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Observational Study
. 2022 May 1;41(5):381-387.
doi: 10.1097/INF.0000000000003475.

Clinical Characteristics and Etiology of Community-acquired Pneumonia in US Children, 2015-2018

Ki Wook Yun  1   2 , Rebecca Wallihan  3 , Ankita Desai  4 , Sherman Alter  5 , Lilliam Ambroggio  6 , Daniel M Cohen  7 , Ossama El-Assal  8 , Sarah Marzec  9 , Todd A Florin  10 , Meghan Keaton  11 , Samir S Shah  12 , Richard M Ruddy  12 , Samantha Sharpe  13 , Amy L Leber  14 , Kathy Everhart  14 , Asuncion Mejias  1   3 , Octavio Ramilo  1   3 ; Children’s Hospitals Initiative for Research in Pneumonia
Affiliations
Observational Study

Clinical Characteristics and Etiology of Community-acquired Pneumonia in US Children, 2015-2018

Ki Wook Yun et al. Pediatr Infect Dis J. .

Abstract

Background: Pneumonia has a major impact on childhood health and health care costs. This study was designed to obtain contemporary information on the clinical characteristics and etiology of community-acquired pneumonia (CAP) in children from both inpatient and outpatient settings in the USA.

Methods: We conducted a prospective, multicenter, observational study of CAP among previously healthy children 2 months to 18 years of age in 6 children's hospitals in Ohio from 2015 to 2018. For pathogen detection, nasopharyngeal swabs were collected from all subjects. Blood and pleural fluid cultures were available per standard of care.

Results: We enrolled a convenience sample of 441 patients: 380 hospitalized and 61 outpatients. Tachypnea and radiologic findings of consolidation and pleural effusion were more frequent among inpatients than outpatients. A pathogen was detected in 64.6% of patients: viruses in 55.6%, atypical bacteria in 8.8% and pyogenic bacteria in 4.3%. Eighteen (4.1%) patients had both viruses and bacteria detected. Rhinovirus/enterovirus (RV; 18.6%) and respiratory syncytial virus (RSV; 16.8%) were the viruses most frequently detected, and Mycoplasma pneumoniae (8.2%) and Streptococcus pneumoniae (2.3%) were the most common bacteria. Except for S. pneumoniae, which was identified more frequently in inpatients, there were no significant differences between inpatients and outpatients in the proportions of children with specific pathogens detected.

Conclusions: Rhinovirus/enterovirus and RSV among viruses and M. pneumoniae and S. pneumoniae among bacteria were the most common pathogens detected in children with CAP. Tachypnea and chest radiographs with consolidation and/or pleural effusion were associated with hospitalization.

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Conflict of interest statement

A.M. has received research grants from the NIH and Janssen and fees from Janssen and Roche for participation in advisory boards. O.R. has received research grants from Janssen, NIH, and the Bill & Melinda and Gates Foundation; fees from Merck, Sanofi/Medimmune, and Pfizer for participation in advisory boards; and fees from Pfizer for educational lectures. A.L.L. has received research funding and participated in advisory boards for BioFire Diagnostics. The remaining authors have no conflicts of interest to disclose.

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