Etiology and characteristics and of community-acquired pneumonia among
children requiring bronchoalveolar lavage in North China
Abstract
Objective: To identify the pathogens and compare the clinical
characteristics between different type pathogen infection among children
with community-acquired pneumonia (CAP) requiring bronchoalveolar
lavage. Study design: Children <14 years old hospitalized with
CAP requiring bronchoalveolar lavage were enrolled between February 2019
to January 2020. Multiplex reverse transcription polymerase chain
reaction (mRT-PCR) and loop-mediated isothermal amplification (LAMP)
were used for pathogen detection. The demographic and clinical
characteristics were compared between different type pathogen infection
groups. Results: Among 1166 children studied, ≥1 pathogen was detected
in 1084 (93.0%) children and co-infection was detected in 215 (18.4%)
children. Mycoplasma pneumoniae, Streptococcus pneumoniae and adenovirus
were the most frequently detected pathogens. Children infected with
atypical bacteria alone were older and more likely to display a fever,
cough, decreased breath sounds, consolidation, single lobar
infiltration, mucosal erosion and/or necrosis and plastic bronchitis.
Children with virus-atypical bacteria co-infection were more prone to
manifest fatigue, chest pain, tachypnea, chest indrawing, and mucosal
erosion and/or necrosis. Those infected with virus alone or co-infected
with ≥3 pathogens were liable to display changes in bronchial
morphology. Conclusions: Pathogens were detected in 93.0% of enrolled
children. M. pneumoniae infection might be the greatest pediatric
disease burden due to CAP in North China. Keywords: Children;
community-acquired pneumonia; bronchoalveolar lavage fluid; etiology;
co-infection.