Related Experiment Video
Updated: Aug 3, 2025
Following in Real Time the Impact of Pneumococcal Virulence Factors in an Acute Mouse Pneumonia Model Using Bioluminescent Bacteria
Published on: February 23, 2014
Epidemiology and mortality predictors for severe childhood community-acquired pneumonia in ICUs: A retrospective
Lu Cao1, Zhaohua Ji2, Peng Zhang1
1Department of Pharmacy, Shaanxi Provincial People's Hospital, Xi'an, China.
Insights
Severe community-acquired pneumonia (CAP) in children under 5 is a major cause of death. Key mortality predictors include severe illness, low birth weight, comorbidities, and mechanical ventilation, while probiotics may reduce infant mortality.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Background:
- Severe community-acquired pneumonia (CAP) remains a significant cause of mortality in children globally.
- Understanding the epidemiology and risk factors for severe CAP is crucial for developing effective interventions.
Purpose of the Study:
- To identify epidemiological factors and mortality predictors of severe childhood CAP.
- To evaluate the real-world influence of medications on clinical outcomes in severe CAP.
Main Methods:
- A multicenter retrospective observational study was conducted on children aged ≤5 years with severe CAP.
- Multivariate logistic regression analysis was used to determine independent risk factors for in-hospital death.
Main Results:
- Of 945 children, 9.3% died. Independent risk factors for death included very severe pneumonia, low birth weight, severe underweight, mechanical ventilation, multiple comorbidities (anemia, gastrointestinal hemorrhage), and sedative-hypnotic use.
- Adherence to antimicrobial guidelines was low in young children, with no improved efficacy for higher-grade empirical regimens.
Conclusions:
- Severe CAP is a critical pediatric health issue with identifiable mortality predictors.
- Targeted interventions focusing on identified risk factors and appropriate medication use are essential to reduce mortality.
Background:
To identify the epidemiology and mortality predictors of severe childhood community-acquired pneumonia (CAP) and evaluate the influence of medications on clinical outcomes in the real world.
Methods:
We conducted a multicenter retrospective observational study among children aged ≤5 years with severe CAP, separately comparing the detailed information between those who experienced in-hospital death and those who survived in three different age groups. A multivariate logistic regression model was used to determine mortality predictors.
Results:
A total of 945 children were recruited: 341 young children aged 2-59 months, 47 infants aged 29 days to 2 months, and 557 neonates aged less than 28 days. A total of 88 deaths occurred (9.3%). There was low adherence to antimicrobial guidelines in the group aged 2-59 months, and carbapenems widely served as initial empirical regimens. However, analysis of all three age groups showed that the efficacy of antibacterial drugs with initial empirical selection grades higher than those recommended by the guidelines was not better than that of antibacterial drugs with grades recommended by the guidelines. In multivariate analyses, very severe pneumonia (odds ratio (OR): 3.48; 95% confidence interval (CI): 1.36-8.93), lower birth weight (OR: 4.64; 95% CI: 1.78-12.20), severe underweight (OR: 6.06; 95% CI: 2.34-15.63), mechanical ventilation (OR: 2.58; 95% CI: 1.00-6.62; OR: 15.63; 95% CI 3.25-76.92), a higher number of comorbidities (OR: 8.40; 95% CI: 1.89-37.04), comorbidities including anemia (OR: 5.24; 95% CI: 2.33-11.76) and gastrointestinal hemorrhage (OR: 3.79; 95% CI: 1.36-10.53), and the use of sedative-hypnotics (OR: 2.60; 95% CI: 1.14-5.95) were independent risk factors for death; infants treated with probiotics had a lower mortality rate (OR: 0.14; 95% CI: 0.06-0.33).
Conclusions:
Severe CAP remains a primary cause of death in children under 5 years of age. Clinical characteristics, comorbidities and medications are evidently associated with death. Importantly, we should pay particular attention to the identification of mortality predictors and establish prophylactic measures to reduce mortality.
More Related Videos
09:17A Robust Pneumonia Model in Immunocompetent Rodents to Evaluate Antibacterial Efficacy against S. pneumoniae, H. influenzae, K. pneumoniae, P. aeruginosa or A. baumannii
Published on: January 2, 2017
07:27Methods for Detecting Cytotoxic Amyloids Following Infection of Pulmonary Endothelial Cells by Pseudomonas aeruginosa
Published on: July 12, 2018
Related Concept Videos
01:30Pneumonia I: Introduction
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
01:30Pneumonia III: Complications and Assessment
01:30Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
01:28Pneumonia IV: Management
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
01:29Pneumonia II: Pathophysiology
01:21Acute Respiratory Failure-II
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include: