Community-acquired Pneumonia In Infants Research Articles

Risk factors for severe community-acquired pneumonia in infants and preschool children

Introduction. The relevance of studying community-acquired pneumonia in children is associated with its high prevalence, despite timely prevention and effective approaches to the treatment of respiratory diseases. Factors influencing the severity of pneumonia are diverse and include comorbid pathology, early age of the child, the state of the immune system, etc.Objective. To identify and rank risk factors for severe community-acquired pneumonia in infants and preschool children.Materials and methods. This article presents the results of a retrospective analysis of 291 medical histories of children from 3 months to 7 years with community-acquired pneumonia. 83 children had severe CAP, of which 63 patients were hospitalized in the ICU.Results and discussion. The average age of a patient with community-acquired pneumonia was 33 months. Children from families with two or more children fell ill more often. On average, children were hospitalized for 4–5 days of illness. Concomitant diseases in children with CAP were quite common and often complicated the course of pneumonia. According to the results of our study, more than 70% of children were not vaccinated against pneumococcus, Haemophilus influenzae and influenza. We established significant linear relationships between the presence of bronchial obstruction and complications of CAP such as respiratory failure and transfer to the ICU (odds ratio (OR) 7.1; Cramer coefficient 0.40; relationship 0.005). It was shown that patients who received outpatient antibiotic therapy were less likely to require transfer to the ICU.Conclusion. Risk factors for severe community-acquired pneumonia and hospitalization in the ICU were: male gender, age under 2 years, lack of vaccination against pneumococcus, Haemophilus influenzae and influenza, combination of bronchial obstruction with CAP, presence of ENT pathology, lack of antibacterial therapy during prehospital stage, as well as the presence of a serious condition already upon admission.

Salivary C-Reactive Protein and Mean Platelet Volume in the Diagnosis and Follow-Up of Community-Acquired Pneumonia in Infants.

Background: Community-acquired pneumonia (CAP) in infants is a major cause of morbidity and mortality, especially in developing countries. Increased salivary C-reactive protein (CRP) levels have been demonstrated in neonatal pneumonia and other diseases. We investigated the applicability of CRP and mean platelet volume (MPV) in the diagnosis and follow-up of CAP in infants. Methods: This prospective observational study included 45 infants admitted for CAP. We measured serum and salivary CRP levels via ELISA, while MPV was measured using an automated blood cell counter. Results: Both salivary and serum CRP values were significantly different in the studied population between admission and follow-up (P = 0.001 and P < 0.0001, respectively). The same was observed for MPV (P < 0.0001). We found significant positive correlations between serum and salivary CRP (r = 0.652, P < 0.0001) and between serum CRP and MPV (r = 0.495, P = 0.001), as well as between salivary CRP and MPV (r = 0.439, P = 0.003). Receiver operating curve analysis showed that salivary CRP at a cutoff value of 3.2 ng/L had a sensitivity of 97.2% and specificity of 90%, while MPV at a cutoff value of 8.4 fL showed 91% sensitivity and 90% specificity. Conclusions: The present study showed that both salivary CRP and MPV are reliable diagnostic markers of CAP in infants.

Epidemiologic and clinical characteristics of human bocavirus infection in infants and young children suffering with community acquired pneumonia in Ningxia, China

BackgroundPneumonia has a high incidence rate and is a major cause of mortality in children, mostly community-acquired pneumonia (CAP). Human bocavirus (HBoV), since it first identified in 2005, has been repeatedly associated with respiratory tract infections. Nevertheless, the role and related information of HBoV as a pathogen of CAP has not been fulfilled. Here our study is to assess the epidemiological and clinical features in HBoV-positive children with CAP.MethodsA total of 878 secretions of lower respiratory samples were obtained, multiplex PCR was used to detect HBoV and other respiratory viruses.ResultsOf all cases, HBoV was detected in 10.0%, with a peak incidence of infection among children < 2 year old, and predominantly noted in autumn and winter. Only 8 patients were HBoV single infection. Co-infection with other respiratory viruses was observed in 86.4%. Moreover, co-infection with bacteria occurred in 27.3% and with Mycoplasma pneumoniae (MP) in 33.0% of HBoV-positive patients. Among all HBoV-positive samples co-infected with bacteria, 87.5% are gram negative bacteria. Compared with HBoV-negative group, age (P = 0.048), wheezing (P = 0.015), tachypnea (P = 0.016), lactate dehydrogenase (P = 0.026) and severe pneumonia (P = 0.023) were statistically significant in HBoV-positive patients. Furthermore, HBoV-positive patients less than 1 year old were more likely to have co-infection with bacteria (P = 0.007).ConclusionsHBoV can be detected alone in respiratory samples of children with CAP, maybe it is one of the causes of CAP in infants. The high incidence of severe pneumonia was found in HBoV-positive patients compared with HBoV-negative cases may indicate a relationship between severe pneumonia and HBoV.

