Статья

Community-Acquired Pneumonia Requiring Hospitalization among U.S. Children

Seema JainFrom the Centers for Disease Control and Prevention, Atlanta (S.J., A.M.B., C.R., L.M.H., M.L., S.L., J.M.W., J.M.K., D.E., E.S., L.A.H., L.F.); Vanderbilt University School of Medicine (D.J.W., C.G.G., W.H.S., Y.Z., J.D.C., J.H.K., K.M.E.), Monroe Carell Jr. Children's Hospital at Vanderbilt (D.J.W., K.M.E.), and Vanderbilt Vaccine Research Program (D.J.W., K.M.E.), Nashville, and Le Bonheur Children's Hospital (S.R.A., A.P., N.L., J.A.M.), University of Tennessee Health Science Center (S.R.A., A.P., R.A.K., N.L., J.A.M.), and St. Jude Children's Research Hospital (R.A.K., J.A.M.), Memphis - all in Tennessee; University of Utah Health Sciences Center, Salt Lake City (K.A., C.S., W.H., D.D., D.R.H., A.T.P.); and Northwestern University Feinberg School of Medicine, Chicago (E.J.A., R.G.W.)Derek J. WilliamsMonroe Carell Jr. Children's Hospital at Vanderbilt, MemphisSandra R. ArnoldNashville, and Le Bonheur Children's Hospital, MemphisKrow AmpofoUniversity of Utah Health Sciences Center, Salt Lake CityAnna M. BramleyCarrie ReedChris StockmannUniversity of Utah Health Sciences Center, Salt Lake CityEvan J. AndersonNorthwestern University Feinberg School of Medicine, ChicagoCarlos G. GrijalvaVanderbilt University School of Medicine, MemphisWesley H. SelfVanderbilt University School of Medicine, MemphisYuwei ZhuVanderbilt University School of Medicine, MemphisAnami PatelNashville, and Le Bonheur Children's Hospital, MemphisWeston HymasUniversity of Utah Health Sciences Center, Salt Lake CityJames D. ChappellVanderbilt University School of Medicine, MemphisRobert A. KaufmanSt. Jude Children's Research Hospital, MemphisJason KanVanderbilt University School of Medicine, MemphisDavid DansieUniversity of Utah Health Sciences Center, Salt Lake CityNoel LennyNashville, and Le Bonheur Children's Hospital, MemphisDavid R. HillyardUniversity of Utah Health Sciences Center, Salt Lake CityLia M. HaynesMin Z. LevineStephen LindstromJonas M. WinchellJacqueline M. KatzDean D. ErdmanEileen SchneiderLauri A. HicksRichard G. WunderinkNorthwestern University Feinberg School of Medicine, ChicagoKathryn M. EdwardsMonroe Carell Jr. Children's Hospital at Vanderbilt, MemphisAndrew T. PaviaUniversity of Utah Health Sciences Center, Salt Lake CityJonathan A. McCullersNashville, and Le Bonheur Children's Hospital, MemphisLyn Finelli

2015en

ABI

Аннотация

BACKGROUND: Incidence estimates of hospitalizations for community-acquired pneumonia among children in the United States that are based on prospective data collection are limited. Updated estimates of pneumonia that has been confirmed radiographically and with the use of current laboratory diagnostic tests are needed. METHODS: We conducted active population-based surveillance for community-acquired pneumonia requiring hospitalization among children younger than 18 years of age in three hospitals in Memphis, Nashville, and Salt Lake City. We excluded children with recent hospitalization or severe immunosuppression. Blood and respiratory specimens were systematically collected for pathogen detection with the use of multiple methods. Chest radiographs were reviewed independently by study radiologists. RESULTS: From January 2010 through June 2012, we enrolled 2638 of 3803 eligible children (69%), 2358 of whom (89%) had radiographic evidence of pneumonia. The median age of the children was 2 years (interquartile range, 1 to 6); 497 of 2358 children (21%) required intensive care, and 3 (<1%) died. Among 2222 children with radiographic evidence of pneumonia and with specimens available for bacterial and viral testing, a viral or bacterial pathogen was detected in 1802 (81%), one or more viruses in 1472 (66%), bacteria in 175 (8%), and both bacterial and viral pathogens in 155 (7%). The annual incidence of pneumonia was 15.7 cases per 10,000 children (95% confidence interval [CI], 14.9 to 16.5), with the highest rate among children younger than 2 years of age (62.2 cases per 10,000 children; 95% CI, 57.6 to 67.1). Respiratory syncytial virus was more common among children younger than 5 years of age than among older children (37% vs. 8%), as were adenovirus (15% vs. 3%) and human metapneumovirus (15% vs. 8%). Mycoplasma pneumoniae was more common among children 5 years of age or older than among younger children (19% vs. 3%). CONCLUSIONS: The burden of hospitalization for children with community-acquired pneumonia was highest among the very young, with respiratory viruses the most commonly detected causes of pneumonia. (Funded by the Influenza Division of the National Center for Immunization and Respiratory Diseases.).

Перевод пока недоступен

Идентификаторы

DOI: 10.1056/nejmoa1405870

Цитирования и источники

Цитирований: 4Использованных источников: 0

Показатели — AkademScholar