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Author Notes:

Reprint requests: Alexander J. Millman, MD, Influenza Division, Centers for Disease Control and Prevention, 1600 Clifton Rd, Mailstop G-37, Atlanta, GA 30329; Email: amillman@cdc.gov

We thank the children and families who graciously consented to participate in the EPIC study.

The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the CDC.

Subjects:

Research Funding:

The Etiology of Pneumonia in the Community (EPIC) study is supported by the Influenza Division in the National Center for Immunizations and Respiratory Diseases at the Centers for Disease Control and Prevention (CDC) through cooperative agreements with each study site and was based on a competitive research funding opportunity (Utah: U18IP000491; Nashville: U18IP000488; and Memphis: U18IP000489).

S.A. is supported by Glaxo Smith Kline. E.A. is supported by MedImmune, Roche, and Abbvie. K.A. is supported by BioFire Diagnostics, Inc (formerly Idaho Technology, Inc) on grants from the National Institutes of Health (Clinical Trial NCT01878383). A.P. is supported by Antimicrobial Therapy Inc, Medscape Inc, and BioFire Diagnostics Inc. K.E. is supported by Vanderbilt University from Novartis.

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Pediatrics
  • IMMUNIZATION PRACTICES ACIP
  • 2009 PANDEMIC INFLUENZA
  • UNITED-STATES
  • OROPHARYNGEAL ASPIRATION
  • ADVISORY-COMMITTEE
  • CEREBRAL-PALSY
  • DISEASE
  • IMPAIRMENT
  • DEATHS
  • RECOMMENDATIONS

Community-Acquired Pneumonia Hospitalization among Children with Neurologic Disorders

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Journal Title:

Journal of Pediatrics

Volume:

Volume 173

Publisher:

, Pages 188-+

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Objective: To describe and compare the clinical characteristics, outcomes, and etiology of pneumonia among children hospitalized with community-acquired pneumonia (CAP) with neurologic disorders, non-neurologic underlying conditions, and no underlying conditions. Study design: Children <18 years old hospitalized with clinical and radiographic CAP were enrolled at 3 US children's hospitals. Neurologic disorders included cerebral palsy, developmental delay, Down syndrome, epilepsy, non-Down syndrome chromosomal abnormalities, and spinal cord abnormalities. We compared the epidemiology, etiology, and clinical outcomes of CAP in children with neurologic disorders with those with non-neurologic underlying conditions, and those with no underlying conditions using bivariate, age-stratified, and multivariate logistic regression analyses. Results: From January 2010-June 2012, 2358 children with radiographically confirmed CAP were enrolled; 280 (11.9%) had a neurologic disorder (52.1% of these individuals also had non-neurologic underlying conditions), 934 (39.6%) had non-neurologic underlying conditions only, and 1144 (48.5%) had no underlying conditions. Children with neurologic disorders were older and more likely to require intensive care unit (ICU) admission than children with non-neurologic underlying conditions and children with no underlying conditions; similar proportions were mechanically ventilated. In age-stratified analysis, children with neurologic disorders were less likely to have a pathogen detected than children with non-neurologic underlying conditions. In multivariate analysis, having a neurologic disorder was associated with ICU admission for children ≥2 years of age. Conclusions: Children with neurologic disorders hospitalized with CAP were less likely to have a pathogen detected and more likely to be admitted to the ICU than children without neurologic disorders.

Copyright information:

© 2016 Elsevier Inc. All rights reserved.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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