Community-acquired pneumonia in infants: Not simply an acute event with complete recovery

BackgroundPneumonia in infancy has been linked to long-term consequences for the rapidly developing lung. We examined the impact of hospitalized community-acquired pneumonia (CAP) on subsequent respiratory health. MethodsWe conducted a retrospective matched-cohort study using the Optum® de-identified Electronic Health Record Dataset (2009–2018). Study population comprised healthy infants hospitalized for CAP (“CAP patients”), and matched comparators without pneumonia (“comparison patients”), before age 2 years. Study outcomes included any chronic respiratory disorder, reactive airway disease (asthma, hyperactive airway disease, recurrent wheezing), and CAP hospitalization occurring between age 2–5 years, and were evaluated overall as well as by age and etiology at first CAP hospitalization. ResultsStudy population totaled 1,343 CAP patients and 6,715 comparison patients. Rates per 100 patient-years and relative rates (RR) of study outcomes from age 2–5 years for CAP patients versus comparison patients were: any chronic respiratory disorder, 11.6 vs. 4.9 (RR = 2.4 [95% CI: 2.1–2.6]); reactive airway disease, 6.1 vs 1.9 (RR = 3.2 [2.6–3.8]); and CAP hospitalization, 1.0 vs 0.2 (RR = 6.3 [3.6–10.9]). Rates of study outcomes were highest among CAP patients who had their initial hospitalization in the second year of life. ConclusionsInfant CAP foreshadows an increased risk of subsequent chronic respiratory disorders, which may be elevated when CAP occurs closer to pre-school age (i.e., age 2–5 years). These findings are most consistent with the hypothesis that inflammation persists beyond the acute stage of pneumonia and plays a role in the development of chronic respiratory sequelae.

Pediatricians' Compliance to the Clinical Management Guidelines for Community-Acquired Pneumonia in Infants and Young Children in Pakistan.

Community-acquired pneumonia (CAP) is among the most commonly prevailing acute infections in children that may require hospitalization. Inconsistencies among suggested care and actual management practices are usually observed, which raises the need to assess local clinical practices. The current study was conducted to evaluate pediatricians’ compliance with the standard clinical practice guidelines and their antibiotic-prescribing behavior for the management of CAP in children. Methods: A descriptive cross-sectional study was conducted using a self-administered questionnaire; which was provided to pediatricians by the researchers. Statistical analysis was performed with SPSS 25 Statistics; χ2 tests (or Fisher-exact tests) with the p-value set at < 0.05 as the threshold for statistical significance. Results: The overall response rate was 59.2%. Male respondents were (n = 101; 42.6%), and the respondents (n = 163; 68.7%) were under 30 years of age. Amoxicillin (n = 122; 51.5%) was considered as the most commonly used first-line treatment for non-severe pneumonia, whereas a smaller proportion (n = 81; 34.2%) of respondents selected amoxicillin–clavulanate. Likewise, amoxicillin (n = 100; 42.2%) was the most popular choice for non-severe pneumonia in hospitalized children; however, if children had used antibiotics earlier to admission, respondents showed an inclination to prescribe a macrolide (n = 95; 40.0%) or second-generation cephalosporin (n = 90; 37.9%). More than 90% responded that children <6 months old with suspected bacterial CAP will probably receive better therapeutic care by hospitalization. Restricting exposure to the antibiotic as much as possible (n = 71; 29.9%), improving antibiotic prescribing (n = 59; 24.8%), and using the appropriate dose of antimicrobials (n = 29; 12.2%) were considered the major factors by the respondents to reduce antimicrobials resistance. Conclusions: The selection of antibiotics and diagnostic approach was as per the recommendations, but indication, duration of treatment, and hospitalization still can be further improved.

