Risk factors for community-acquired pneumonia in children

Abstract

Introduction: In the last years our knowledge on epidemiology of community-acquired pneumonia has revealed: the number of annual community-acquired pneumonia (CAP) cases is difficult to estimate. Pneumonia is an infection that inflames the air sacs in one or both lungs. This disease can range in seriousness from mild to life-threatening. It is most serious for infants and young children, people older than age 65, and people with health problems or weakened immune systems. Methods: Risk factors for community-acquired pneumonia were studied by collecting data and achieving a prospective study of 64 children, age ranged between 1-192 months, hospitalized in the Paediatrics I Clinic of Tirgu Mures County Clinical Emergency Hospital in November or December 2015, January or February 2016. We included newly diagnosed patients with pneumonia and using SPSSsoftware, descriptive statistics were applied to summarize the demographic and clinical data with laboratory indicator levels and medical imaging data.Results: We prospectively investigated 64 patients and found a predominance of male 57.8 % (37). The mean age at diagnosis was 50.03 months with a standard deviation: σ = 58.75, between 1 and 192 months old. The air sacs may fill with fluid or pus (purulent material), causing cough with mucus 53.1 % (34) or pus 15.6 (10 cases), fever for 60.9% (39 patients) with a mean of 38.05oC where the minimum is 37.0oC and the maximum is 40.0oC resulting in a total of 7.8% (5 cases) of convulsions in febrile context. They presented also chills 15.6% (10), tachypnea 32.8% (21), rhinorrhea 68.8% (44) and intercostal retraction 42.4% (27). A variety of organisms, including bacteria, viruses and fungi, can cause pneumonia. The average level of leukocytes (WBC) was 13.75*103/μL with a minimum at 4.6*103/μL and a maximum at 35.0*103/μL and a standard deviation of 6.27, the mean of neutrophil was 7.59*103/μL and for erythrocyte sedimentation rate (ESR) was 27.14 mm/h with a maximum at 108 mm/h. Pneumonia confirmation was performed using auscultatory examination and chest radiograph where we founded characteristic pathological changes. Malnutrition was present in 37.5% (24) of patients and other significant risk factors were a history of recurrent respiratory infections 26.6% (17) such us: bronchopneumonia, bronchiolitis or recurrent wheezing, chronic diseases 23.4% (15): congenital heart disease, asthma or diabetes mellitus. 12.5% (8) have the house heating with the wood fire, 14.1% (9) of children come from a difficult social environment and 12.5% (8) living in a institutional care. Conclusions: In fact, children who suffer from underlying chronic disease (e.g. asthma, recurrent wheezing, congenital heart diseases, neuromuscular diseases and seizure disorders, chronic disorder of the nutritionalstatus) or who living in a difficult social environment are at higher risk for acquiring pneumonia.