clinical characteristics of RV-associated pneumonia have not been sufficiently investigated.Methods: We identified children and adolescents younger than 18 years of age treated for community-acquired pneumonia as inpatients at the Turku University Hospital from 2003 to 2014 and analyzed for RV by PCR of a respiratory tract specimen. We collected the data from medical records and compared RV-positive children with RV-negative children.Results: Of the study population of 313 children with pneumonia who were studied for RV, it was detected in 82 (26%). RV-positive children were younger (median age 2.6 years, interquartile range [IQR] 1.1–4.6 vs. 3.5 years, IQR 1.7–8.3, p = 0.002) and they had more often a history of preterm birth (16% vs. 5%, adjusted odds ratio 2.89, 95% confidence interval 1.21–6.92, p = 0.017) than RV-negative children. RV-positive children had a higher median white blood cell count than RV-negative children at presentation with pneumonia. The signs, symptoms, and severity of pneumonia were mostly similar in RV-positive and RV-negative children.Conclusions: RV was frequently detected in young children hospitalized with community-acquired pneumonia. We identified premature birth as a factor associated with RV-positive pneumonia. The clinical features of pneumonia did not clearly differ between RV-positive and RV-negative children. Further studies are needed to clarify the clinical significance of detection of RV in children with pneumonia.

Epidemiological and economic efficiency of mass vaccinal prevention against pneumococcal infection in children compared with selective immunization at the example of community-acquired pneumonia

Aim. To study the epidemiological pattern of community-acquired pneumonias in children and the influence of mass vaccinal prevention on morbidity and mortality.&#x0D; Materials and methods. Vaccination of children against pneumococcal infection on the territory of a large industrial center of Western Urals was analyzed, influence of mass vaccination against pneumococcal infection on pneumonia morbidity and mortality in children was determined.&#x0D; Results. Mass vaccinal prevention of children of the first year of life against pneumococcal infection (vaccination volume 102 353.6 per 100 thousand children under 6) significantly influenced morbidity level regarding community-acquired pneumonias in the group of vaccinated children under 2 (1619.9 0.78 versus 15233.7 2.5 per 100 thousand in the group of unvaccinated, odds ratio and its confidence interval was 9.40 [95 % CI 8.4610.44]), on community-acquired streptococcal morbidity of children under 6 (r = 0.97; regression coefficient = 36.30, р 0.001; R2 = 91.0 %, significance F = 0.01 and possibility 95.0 %) and 5-fold decreased the mortality level (from 35.2 before vaccination started to 6.8 per 100 thousand) till its full absence in the third year of realization of this strategy. No analogous influence on the main manifestations of epidemiological process of community-acquired pneumonia was noted in case of selective immunization against pneumococcal infection among 25 year olds, belonging to high risk groups (vaccination volume 10 417.08 per 100 thousand children under 6).&#x0D; Conclusions. The strategy of mass vaccination of children of the first year of life was characterized by the greatest epidemiological and economic benefits. Economic efficiency taking into account vaccination costs in terms of 1000 of vaccinated children was 17.1 times higher and was equal to 8.3656 mln rub per 1000 inhabitants versus 0.4890 mln rub in case of selective immunization of high risk group children.

Epidemiological approach to optimizing surveillance for community-acquired pneumonia

The organization of medical care is key in terms of reducing the social and economic importance of communityacquired pneumonia in children. Purpose of the study . To study the characteristics of the organization of inpatient care for community-acquired pneumonia in children from the perspective of an epidemiological approach. Materials and methods . Аnalyzed 592 medical records of in-patient with a confirmed diagnosis of «community-acquired pneumonia» patients who were treated in Clinical Hospital № 17 city of Ufa in the period 01.01.2016–01.08.2017. Results and conclusions . The coincidence of preliminary diagnoses of EP with final only in half of the analyzed cases was determined. Gram-positive bacteria Staphylococcus haemolyticus and Staphylococcus aureus predominate in the structure of isolated microorganisms in CAP. Different resistance and resistance of microorganisms isolated from the analyzed material from patients with CAP have been established. The necessity of optimization of microbiological monitoring of community-acquired pathogens pneumonia, as well as an integrated approach when providing medical care on an outpatient and inpatient.