Procalcitonin, C-reactive Protein and White Blood Cells Count in Children With Community Acquired Pneumonia

v Background: community-acquired pneumonia (CAP) is one of the most common pediatric diseases. Early and accurate diagnosis of CAP in children has a great value in avoiding pneumonia complications and decreasing rates of pneumonia related mortality. Aim of the work:this study aims to investigate the role of procalcitonin (PCT), C-reactive protein (CRP) and white blood cells (WBCs) count in diagnosis of childhood CAP. Patients and Methods: 90 infants and children aged from 2 months to 5 years (60 months) were included in this study. They were divided into two groups group I: 60 patients hospitalized for CAP and group II: 30, age and sex matched, healthy controls attending the outpatient clinics of the same hospitals for routine care. Chest x-ray was performed to the patients group only, while WBCs count, serum CRP, serum procalcitonin were applied to both patients and controls. Results: WBCs count, neutrophil percentage, CRP level, procalcitonin concentration were higher in the patients group than the controls with high statistically significant difference (13.4±3.4 vs 8.3±1.7) (54.5±15.4 vs 37.2±6.7) (57.5±30.1 vs 5.7±5.6) (0.5±0.47 vs 0.07±0.04) respectively. Using the AUROC test WBCs count at cut-off value >10.5 x103 cell/mm3, CRP at cut-off value >20 mg/L, procalcitonin at cut-off value >0.17 ng/ml could predict presence of CAP in the patients with 83.3%, 85%, 86.7% sensitivity and 76.6%, 100%, 96.7% specificity respectively. Conclusion: evaluation of WBCs count, serum CRP and serum procalcitonin concentration has an important role in diagnosis of CAP in infants and children.

Lung ultrasound for the diagnosis of community-acquired pneumonia in infants and children

Background Lung ultrasound (LUS) has been suggested as an effective tool in the evaluation of community-acquired pneumonia (CAP) in pediatrics. Objectives Evaluation of the validity of LUS in the diagnosis of CAP in children, compared with chest radiography (CXR). Patients and methods A prospective observational study was done. LUS and CXR were carried out in 90 children with median (range) age of 2.2 (0.5–15) years who presented with clinical features suggestive of CAP. Results One hundred and five patients were initially enrolled. Fifteen patients were secondarily excluded, resulting in 90 finally analyzed patients. CAP diagnosis was established in 84 patients, and six patients were finally diagnosed as having acute bronchiolitis. Of the 84 patients with CAP, CXR detected 73 (87%) cases and LUS spotted 82 (97.6%) cases. Moreover, CXR identified 11 false-negative cases and one false-positive case, whereas LUS detected two false-negative cases and one false-positive case. The sensitivity, specificity, positive predictive value, and negative predictive value of LUS were 97.6% [95% confidence interval (CI), 91.7–99.7], 83.3% (95% CI, 35.9–99.6), 98.8% (95% CI, 93.2–99.8), and 71.4% (95% CI, 37.8–91.2), respectively, whereas, the sensitivity, specificity, positive predictive value, and negative predictive value of CXR were 86.7% (95% CI, 78.5–92.5), 83.3% (95% CI, 43.6–96.9), 98.6% (95% CI, 92.4–99.7), and 31.2% (95% CI, 19.1–46.7), respectively. Conclusion LUS, done by an expert radiologist, can be considered a promising alternative tool to CXR in the diagnosis of children with suspected CAP.

MicroRNA Expression Profile of Whole Blood Is Altered in Adenovirus-Infected Pneumonia Children.

