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Are there any differences in the community acquired pneumonias admitted to hospital over the past decade?

Cláudia Calado1, Pedro Nunes, Luísa Pereira

  • 1Hospital de Faro EPE. Serviço de Pediatria. Director: Dr. José Maio/Hospital de Faro EPE. Paediatrics Unit. Director Dr. José Maio. claudiasilvacalado@hotmail.com

Revista Portuguesa De Pneumologia
|May 4, 2010
PubMed

Insights

Community acquired pneumonia (CAP) in children has become more severe, with increased hospital admissions and complications like pleural effusion and empyema. Despite this, hospital stays and fever duration have shortened, with updated antibiotic prescribing patterns observed.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Respiratory Medicine

Background:

  • Community acquired pneumonia (CAP) incidence has decreased in Western countries, but with a trend towards more severe cases requiring hospitalization.
  • Previous studies provide a baseline for comparing current trends in pediatric CAP severity and management.

Purpose of the Study:

  • To characterize hospitalized pediatric CAP cases and compare their severity and management with a previous study from 2001.
  • To identify trends in bacterial agents, complications, and treatment outcomes.

Main Methods:

  • Retrospective data collection on 63 pediatric CAP admissions over a six-month period.
  • Analysis of clinical data, chest X-ray findings, microbiological results, and treatment protocols.
  • Comparison of current data with a 2001 study on pediatric CAP.

Main Results:

  • The majority of patients were aged 0-2 years. Consolidation/atelectasis was seen in 92.1%, and pleural effusion (PE) in 27.0%, with empyema in 17.4%.
  • Streptococcus pyogenes, Streptococcus pneumoniae, and Haemophilus influenzae were identified bacterial agents.
  • Patients with PE experienced longer fever duration, higher inflammatory markers, and longer hospital stays. Overall severity, including PE and empyema rates, increased compared to the 2001 study, yet hospital stay and fever duration decreased.

Conclusions:

  • Pediatric CAP has increased in severity, evidenced by higher rates of PE and empyema, potentially linked to new bacterial strains.
  • Despite increased severity, hospital stays and fever duration have reduced, possibly due to changes in antibiotic prescribing. Ampicillin use increased during hospitalization.
  • Referral to specialized centers for complicated CAP diagnosis and management is recommended. Development of new vaccines targeting aggressive serotypes is of significant interest.

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