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. 2020 Feb 12;20(1):132.
doi: 10.1186/s12879-020-4810-9.

Annual and seasonal patterns in etiologies of pediatric community-acquired pneumonia due to respiratory viruses and Mycoplasma pneumoniae requiring hospitalization in South Korea

Eun Lee  1 , Chul-Hong Kim  2 , Yong Ju Lee  3 , Hyo-Bin Kim  4 , Bong-Seong Kim  5 , Hyung Young Kim  6 , Yunsun Kim  7 , Sangyoung Kim  7 , Chorong Park  7 , Ju-Hee Seo  8 , In Suk Sol  9 , Myongsoon Sung  10 , Min Seob Song  11 , Dae Jin Song  12 , Young Min Ahn  13 , Hea Lin Oh  14 , Jinho Yu  15 , Sungsu Jung  6 , Kyung Suk Lee  16 , Ju Suk Lee  2 , Gwang Cheon Jang  17 , Yoon-Young Jang  18 , Eun Hee Chung  19 , Hai Lee Chung  18 , Sung-Min Choi  20 , Yun Jung Choi  21 , Man Yong Han  22 , Jung Yeon Shim  23 , Jin Tack Kim  24 , Chang-Keun Kim  25 , Hyeon-Jong Yang  26   27 ; Pneumonia and Respiratory Disease Study Group of Korean Academy of Pediatric Allergy and Respiratory Disease
Affiliations

Annual and seasonal patterns in etiologies of pediatric community-acquired pneumonia due to respiratory viruses and Mycoplasma pneumoniae requiring hospitalization in South Korea

Eun Lee et al. BMC Infect Dis. .

Abstract

Background: Community-acquired pneumonia (CAP) is one of the leading worldwide causes of childhood morbidity and mortality. Its disease burden varies by age and etiology and is time dependent. We aimed to investigate the annual and seasonal patterns in etiologies of pediatric CAP requiring hospitalization.

Methods: We conducted a retrospective study in 30,994 children (aged 0-18 years) with CAP between 2010 and 2015 at 23 nationwide hospitals in South Korea. Mycoplasma pneumoniae (MP) pneumonia was clinically classified as macrolide-sensitive MP, macrolide-less effective MP (MLEP), and macrolide-refractory MP (MRMP) based on fever duration after initiation of macrolide treatment, regardless of the results of in vitro macrolide sensitivity tests.

Results: MP and respiratory syncytial virus (RSV) were the two most commonly identified pathogens of CAP. With the two epidemics of MP pneumonia (2011 and 2015), the rates of clinical MLEP and MRMP pneumonia showed increasing trends of 36.4% of the total MP pneumonia. In children < 2 years of age, RSV (34.0%) was the most common cause of CAP, followed by MP (9.4%); however, MP was the most common cause of CAP in children aged 2-18 years of age (45.3%). Systemic corticosteroid was most commonly administered for MP pneumonia. The rate of hospitalization in intensive care units was the highest for RSV pneumonia, and ventilator care was most commonly needed in cases of adenovirus pneumonia.

Conclusions: The present study provides fundamental data to establish public health policies to decrease the disease burden due to CAP and improve pediatric health.

Keywords: Children; Macrolide less-effective; Macrolide- refractory; Macrolide-sensitive; Mycoplasma pneumoniae; Pneumonia; Respiratory virus.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Number of children hospitalized with community-acquired pneumonia according to etiology between 2011 and 2015 in Korea
Fig. 2
Fig. 2
Number of children hospitalized with community acquired pneumonia according to etiology
Fig. 3
Fig. 3
Time-dependent changes in the numbers of children hospitalized due to Mycoplasma pneumoniae (MP) pneumonia according to clinical macrolide sensitivity. a Number of children hospitalized with MP pneumonia classified as macrolide-sensitive (MSMP), macrolide-refractory (MRMP), and macrolide less-effective (MLEP). b Time-dependent changes in the ratios of MSMP/total MP pneumonia, MRMP pneumonia/total MP pneumonia, and MLEP pneumonia/total MP pneumonia during the study period
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