Del Rosal Teresa, Caminoa María Belén, González-Guerrero Alba, Falces-Romero Iker, Romero-Gómez María Pilar, Baquero-Artigao Fernando, Sainz Talía, Méndez-Echevarría Ana, Escosa-García Luis, Aracil Francisco Javier, Calvo Cristina
Department of Pediatric Infectious Diseases, Hospital Universitario La Paz and IdiPAZ Research Institute, Madrid, Spain.
Department of Pediatrics, Hospital de Torrejón, Madrid, Spain.
Front Pediatr. 2020 Dec 15;8:576519. doi: 10.3389/fped.2020.576519. eCollection 2020.
After the introduction of pneumococcal conjugate vaccines, community-acquired pneumonia (CAP) caused by has decreased whereas and could be increasing. These bacteria have been associated with high rates of complications. (1) To describe the characteristics of pediatric bacterial CAP requiring hospitalization. (2) To compare outcomes according to causative microorganisms. (3) To analyze changes in bacterial CAP rate and etiology over time. Retrospective single-center study of inpatients aged 1 month-16 years with culture-confirmed bacterial CAP in 2010-2018 in Madrid, Spain. We included 64 cases (42 , 13 and 9 ). Culture-confirmed CAP represented 1.48-2.33/1,000 all-cause pediatric hospital admissions, and its rate did not vary over time. However, there was a significant decrease in pneumococcal CAP in the last 3 years of the study (78% of CAP in 2010-2015 vs. 48% in 2016-18, = 0.017). Median hospital stay was 10.5 days (interquartile range 5-19.5), 38 patients (59%) developed complications and 28 (44%) were admitted to the intensive care unit. Outcomes were similar among children with and CAP, whereas was associated with a higher risk for complications (OR 8 [95%CI 1.1-57.2]) and ICU admission (OR 7.1 [95%CI 1.7-29.1]) compared with pneumococcal CAP. In a setting with high PCV coverage, culture-confirmed bacterial CAP did not decrease over time and there was a relative increase of and . Children with CAP caused by were more likely to develop complications.
引入肺炎球菌结合疫苗后，由[未提及的细菌名称]引起的社区获得性肺炎（CAP）有所减少，而[未提及的细菌名称]和[未提及的细菌名称]引起的CAP可能在增加。这些细菌与高并发症发生率相关。（1）描述需要住院治疗的儿童细菌性CAP的特征。（2）根据致病微生物比较治疗结果。（3）分析细菌性CAP发生率和病因随时间的变化。对2010 - 2018年西班牙马德里1个月至16岁确诊为细菌性CAP的住院患者进行回顾性单中心研究。我们纳入了64例病例（42例[未提及的细菌名称]感染、13例[未提及的细菌名称]感染和9例[未提及的细菌名称]感染）。确诊的CAP占所有儿科住院病例的1.48 - 2.33/1000，其发生率随时间无变化。然而，在研究的最后3年中，肺炎球菌性CAP显著下降（2010 - 2015年CAP的78% vs 2016 - 2018年的48%，P = 0.017）。中位住院时间为10.5天（四分位间距5 - 19.5），38例患者（59%）出现并发症，28例（44%）入住重症监护病房。[未提及的细菌名称]和[未提及的细菌名称]感染的儿童CAP的治疗结果相似，而与肺炎球菌性CAP相比，[未提及的细菌名称]感染与更高的并发症风险（OR 8 [95%CI 1.1 - 57.2]）和入住ICU风险（OR 7.1 [95%CI 1.7 - 29.1]）相关。在肺炎球菌结合疫苗高覆盖率的情况下，确诊的细菌性CAP发生率未随时间下降，[未提及的细菌名称]和[未提及的细菌名称]感染相对增加。由[未提及的细菌名称]引起的CAP患儿更易发生并发症。
