Epidemiology and Etiology of Hospitalized Pneumonia in Children

项目总结/摘要 儿童肺炎是发病的主要原因，也是年龄较小的儿童死亡的主要原因 全球范围内5岁以上。在美国的儿童中，肺炎和流感排在第八位 主要死因。虽然肺炎在儿童中的负担得到了很好的理解，但最近的数据显示， 儿童肺炎发病率和病因很少。到目前为止，确定肺炎的真正病因 由于1）可能导致肺炎的大量细菌和病毒因子; 2） 病毒和细菌合并感染的频率; 3）来自 儿童; 4）目前实验室技术的局限性和5）以前开始的抗生素治疗 微生物评价这些局限性导致经验性临床管理的儿童与 肺炎小儿肺炎的最佳管理取决于对 按年龄和地理区域划分的肺炎病原体流行病学。 犹他州大学与相关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，非常适合解决这个问题 问题.作为CDC指导的多中心研究的一部分，我们正在进行一项前瞻性研究 确定引起社区获得性肺炎和并发症的病毒和细菌病原体， 住院儿童的细支气管炎。目的：了解儿童住院的发病率和病因， 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：确定盐湖县所有确诊和住院的儿童， 经诊断和放射学证实的CAP。 具体目标2：确定基于人群的儿科疾病的发病率、病因和结局 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 细菌合并感染和流感后细菌性肺炎。 具体目标3：记录小儿肺炎的细菌和病毒病因， 和新出现的病原体使用分子分析和高阶多重检测。 提高利用分子生物学技术鉴定假定细菌感染病原学的能力 分析胸腔积液和血液。 肺炎住院患儿呼吸道病毒载量的定量和比较。a. 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.