Human adenovirus (Adv) infection is responsible for most community-acquired pneumonia in infants and children, which results in significant morbidity and mortality in children every year. MicroRNAs (miRNAs) are associated with viral replication and host immune response. Knowing the miRNA expression profile will help understand the role of miRNAs in modulating the host response to adenovirus infection and possibly improve the diagnosis of adenovirus-infected pneumonia. In our study, total RNA extracted from whole blood of adenovirus-infected pneumonia children and healthy controls were analyzed by small RNA deep sequencing. Expression profiles of whole blood microRNAs were altered and distinctly different in adenovirus-infected children. The top 3 upregulated miRNA (hsa-miR-127-3p, hsa-miR-493-5p, and hsa-miR-409-3p) were identified in adenovirus-infected children and provided a clear distinction between infected and healthy individuals. Potential host target genes were predicated and validated by qRT-PCR to study the impact of microRNAs on the host genes. Most of the target genes were involved in the MAPK signaling pathway and innate immune response. These highly upregulated microRNAs may have crucial roles in Adv pathogenesis and are potential biomarkers for adenovirus-infected pneumonia.

Management of community-acquired pneumonia in infants and children: Clinical practice guidelines endorsed by the Saudi Pediatric Infectious Diseases Society.

The World Health Organization (WHO) has reported that pneumonia continues to be a significant cause of mortality in the pediatric age group for children under five years of age, where it accounts for nearly one-fifth of childhood deaths worldwide [1]. In this report, we provide the most up to date guidelines for the management of community-acquired pneumonia (CAP) in infants and children aged over 90 days. The current recommendations given by the Pediatric Infectious Diseases Society and Infectious Diseases Society of America 2011 Practice guidelines, WHO, and other international guidelines are considered as well as regional variations in susceptibility patterns and resources [[1], [2], [3], [4], [5], [6]]. Some published and unpublished antibiograms from several tertiary care organizations in the regions comprising Saudi Arabia, United Arab Emirates, Kuwait, and Oman have shown significant improvements in the susceptibility pattern of Streptococcus pneumoniae to penicillin for the last three years, so the current recommendations have been customized accordingly [2,3]. These guidelines cover the diagnosis and therapeutic options for the management of CAP in children. The definition of children-specific guidelines for the management of CAP can reduce morbidity and mortality. We present a clinical statement from the Saudi Pediatric Infectious Diseases Society (SPIDS) concerning the management of CAP in children.

Blood Cultures in Hospitalized Pneumonia Patients

Research Article| December 01 2017 Blood Cultures in Hospitalized Pneumonia Patients AAP Grand Rounds (2017) 38 (6): 67. https://doi.org/10.1542/gr.38-6-67 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Blood Cultures in Hospitalized Pneumonia Patients. AAP Grand Rounds December 2017; 38 (6): 67. https://doi.org/10.1542/gr.38-6-67 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: blood culture, pneumonia Source: Neuman MI, Hall M, Lipsett SC, et al. Utility of blood culture among children hospitalized with community-acquired pneumonia. Pediatrics. 2017; 140(3). pii: e20171013; doi: https://doi.org/10.1542/peds.2017-1013Google Scholar Investigators at multiple institutions conducted a cross-sectional study to assess the prevalence and microbiology of bacteremia among children hospitalized with community-acquired pneumonia (CAP). Children aged 3 months to 18 years without complex chronic conditions who were hospitalized with CAP at 1 of 6 tertiary children’s hospitals belonging to the Pediatric Health Information System Plus database were eligible. CAP was identified by using ICD-9 codes contained in the database. Data on demographics and length of stay were also extracted. The primary outcome was having a blood culture performed during the hospitalization, as determined via database review. Blood culture results were classified as either positive or negative, with positive results further classified as being pathogenic or contaminant. Bacteremia was defined as a blood culture result positive for a pathogen. Among these, the pathogen was classified as either susceptible or nonsusceptible to penicillin on the basis of the minimum inhibitory concentration of <2 μg/mL. Investigators determined the prevalence of bacteremia, the frequencies of pathogens, and the susceptibility to penicillin, and compared the characteristics of children who underwent blood culture with those who did not. There were 7,509 participants included in the analysis. Overall, 2,568 children (34.2%) had a blood culture performed. Participants with a blood culture were more likely to have private insurance and have a longer length of stay. There were 65 blood cultures that grew a pathogen, resulting in a prevalence of bacteremia of 0.9% (95% CI, 0.7%–1.1%) among all participants and 2.5% (95% CI, 2.0%–3.2%) among participants with a blood culture. The most common pathogen was Streptococcus pneumoniae (78.5%), and 92% of S pneumoniae isolates were susceptible to penicillin. Among all pathogens isolated, 82% were susceptible to penicillin. Only 0.43% (95% CI, 0.23%–0.77%) of children with a blood culture performed grew an organism resistant to penicillin. The investigators conclude that the prevalence of bacteremia is low among children without comorbidities who are hospitalized for CAP. Dr Winer has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device. Whether or not to perform blood cultures in pediatric patients who are admitted to the hospital with nonsevere, noncomplicated CAP has been an ongoing debate. The Pediatric Infectious Diseases Society and the Infectious Diseases Society of America clinical practice guideline for CAP in infants and children >3 months of age recommend blood cultures in children requiring hospitalization for presumed bacterial CAP that is moderate to severe, particularly those with complicated pneumonia.1 This is a strong recommendation, despite low-quality evidence. In the evidence summary, the authors of the guideline state that the rate of bacteremia is likely to be low in patients without effusion, sepsis, or organ dysfunction. They cite 1 study in which 5 of the 6 patients with positive... You do not currently have access to this content.

