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Etiology of community-acquired pneumonia in 1500 hospitalized children
Hao Oumei1, Wang Xuefeng1, Liu Jianping2
1Affiliated Hospital to Liaoning University Traditional Chinese Medicine, Shenyang, China.
Insights
Mycoplasma pneumoniae and respiratory viruses are common causes of childhood community-acquired pneumonia (CAP) in China. Identifying these pathogens could prevent over half of CAP hospitalizations through vaccination.
Area of Science:
- Pediatric Infectious Diseases
- Respiratory Medicine
- Microbiology
Background:
- Childhood community-acquired pneumonia (CAP) is a significant global health concern.
- Limited prospective, multicenter data exists on CAP etiology in hospitalized Chinese children.
- Understanding causative pathogens is crucial for effective prevention and treatment strategies.
Purpose of the Study:
- To identify the primary respiratory pathogens responsible for CAP in hospitalized children across China.
- To determine the prevalence of specific viral and bacterial agents, including Mycoplasma pneumoniae.
- To assess the rate of co-infections in pediatric CAP cases.
Main Methods:
- Prospective, multicenter study conducted from January to December 2015.
- Oropharyngeal swabs and blood serum collected from 1500 children (6 months–14 years) with CAP.
- Immunofluorescence and passive agglutination assays used to detect eight respiratory viruses and Mycoplasma pneumoniae.
Main Results:
- 691 out of 1500 (46.1%) children tested positive for at least one pathogen.
- Mycoplasma pneumoniae was the most frequent pathogen (32.4%), followed by respiratory syncytial virus (11.5%) and adenovirus (5.0%).
- Co-infections were present in 18.5% of positive cases.
Conclusions:
- Mycoplasma pneumoniae and common respiratory viruses are key contributors to pediatric CAP in China.
- Vaccination against RSV, adenovirus, and M. pneumoniae could potentially prevent over half of these CAP hospitalizations.
- Further etiological investigations are needed to optimize pneumonia management in children.
Abstract:
Childhood community-acquired pneumonia (CAP) is a common illness; however, comprehensive studies of hospitalizations for CAP among children in China based on prospective and multicenter data collection are limited. The aim of this investigation was to determine the respiratory pathogens responsible for CAP in hospitalized children. From January to December 2015, oropharyngeal swabs and blood serum were collected from hospitalized children with CAP symptoms ranging in age from 6 months to 14 years at 10 hospitals across China. We used immunofluorescence to detect antibodies for eight respiratory viruses and passive agglutination to detect specific IgM against Mycoplasma pneumoniae (M. pneumoniae). Of 1500 children presenting with CAP, 691 (46.1%) tested positive for at least one pathogen (virus or M. pneumoniae). M. pneumoniae (32.4%) was detected most frequently, followed by respiratory syncytial virus (11.5%), adenovirus (5.0%), influenza A virus (4.1 %), influenza B virus (3.4%), parainfluenza virus types 2 and 3 type (3.1 %), parainfluenza virus type 1 (2.9%), and human metapneumovirus (0.3%). Co-infections were identified in 128 (18.5%) of the 691 cases. These data provide a better understanding of viral etiology and M. pneumoniae in CAP in children between 6 months and 14 years in China. More study of the etiologic investigations that would further aid the management of pneumonia is required. With effective immunization for RSV, ADV, and M. pneumoniae infections, more than one-half of the pneumonia cases in this study could have been prevented.
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