BACKGROUND Pediatric complicated community-acquired pneumonia(CCAP)is on the rise.The three subtypes include para-pneumonic effusion(PPE),necrotizing pneumonia(NP),and empyema.AIM To study different sub-types of pedia...BACKGROUND Pediatric complicated community-acquired pneumonia(CCAP)is on the rise.The three subtypes include para-pneumonic effusion(PPE),necrotizing pneumonia(NP),and empyema.AIM To study different sub-types of pediatric CCAP,and compare their etiology,clinical profile,and outcome in the post-pneumococcal vaccination era.METHODS This prospective observational study was conducted over a 2-year period.All details(demographics,clinical,management,and outcomes)were recorded.Continuous data were presented either as mean and SD,or as median and interquartile range.Categorical data were presented as frequencies and percentages(%).Data were analyzed by using the IBM SPSS Statistics for Windows,version 21(IBM Corp.,Armonk,NY,United States).RESULTS Of the 80 cases included(71%aged 4-8 years),the distribution was as follows:PPE(42%),empyema(39%),and NP(19%).Bacterial etiology was identified in 28%(empyema 63%,P=0.012).Staphylococcus aureus(45%)was most common followed by Escherichia coli(E.coli)(22.7%),and Streptococcus pneumoniae(13.6%).Patients with empyema,compared to PPE and NP,were less likely to receive prior antibiotics(32%vs 56%and 58%,respectively,P=0.03).Duration(days,mean±SD)of hospitalization was longer in children with NP compared to empyema and PPE(17.7±9.8,16.1±7.5,and 13.6±4.2,respectively).All children recovered with the medical management except 2 children requiring decortication.CONCLUSION Staphylococcus aureus and E.coli are the most common bacterial etiology in the post-pneumococcal vaccination era.Empyema might be related to a delay in antibiotics administration.NP is the most severe pediatric CCAP with prolonged hospitalization.展开更多
文摘BACKGROUND Pediatric complicated community-acquired pneumonia(CCAP)is on the rise.The three subtypes include para-pneumonic effusion(PPE),necrotizing pneumonia(NP),and empyema.AIM To study different sub-types of pediatric CCAP,and compare their etiology,clinical profile,and outcome in the post-pneumococcal vaccination era.METHODS This prospective observational study was conducted over a 2-year period.All details(demographics,clinical,management,and outcomes)were recorded.Continuous data were presented either as mean and SD,or as median and interquartile range.Categorical data were presented as frequencies and percentages(%).Data were analyzed by using the IBM SPSS Statistics for Windows,version 21(IBM Corp.,Armonk,NY,United States).RESULTS Of the 80 cases included(71%aged 4-8 years),the distribution was as follows:PPE(42%),empyema(39%),and NP(19%).Bacterial etiology was identified in 28%(empyema 63%,P=0.012).Staphylococcus aureus(45%)was most common followed by Escherichia coli(E.coli)(22.7%),and Streptococcus pneumoniae(13.6%).Patients with empyema,compared to PPE and NP,were less likely to receive prior antibiotics(32%vs 56%and 58%,respectively,P=0.03).Duration(days,mean±SD)of hospitalization was longer in children with NP compared to empyema and PPE(17.7±9.8,16.1±7.5,and 13.6±4.2,respectively).All children recovered with the medical management except 2 children requiring decortication.CONCLUSION Staphylococcus aureus and E.coli are the most common bacterial etiology in the post-pneumococcal vaccination era.Empyema might be related to a delay in antibiotics administration.NP is the most severe pediatric CCAP with prolonged hospitalization.