The etiology of viral respiratory infections in infants with community-acquired pneumonia

Background: Community-acquired pneumonia can be caused by both bacterial and viral pathogens. The differential diagnosis based only on clinical data is not always feasible. The use of C-reactive protein (CRP) and procalcitonin might give some additional information for treatment decision-making. Aim: To evaluate the structure and rates of viral isolation in community-acquired pneumonia in hospitalized infants and changes in CRP and procalcitonin levels. Materials and methods: Seventy five infants at the age of up to 11 months and 29 days, who were hospitalized with community-acquired pneumonia confirmed by chest X-ray from March 2015 till February 2016, were included into the study. CRP and procalcitonin levels were measured. Detection of viruses in nasopharyngeal swabs was performed by a real-time polymerase chain reaction. Results: Nucleic acids of respiratory viruses were isolated in 72% (54/75) of infants. The most common were respiratory syncytial virus (in 70.4%, 38/54) and human rhinovirus (in 16.6%, 9/54). Median of white blood cell count in pneumonia associated with respiratory viruses was 10.95 (9; 14.1)×10 9 /L, CRP level, 1.95 (0.5; 7) mg/L, procalcitonin level, 0.087 (0.067; 0.17) ng/mL. Conclusion: The study showed a high prevalence of respiratory viruses in community-acquired pneumonia in infants. There was no increase in CRP and procalcitonin levels in pneumonia associated with respiratory viruses.

PO-0010 The Physicians Approach To Community-acquired Pneumonia In Childhood

Background and aims Diagnosis and treatment guidelines for community-acquired pneumonia (CAP) are prepared to avoid differences for the diagnosis and management of CAP between physicians. We investigated the approaches of physicians to diagnosis, laboratory findings, treatment and the compatibility with guidelines for CAP. Method A total of 322 doctors were interviewed face to face and a 12 item-questionary incluiding diagnosis, investigation, treatment criteria and drug choices was filled by the physician. Results Contrarily to the guidelines 6.9% of physicians preferred auscultation and chest radiographygraphy (CXR) and did not use the symptoms for diagnosis. Only 11.8% preferred symptoms and diagnostic investigations. 58.8% did not use CXR, CBC and CRP, 24.5% did not use CXR, CBC, CRP and ERS and 4.9% of them did not prefer any investigations. Also routine CXR to confirm CAP in outpatient setting children is not recommended by guidelines physicians preferred CXR at high percentage. Physicians did not preferred Amoksisilin for mild CAP between 3 months - 2 years old children, 55% preferred parenteral treatment with ampisilin/sulbactam. Parenteral Seftriakson was preferred for hospitalised patients (>5 years) with severe pneumonia. 49.7% of physicians preferred ten day duration of therapy, 17.1% stopped treatment after disappearance of symptoms and auscultation findings, 13.7% completed the treatment after improvement of CXR. Conclusion Physicians applied different approaches to the diagnosis and treatment of CAP in infants and children. According to our findings, we suggested that physicians should be educated about approaches for treatment of CAP according to guidelines.

