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Abstract：
OBJECTIVE: To investigate the etiology of common respiratory pathogens in children < 2 years of age hospitalized with pneumonia in Xiamen from 2014 to 2017.
METHODS: The medical records of 5581 children with pneumonia were retrospectively reviewed. Direct immunofluorescent test was used for respiratory virus testing. Bacteria were detected by conventional culture method. The results of pathogen detection at admission were analyzed as well as the clinical outcomes of children.
RESULTS: The burden of hospitalized children with pneumonia was highest among infants < 6 months old (58.2%). Respiratory syncytial virus (RSV) was the most common respiratory virus (26.0%) followed by parainfluenza (4.8%) and adenovirus (3.2%). Haemophilus influenzae was the most common bacteria detected (16.6%) followed by Moraxella catarrhalis (13.4%), Staphylococcus aureus (13.0%), Streptococcus pneumoniae (12.3%), Escherichia coli (5.1%) and Klebsiella pneumoniae (4.8%). Notably, RSV and K. pneumoniae were detected more frequently in severe pneumonia (35.0% and 10.9%) versus mild pneumonia (25.6% and 4.6%), with higher rates of ICU admissions, longer hospital stays and higher hospital costs compared to those infected with other respiratory pathogens.
CONCLUSIONS: Among children < 2 years of age hospitalized with pneumonia in Xiamen, RSV was the most common respiratory virus, while H. influenzae and S. pneumoniae remained the predominant bacterial pathogens detected. Considering the low implementation rate of vaccines against pneumococcal and Hib pneumonia in China, there is an urgent need to increase both vaccination rates to reduce pneumococcal and Hib disease burden.
METHODS: The medical records of 5581 children with pneumonia were retrospectively reviewed. Direct immunofluorescent test was used for respiratory virus testing. Bacteria were detected by conventional culture method. The results of pathogen detection at admission were analyzed as well as the clinical outcomes of children.
RESULTS: The burden of hospitalized children with pneumonia was highest among infants < 6 months old (58.2%). Respiratory syncytial virus (RSV) was the most common respiratory virus (26.0%) followed by parainfluenza (4.8%) and adenovirus (3.2%). Haemophilus influenzae was the most common bacteria detected (16.6%) followed by Moraxella catarrhalis (13.4%), Staphylococcus aureus (13.0%), Streptococcus pneumoniae (12.3%), Escherichia coli (5.1%) and Klebsiella pneumoniae (4.8%). Notably, RSV and K. pneumoniae were detected more frequently in severe pneumonia (35.0% and 10.9%) versus mild pneumonia (25.6% and 4.6%), with higher rates of ICU admissions, longer hospital stays and higher hospital costs compared to those infected with other respiratory pathogens.
CONCLUSIONS: Among children < 2 years of age hospitalized with pneumonia in Xiamen, RSV was the most common respiratory virus, while H. influenzae and S. pneumoniae remained the predominant bacterial pathogens detected. Considering the low implementation rate of vaccines against pneumococcal and Hib pneumonia in China, there is an urgent need to increase both vaccination rates to reduce pneumococcal and Hib disease burden.
摘要：
目的：了解2014-2017年厦门市<2岁肺炎住院患儿呼吸道常见病原体的病原学特征。
方法：对5581例肺炎患儿的病历进行回顾性分析。直接免疫荧光试验用于呼吸道病毒检测。采用常规培养法检测细菌。分析患儿入院时病原体检测结果及临床转归情况。
结果：住院肺炎患儿的负担在<6个月的婴儿中最高（58.2%）。呼吸道合胞病毒（RSV）是最常见的呼吸道病毒（26.0％），其次是副流感（4.8％）和腺病毒（3.2％）。流感嗜血杆菌是最常见的细菌（16.6%），其次是粘膜炎莫拉菌（13.4%），金黄色葡萄球菌（13.0%），肺炎链球菌(12.3%),大肠埃希菌(5.1%)和肺炎克雷伯菌(4.8%)。值得注意的是,与轻度肺炎(25.6%和4.6%)相比，RSV和肺炎克雷伯菌在重症肺炎(35.0%和10.9%)中的检出频率更高。随着ICU入院率的提高，与感染其他呼吸道病原体的患者相比，住院时间更长，住院费用更高。
结论：厦门2岁以下儿童因肺炎住院，RSV是最常见的呼吸道病毒，而流感嗜血杆菌和肺炎链球菌仍然是检测到的主要细菌病原体。考虑到中国肺炎球菌和Hib肺炎疫苗的实施率低，迫切需要提高两种疫苗接种率,以降低肺炎球菌和Hib疾病负担.
方法：对5581例肺炎患儿的病历进行回顾性分析。直接免疫荧光试验用于呼吸道病毒检测。采用常规培养法检测细菌。分析患儿入院时病原体检测结果及临床转归情况。
结果：住院肺炎患儿的负担在<6个月的婴儿中最高（58.2%）。呼吸道合胞病毒（RSV）是最常见的呼吸道病毒（26.0％），其次是副流感（4.8％）和腺病毒（3.2％）。流感嗜血杆菌是最常见的细菌（16.6%），其次是粘膜炎莫拉菌（13.4%），金黄色葡萄球菌（13.0%），肺炎链球菌(12.3%),大肠埃希菌(5.1%)和肺炎克雷伯菌(4.8%)。值得注意的是,与轻度肺炎(25.6%和4.6%)相比，RSV和肺炎克雷伯菌在重症肺炎(35.0%和10.9%)中的检出频率更高。随着ICU入院率的提高，与感染其他呼吸道病原体的患者相比，住院时间更长，住院费用更高。
结论：厦门2岁以下儿童因肺炎住院，RSV是最常见的呼吸道病毒，而流感嗜血杆菌和肺炎链球菌仍然是检测到的主要细菌病原体。考虑到中国肺炎球菌和Hib肺炎疫苗的实施率低，迫切需要提高两种疫苗接种率,以降低肺炎球菌和Hib疾病负担.
