Epidemiology and risk factors of pediatric pneumonia in a tertiary center in Taiwan

Background: Pneumonia is a common disease in children, and causes a substantial burden both on patients and health care systems. Comparison between community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP) and the prognosticator of hospitalized pneumonia patients in Taiwan is unclear. Materials and Methods: In this retrospective study, data from hospitalized children aged <18 years with a diagnosis of pneumonia from 2012 to 2013 in our institutional database were investigated. Demographic characteristics, laboratory data, identified pathogens, and treatment course was recorded for analysis. A value of P < 0.05 was considered statistically significant. Results: A total of 548 patients with 598 episodes of pneumonia (male/female ratio = 1.08) were enrolled in the database. Underlying diseases are more common in patients with HAP than those with CAP. Patients with HAP had a higher mortality and length of hospital and intensive care unit (ICU) stay than that of those with CAP. C-reactive protein (CRP) and band form plus segment neutrophil percentage were higher in patients with CAP. In multivariate analysis of CAP group, underlying disease, CRP, and band form plus segment neutrophil percentage were independent prognosticators of admission to ICU. Underlying disease and CRP were independent prognosticators of mortality. The most common pathogens were respiratory syncytial virus, Streptococcus pneumoniae, and influenza virus. Conclusions: Patients with HAP had significantly higher mortality rates and longer lengths of hospital and ICU stay than those with CAP. CRP was an independent prognosticator of admission to ICU and mortality in patients with CAP, and also served as a prognosticator of mortality in patients with HAP.