PO-1029 Diagnostic Value Of Apoptotic Activity And Oxidative Stress In Community-acquired Pneumonia In Infants

Background Community-acquired pneumonia is one of the most studied pathologies of childhood, while the problem of diagnostics the disease severity still remains. Aim To increase the effectiveness of diagnostics the severity of community-acquired pneumonia in infants by studying the processes of neutrophils’ apoptotic activity and oxidative stress. Methods The study involved 73 infants with community-acquired pneumonia (moderate severity of disease was diagnosed in 44 children (I group); severe pneumonia – in 29 (II group)) and 23 healthy children of the control group. The intensity of neutrophils’ apoptosis and necrosis was determined by flow cytometry, the generation of superoxide anion (O 2 - ) – by spectrophotometric method, reactive oxygen species (ROS) – by fluorometric method. Results The intensive growth of neutrophils’ apoptosis was revealed in infants with community-acquired pneumonia of moderate severity (p c-1 c-2 The oxidative stress indicators correlated with disease severity. ROS generation indices in infants of I group – 17.23 (16.29; 18.73) RFU·ml -1 , II group – 24.11 (21.23; 25.75) RFU·ml -1 , p c-1 c-2 2 - – 1.13 (1.06; 1.14) nmol·(min·mL) -1 and 1.41 (1.33; 1.49) nmol·(min·mL) -1 accordingly, p c-1 c-2 The method of multiple regression analysis showed, that lowering of saturation in infants with severe pneumonia for 33.8% is interrelated with the changes of neutrophils’ apoptosis and necrosis, determined by the determination index, and confirm the diagnostic value of apoptotic activity. Conclusion The oxidative stress indicators allow to determine the community-acquired pneumonia severity in infants, and intensification of neutrophils’ necrosis with simultaneous inhibition of apoptotic activity is an accurate criterion of severe pneumonia.

Detection of Mycoplasma pneumoniae and Chlamydia trachomatis in Iranian children with acute lower respiratory infections by polymerase chain reaction

ObjectiveTo determine the frequency of Mycoplasma pneumoniae (M. pneumoniae)and Chlamydia trachomatis (C. trachomatis) in young children with community acquired pneumonia (CAP) and detect C. trachomatis in the subgroup of infants under 1 year of age in Tehran, Iran. MethodsThis cross-sectional study was designed to detect M. pneumoniae from all children (<5 years of age) presenting with CAP, admitted to a tertiary care children's hospital affiliated with the Shaheed Beheshti University of Medical Sciences in Tehran during a period of 14 months, from November 2010 to December 2011. Nasopharyngeal and oropharyngeal swabs were collected from 102 children during the study period. Pathogens were detected using polymerase chain reaction and confirmed with real-time polymerase chain reaction. ResultsOnly one case of M. pneumoniae was isolated from 102 children (1%). C. trachomatis was not detected in any of the 69 infants (<1 year of age). ConclusionsAccording to our findings, M. pneumoniae is an uncommon cause of CAP in children under 5 years old and C. trachomatis could not be listed as causing CAP in infants in our study population. However, more studies with a larger sample size are needed to confirm this observation.

Prevalence of Herpes and Respiratory Viruses in Induced Sputum among Hospitalized Children with Non Typical Bacterial Community-Acquired Pneumonia

