Epidemiology and clinical characteristics of pathogens responsible for the hospitalization of children with segmental/lobar pattern pneumonia

Abstract Backgrounds: The occurrence of segmental/lobar pattern pneumonia (S/L-PP) in children has recently increased. The pathogens of the disease may change due to the misuse of antibiotics and the application of vaccines. Therefore, pathogens of S/L-PP in hospitalized children and their association with clinical characteristics may have changed. Objective: To analyze the pathogens of S/L-PP in hospitalized children and their association with clinical characteristics. Methods: The current study analyzed the epidemiological and clinical characteristics of pathogens in children with S/L-PP under 14 years old at a single hospital between 1 st Jan 2014 and 31 st Dec 2018 retrospectively. The pathogens were detected by microbial cultivation, and/or indirect immunofluorescence of the kit (PNEUMOSLIDE IgM), and/or ELISA, and/or realtime PCR in the samples of the patients. Results: A total of 593 children with S/L-PP received treatment at a single hospital during the study period by inclusion criteria. 451 (76.05%) patients were single positive for one pathogen and 83 (14.00%) patients had multiple infections. Mycoplasma pneumoniae ( M.pneumoniae ) (72.34%) was the most frequently identified pathogen, followed by Streptococcus pneumoniae ( S.pneumoniae ) (8.77%). The infection of M.pneumoniae in children with S/L-PP increased with time (p<0.05). The positive rate of M.pneumoniae increased with ages of patients (p<0.05). M.pneumoniae was statistically associated with extrapulmonary manifestations while S.pneumoniae was statistically associated with abnormal white blood cells (WBCs) and C reactive proteins (CRPs) (p<0.05). Conclusion: M.pneumoniae was the most frequently identified pathogen in children with S/L-PP. The positive rate of M.pneumoniae in children with S/L-PP increased with time and the ages of children. M.pneumoniae was associated with extrapulmonary manifestations while S.pneumoniae was associated with abnormal WBCs and CRPs.