Work

Etiology and Clinical Prediction of Community-Acquired Lower Respiratory Tract Infection in Children

Year: 2024

Type: article

Abstract: Background: Community acquired lower respiratory tract infection (LRTI) is a leading cause for hospitalization in children and important cause for antibiotic prescription.We aimed to describe the aetiology of LRTI in children and analyse factors associated with bacterial or viral infection.Methods: Patients aged < 19 years with a diagnosis of LRTI were identified from the Observational Medical Outcomes Partnership Common Data Model Database of Seoul National University Bundang Hospital from January 2005-July 2019, and their clinical characteristics were obtained from the electronic medical records and retrospectively reviewed.Results: Among 5,924 cases of LRTI, 74.2% were pneumonia and 25.8% were bronchiolitis/ bronchitis.Patients' median age was 1.8 (interquartile range, 3.1) years and 79.9% were < 5 years old.Pathogens were identified in 37.8%; 69.1% were viral and 30.9% were bacterial/ Mycoplasma pneumoniae.Respiratory syncytial virus was most common (70.9%) among viruses and M. pneumoniae (94.6%) was most common among bacteria.Viral LRTI was associated with winter, age < 2 years, rhinorrhoea, dyspnoea, lymphocytosis, thrombocytosis, wheezing, stridor, chest retraction, and infiltration on imaging.Bacteria/M.pneumoniae LRTI was associated with summer, age ≥ 2 years, fever, decreased breathing sounds, leucocytosis, neutrophilia, C-reactive protein elevation, and positive imaging findings (consolidation, opacity, haziness, or pleural effusion).Conclusion: In children with LRTI, various factors associated with viral or bacterial/M.pneumoniae infections were identified, which may serve as guidance for antibiotic prescription.

Source: Journal of Korean Medical Science

DOI: 10.3346/jkms.2025.40.e5