PedCAPNETZ – prospective observational study on community acquired pneumonia in children and adolescents

Abstract

BackgroundPediatric community acquired pneumonia (pedCAP) is one of the leading causes for childhood morbidity accounting for up to 20% of pediatric hospital admissions in high income countries. In spite of its high morbidity, updated epidemiological and pathogen data after introduction of preventive vaccination and novel pathogen screening strategies are limited. Moreover, there is a need for validated recommendations on diagnostic and treatment regimens in pedCAP. Through collection of patient data and analysis of pathogen and host factors in a large sample of unselected pedCAP patients in Germany, we aim to address and substantially improve this situation.MethodspedCAPNETZ is an observational, multi-center study on pedCAP. Thus far, nine study centers in hospitals, outpatient clinics and practices have been initiated and more than 400 patients with radiologically confirmed pneumonia have been enrolled, aiming at a total of 1000 study participants. Employing an online data base, information on disease course, treatment as well as demographical and socioeconomical data is recorded. Patients are followed up until day 90 after enrollment; Comprehensive biosample collection and a central pedCAPNETZ biobank allow for in-depth analyses of pathogen and host factors. Standardized workflows to assure sample logistics and data management in more than fifteen future study centers have been established.DiscussionThrough comprehensive epidemiological, clinical and biological analyses, pedCAPNETZ fills an important gap in pediatric and infection research. To secure dissemination of the registry, we will raise clinical and scientific awareness at all levels. We aim at participating in decision making processes for guidelines and prevention strategies. Ultimately, we hope the results of the pedCAPNETZ registry will help to improve care and quality of life in pedCAP patients in the future.

Interobserver agreement in interpretation of chest radiographs for pediatric community acquired pneumonia: Findings of the pedCAPNETZ‐cohort

“…Parainfluenzavirus 16 ( 7) 13 ( 7) 3 ( 6) 5 ( 4) 5 ( 5) 0 (0) Adenovirus 11 (5) 9 ( 5) 2 ( 4) 1 ( 1) 1 ( 1) 0 (0) Enterovirus 10 (4) 6 (3) 4 ( 9) 10 ( 7) 5 ( 5) 5 (17) Influenza-A-virus 7 (3) 7 ( 4) 0 (0) 5 ( 4) 5 ( 5) 0 (0) Haemophilus influenzae 20 ( 9) 2 ( 6) quality of life. 19 However, a concurring diagnosis is a prerequisite for subsequent in-depth analysis in the pedCAPNETZ cohort. Nonspecific clinical symptoms make it difficult to distinguish pneumonia from other respiratory diseases.…”

“…Candida albicans 0 0 0 8 quality of life. 19 However, a concurring diagnosis is a prerequisite for subsequent in-depth analysis in the pedCAPNETZ cohort. Nonspecific clinical symptoms make it difficult to distinguish pneumonia from other respiratory diseases.…”

“…Between December 2014 and July 2017, study data of n = 233 patients with pCAP were collected in private practices, outpatient clinics, and hospitals across Germany as part of the pedCAPNETZ study, an observational, multicenter study on pCAP. 19 All patients or their legal guardians gave informed consent to participate in this study. Inclusion criteria for inclusion into the analysis were the presence of at least one of the following signs or symptoms: cough, tachypnea, fever, or abnormal findings on auscultation plus pCAP radiographically confirmed by a local radiologist at the site of recruitment.…”

“…Furthermore, we analyzed the interobserver agreement of radiographic findings commonly described in childhood pneumonia. Therefore, the two independent radiologists were requested to report diagnostic findings using the clinical pedCAPNETZ-item-catalog (peribronchial thickening, interstitial pattern, infiltrate, atelectasis, and dystelectasis, pleural effusion 19 ) T A B L E 1 Interobserver agreement of pediatric radiologists, prevalence and bias-adjusted kappa (PABAK) with 95% confidence interval and Cohens Kappa (κ) with 95% confidence interval evaluating chest radiographs in children Interobserver agreement in the interpretation of CXR for the diagnosis of pCAP by local pediatric radiologists and two external pediatric radiologists.…”

Efficacy of amoxicillin-clavulanic acid versus ceftriaxone in children hospitalized under 5 years of age with uncomplicated community acquired pneumonia.

“…12 Study participants were children of both genders, aged 2 months to 5 years, having CAP and admitted through OPD and Emergency department in pediatric ward. CAP was labeled as per WHO guidelines 13 as no hospitalization in the last 1 month, presence of consolidations or other infiltrates, on chest x-ray and the presence of minimum one out of the following: I) fever, II) cough, III) respiratory rate > 50 per minute in 2 months to 11 months of age, > 40 above 12 months to 59 months of age, IV) chest in-drawing, V) crepitation or wheeze on auscultation. Uncomplicated CAP was defined as CAP without complications on imaging study i.e.…”