The changes of prevalence and etiology of pediatric pneumonia from National Emergency Department Information System in Korea, between 2007 and 2014

Abstract

PurposeUnderstanding changes in pathogen and pneumonia prevalence among pediatric pneumonia patients is important for the prevention of infectious diseases.MethodsWe retrospectively analyzed data of children younger than 18 years diagnosed with pneumonia at 117 Emergency Departments in Korea between 2007 and 2014.ResultsOver the study period, 329,380 pediatric cases of pneumonia were identified. The most frequent age group was 1–3 years old (48.6%) and the next was less than 12 months of age (17.4%). Based on International Classification of Diseases, 10th revision diagnostic codes, confirmed cases of viral pneumonia comprised 8.4% of all cases, pneumonia due to Mycoplasma pneumoniae comprised 3.8% and confirmed cases of bacterial pneumonia 1.3%. The prevalence of confirmed bacterial pneumonia decreased from 3.07% in 2007 and 4.01% in 2008 to 0.65% in 2014. The yearly rate of pneumococcal pneumonia also decreased from 0.47% in 2007 to 0.08% in 2014. A periodic prevalence of M. pneumoniae pneumonia (MP) was identified.ConclusionThe increased number of patients with pneumonia, bacterial pneumonia, pleural effusion, and empyema in 2011 and 2013–2014 resulted from an MP epidemic. We provide evidence that the frequency of confirmed cases of bacterial pneumonia and pneumococcal pneumonia has declined from 2007 to 2014, which can simultaneously reflect the effectiveness of the pneumococcal conjugate vaccine.

The Etiology of Community-Acquired Pneumonia Correlates with Serum Inflammatory Markers in Children

“…A comprehension of these dependencies may ameliorate the use of antimicrobials and the clinical approach in everyday practice. Viral/possibly viral etiology was found in 17.9% of cases in our study; these results are in line with a Taiwanese study, in which viral pneumonia accounted for 17.4% of pneumonia cases [ 11 ], while other researchers have report varied data, ranging from 8.4% in a Korean study to 70.4% in data from Ecuador [ 12 , 14 ]. Nevertheless, some generalizations may be made.…”

“…Prior to the introduction of conjugate vaccines, typical bacteria, i.e., Streptococcus pneumoniae ( S. pneumoniae ) and Hemophilus influenzae type B, were the most common causes of pneumonia [ 8 ], yet pediatric vaccination programs managed to decrease its frequency, and more cases of viral pneumonia are now diagnosed; a recent development in diagnostic techniques has also played an important role [ 10 ]. Viral etiology is most commonly related with respiratory syncytial virus (RSV), influenza, and adenovirus [ 11 , 12 , 13 , 14 , 15 , 16 ], and strongly relies on virus detection in upper respiratory tract samples; thus, the risk of a false-positive result related to colonization instead of an infection may be encountered [ 10 ]. On the other hand, blood cultures pose the risk of a false-negative outcome, since a positive result is seen only in 2.5–15% of samples [ 17 , 18 , 19 , 20 ].…”

“…Children with CAP often require antimicrobial treatment, which is inherently associated with side effects and the development of antimicrobial resistance; a targeted therapy should be sought after to minimize these adverse outcomes [ 22 ]. Difficulties with the confirmation of the etiology are met in 15.8–67.3% of cases of clinically confirmed pneumonia [ 11 , 12 , 14 , 15 , 16 ], thus making empirical therapy an everyday clinical practice; the extensive comprehension of local epidemiologic conditions is crucial for appropriate therapy implementation. Serum inflammatory markers, including C-reactive protein (CRP) and procalcitonin (PCT), may provide substantial data for antimicrobial guidance, although evidence in this area of pediatrics is rather scarce, and broader studies are needed [ 23 , 24 , 25 ].…”

Bronchiolitis Associated with Mycoplasma pneumoniae Infection in Infants in Foshan China: An Epidemiologic Study

“…This suggests the importance of MP as a pathogen causing bronchiolitis. MP was reported as an important pathogen in children with community-acquired pneumonia [ 13 , 14 ]. Two studies from Guangzhou and Suzhou in southern China reported that the rate of MP infection was 11.3% and 36.08%, respectively [ 14 , 15 ], and another study in 5 cities of southern and northern China reported that the rate of MP infection was 25.5% [ 16 ].…”

Update on the Epidemiology of Macrolide-Resistant Mycoplasma pneumoniae in Europe: A Systematic Review

“…Mycoplasma pneumoniae (MP) is a common cause of upper and lower respiratory tract disease in both children and adults. In the post-pneumococcal conjugate vaccine (PCV) 13 era, MP has become the leading cause of pediatric community-acquired pneumonia (CAP) in countries where PCV13 is included in the national immunization program [ 1 , 2 ]. Clinical symptoms are usually mild, although occasionally MP infection can be life-threatening as it can cause extra-respiratory manifestations, mainly skin lesions, hematologic disorders, and cardiovascular and nervous disease [ 3 , 4 , 5 ].…”