TY - JOUR
T1 - Risk factors of progressive community-acquired pneumonia in hospitalized children
T2 - A prospective study
AU - on behalf of the Taiwan Pediatric Infectious Disease Alliance
AU - Huang, Ching Ying
AU - Chang, Lung
AU - Liu, Ching Chuan
AU - Huang, Yhu Chering
AU - Chang, Luan Yin
AU - Huang, Yi Chuan
AU - Chiu, Nan Chang
AU - Lin, Hsiao Chuan
AU - Ho, Yu Huai
AU - Chi, Hsin
AU - Huang, Li Min
N1 - Funding Information:
This work was supported by the Taiwan National Health Research Institutes . The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The authors wish to thank the Taiwan Pediatric Infectious Disease Alliance (TPIDA) for assistance in case enrollment. The individual authors and affiliations within the TPIDA are the following:
Publisher Copyright:
© 2013 .
PY - 2015/2/1
Y1 - 2015/2/1
N2 - Background: Complications regarding pneumonia occur in children during hospitalization and treatment. The objective of this study is to identify the risk factors of progressive pneumonia in order to institute early appropriate therapy. Methods: This was a prospective study which involved the pediatric departments of seven medical centers in Taiwan. Children aged from 6 weeks to 18 years old, hospitalized with community-acquired pneumonia (CAP) from January 2010 to August 2011, were enrolled. Progressive pneumonia was defined by the deterioration of discharge diagnosis as compared to admission. Demographic, clinical, and laboratory variables, diagnosis, antimicrobial therapy, and pathogens were compared. Results: Four hundred and two children were included and 57 (14.2%) had progressive pneumonia. Independent associated factors identified for the development of progressive disease, by multivariate logistic regression analysis, included the following, age<2 years, pleural effusion as admission diagnosis, Hb<10g/dL, WBC count > 17,500/μL, tachypnea, and duration to defervescence > 3 days. Streptococcus pneumoniae was the main etiology for progressive pneumonia (57.9%). There was no difference in choice of initial parenteral antibiotics between groups of progressive and non-progressive pneumococcal pneumonia. Conclusion: We found six clinical factors for predicting progressive pneumonia. Further evaluation should be performed in hospitalized pneumonic children with persistent fever not responding to therapy within 72 hours. The initial parenteral antibiotics were not related to the progression of pneumococcal pneumonia.
AB - Background: Complications regarding pneumonia occur in children during hospitalization and treatment. The objective of this study is to identify the risk factors of progressive pneumonia in order to institute early appropriate therapy. Methods: This was a prospective study which involved the pediatric departments of seven medical centers in Taiwan. Children aged from 6 weeks to 18 years old, hospitalized with community-acquired pneumonia (CAP) from January 2010 to August 2011, were enrolled. Progressive pneumonia was defined by the deterioration of discharge diagnosis as compared to admission. Demographic, clinical, and laboratory variables, diagnosis, antimicrobial therapy, and pathogens were compared. Results: Four hundred and two children were included and 57 (14.2%) had progressive pneumonia. Independent associated factors identified for the development of progressive disease, by multivariate logistic regression analysis, included the following, age<2 years, pleural effusion as admission diagnosis, Hb<10g/dL, WBC count > 17,500/μL, tachypnea, and duration to defervescence > 3 days. Streptococcus pneumoniae was the main etiology for progressive pneumonia (57.9%). There was no difference in choice of initial parenteral antibiotics between groups of progressive and non-progressive pneumococcal pneumonia. Conclusion: We found six clinical factors for predicting progressive pneumonia. Further evaluation should be performed in hospitalized pneumonic children with persistent fever not responding to therapy within 72 hours. The initial parenteral antibiotics were not related to the progression of pneumococcal pneumonia.
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U2 - 10.1016/j.jmii.2013.06.009
DO - 10.1016/j.jmii.2013.06.009
M3 - Article
C2 - 23993455
AN - SCOPUS:84921345379
VL - 48
SP - 36
EP - 42
JO - Journal of Microbiology, Immunology and Infection
JF - Journal of Microbiology, Immunology and Infection
SN - 1684-1182
IS - 1
ER -