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Pneumonia in ventilated babies in an emerging country: clinical features, aetiology and short-term outcome
1Department of Paediatrics and Child Health, Tygerberg Hospital and University of Stellenbosch, South Africa. sk@gerga.sun.ac.za
Insights
Pneumonia in infants under six months requiring ventilation is serious, with significant rates of apnea and a 11% mortality rate. Bacterial and viral infections were identified in a notable proportion of these critically ill children.
Area of Science:
- Pediatrics
- Critical Care Medicine
- Infectious Diseases
Background:
- Pneumonia is a leading cause of mortality in infants.
- Ventilatory support is often required for severe pediatric pneumonia.
- Low-income communities face unique challenges in managing infant respiratory illnesses.
Purpose of the Study:
- To investigate the clinical characteristics and outcomes of infants under six months with pneumonia requiring mechanical ventilation.
- To identify common pathogens and risk factors in this vulnerable population.
- To assess the mortality rate and identify potential areas for intervention.
Main Methods:
- Retrospective study of 44 infants (< 6 months) admitted to a pediatric ICU for ventilation due to pneumonia.
- Analysis of clinical data including prior ventilation, bronchopulmonary dysplasia, symptom duration, and presenting symptoms like apnea.
- Microbiological investigations including blood cultures and viral cultures.
Main Results:
- 11% of infants (5/44) died.
- 45% presented with apnea.
- Bacterial infections (positive blood cultures) were found in 14% (6/44).
- Viral infections were identified in 30% (13/44).
- 23% had prior neonatal ventilation, and 3 had bronchopulmonary dysplasia.
Conclusions:
- Infants under six months with pneumonia requiring ventilation have a high incidence of apnea and significant mortality.
- Both bacterial and viral pathogens contribute to severe pneumonia in this age group.
- The findings highlight the need for prompt diagnosis and management of pneumonia in critically ill infants, particularly in resource-limited settings.
Abstract:
Forty-four babies (< 6 months) with pneumonia admitted for ventilation to a paediatric ICU serving a low-income community, were studied. Twenty-three per cent had been ventilated during the neonatal period and three had bronchopulmonary dysplasia. The median duration of symptoms was 1.5 days; 45 per cent presented with apnoea. Five babies (11 per cent) died. Blood cultures were positive in six children (14 per cent). Viruses were cultured in 13 children (30 per cent).
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