ObjectiveFew comprehensive studies have searched for viruses in infants and young children with community-acquired pneumonia (CAP) in China. The aim of this study was to investigate the roles of human herpes viruses (HHVs) and other respiratory viruses in CAP not caused by typical bacterial infection and to determine their prevalence and clinical significance.MethodsInduced sputum (IS) samples were collected from 354 hospitalised patients (infants, n = 205; children, n = 149) with respiratory illness (CAP or non-CAP) admitted to Wenling Hospital of China. We tested for HHVs and respiratory viruses using PCR-based assays. The epidemiological profiles were also analysed.ResultsHigh rate of virus detection (more than 98%) and co-infection (more than 80%) were found among IS samples from 354 hospitalised infants and children with respiratory illness in this study. Of 273 CAP samples tested, CMV (91.6%), HHV-6 (50.9%), RSV (37.4%), EBV (35.5%), HBoV (28.2%), HHV-7 (18.3%) and rhinovirus (17.2%) were the most commonly detected viruses. Of 81 non- CAP samples tested, CMV (63%), RSV (49.4%), HHV-6 (42%), EBV (24.7%), HHV-7 (13.6%) and HBoV (8.6%) were the dominant viruses detected. The prevalence of several viral agents (rhinovirus, bocavirus, adenovirus and CMV) among IS samples of CAP were significantly higher than that of non-CAP control group. We also found the prevalence of RSV coinfection with HHVs was also higher among CAP group than that of non-CAP control.ConclusionsWith sensitive molecular detection techniques and IS samples, high rates of viral identification were achieved in infants and young children with respiratory illness in a rural area of China. The clinical significance of rhinovirus, bocavirus, adenovirus and HHV (especially CMV) infections should receive greater attention in future treatment and prevention studies of CAP in infants and children.

Management of Community-Acquired Pneumonia in Infants and Children Older Than 3 Months

Management of Community-Acquired Pneumonia in Infants and Children Older Than 3 Months

Community-Acquired Pneumonia in Infants and Children

Community-Acquired Pneumonia in Infants and Children

Executive Summary: The Management of Community-Acquired Pneumonia in Infants and Children Older Than 3 Months of Age: Clinical Practice Guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America

Evidenced-based guidelines for management of infants and children with community-acquired pneumonia (CAP) were prepared by an expert panel comprising clinicians and investigators representing community pediatrics, public health, and the pediatric specialties of critical care, emergency medicine, hospital medicine, infectious diseases, pulmonology, and surgery. These guidelines are intended for use by primary care and subspecialty providers responsible for the management of otherwise healthy infants and children with CAP in both outpatient and inpatient settings. Site-of-care management, diagnosis, antimicrobial and adjunctive surgical therapy, and prevention are discussed. Areas that warrant future investigations are also highlighted.

The management of community-acquired pneumonia in infants and children older than 3 months of age: clinical practice guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America.

Evidenced-based guidelines for management of infants and children with community-acquired pneumonia (CAP) were prepared by an expert panel comprising clinicians and investigators representing community pediatrics, public health, and the pediatric specialties of critical care, emergency medicine, hospital medicine, infectious diseases, pulmonology, and surgery. These guidelines are intended for use by primary care and subspecialty providers responsible for the management of otherwise healthy infants and children with CAP in both outpatient and inpatient settings. Site-of-care management, diagnosis, antimicrobial and adjunctive surgical therapy, and prevention are discussed. Areas that warrant future investigations are also highlighted.

Incidence of Hospitalization Due to Pneumonia in Children Aged Less than 3 Years

Background: The aim of this study was to determine the hospitalization rate due to pneumonia in preschool children in our region and to compare the rate found with those reported in the literature. Methods: We performed a prospective study between October 2004 and September 2006 in patients aged less than 3 years old in San Sebastian (Spain) and the surrounding region. All children admitted to hospital for radiologically-confirmed pneumonia (presence of lobar or segmental alveolar infiltrate, interstitial infiltrate and/or pleural effusion) were included. Results: There were 116 episodes requiring hospitalization, representing an incidence of 6.4 cases/1000 inhabitants (6.2 in infants aged less than 1 year and 6.6 in children aged 12-35 months). Admission to the intensive care unit was required in 10.3% (12/116). Alveolar infiltrate was found on chest radiograph in 62.1% (72/116), ranging from 51.4% (19/37) in in- fants aged less than 1 year and 69.6% (32/46) in children aged 24 months or more. Mortality at 30 days of admission was nil. Conclusion: The incidence of hospitalization due to community-acquired pneumonia in infants and children, as well as that of pneumonia with alveolar infiltrate, was high in our region. Evaluation of the potential utility of the new pneumo- coccal conjugate vaccine and the influenza vaccine for children should also take into account their effectiveness in pre- venting pneumonia in this age group.