Epidemiology and Etiology of Hospitalized Pneumonia in Children

项目摘要/摘要 儿童肺炎是儿童发病的主要原因，也是幼儿死亡的主要原因。 全球范围内超过5岁的儿童。在美国儿童中，肺炎和流感排在第八位 导致死亡的主要原因。尽管儿童肺炎的负担得到了很好的理解，但最近关于儿童肺炎的数据 儿童肺炎的发病率和病原学均较少。到目前为止，确定肺炎的真正病因 由于1)大量可能导致肺炎的细菌和病毒因素而变得复杂；2) 病毒和细菌混合感染的频率；3)从中国获得的深呼吸道样本有限 儿童；4)当前实验室技术的局限性；5)以前开始的抗生素治疗 微生物学评价。这些局限性导致了对儿童的经验性临床治疗 肺炎。儿科肺炎的最佳治疗取决于对 按年龄和地理区域划分的引起肺炎的病原体的流行病学。 犹他大学，与联合大学和地区大学病理学家合作 实验室和研究企业以及爱达荷州技术公司是唯一适合解决这一问题的公司 有问题。作为疾控中心指导的一项多中心研究的一部分，我们正在进行一项前瞻性研究 识别引起社区获得性肺炎和复杂性肺炎的病毒和细菌病原体 住院儿童的毛细支气管炎。目的了解儿科住院患者的发病率及病因。 为了进一步了解与流感相关的并发症，我们提出以下建议： 具体目标： 具体目标1：确定盐湖县所有被诊断为临床住院的儿童 经诊断和放射学证实的CAP。 具体目标2：确定以人群为基础的发病率、病因和预后 盐湖县流感相关肺炎，包括原发性病毒性肺炎、病毒性肺炎和 细菌混合感染和流感后细菌性肺炎。 具体目标3：记录建立的儿童肺炎的细菌和病毒病原学 以及使用分子分析和高阶多重测试的新出现的病原体。 提高使用分子识别假定细菌感染的病原学的能力 胸腔积液和血液分析。 量化和比较肺炎住院儿童的呼吸道病毒载量。一个。 B.

PROJECT SUMMARY/ABSTRACT Pneumonia in children is a major cause of morbidity and the leading cause of death in children younger than 5 years of age worldwide. Among children in the United States, pneumonia and influenza are the eighth leading causes of death. Although the burden of pneumonia in children is well appreciated, recent data on the incidence and etiology of pneumonia in children are few. Thus far, determining the true etiology of pneumonia is complicated due to 1) the large number of bacterial and viral agents that may cause pneumonia; 2) the frequency of viral and bacterial co-infections; 3) the limited availability of deep respiratory specimens from children; 4) the limitations of current laboratory technology and 5) antibiotic therapy initiated before microbiological evaluation. These limitations result in empirical clinical management of children with pneumonia. The optimum management of pediatric pneumonia is dependent on understanding the epidemiology of the pathogens that cause pneumonia by age and geographic region. The University of Utah, in collaboration with the Associated and Regional University Pathologists Laboratories and Research Enterprise, as well as Idaho Technology, Inc., is uniquely suited to address this problem. As part of a multicenter research study directed by the CDC, we are conducting a prospective study to identify viral and bacterial pathogens which cause community-acquired pneumonia and complicated bronchiolitis in hospitalized children. To determine the incidence and etiology of pediatric hospitalized pneumonia and to further understand the complications associated with influenza, we propose the following Specific Aims: Specific Aim 1: Identify all children in Salt Lake County diagnosed and hospitalized for clinically diagnosed and radiologically-confirmed CAP. Specific Aim 2: Determine the population-based incidence, etiology, and outcomes of pediatric influenza-associated pneumonia in Salt Lake County, including primary viral pneumonia, viral and bacterial co-infection, and post-influenza bacterial pneumonia. Specific Aim 3: Document the bacterial and viral etiology of pediatric pneumonia due to established and emerging pathogens using molecular analysis and high-order multiplex testing. Improve the ability to identify the etiology of presumed bacterial infection using molecular analysis of pleural fluid and blood. Quantify and compare respiratory viral loads in children hospitalized with pneumonia. a. b.