Community-acquired pneumonia requiring hospitalization among U.S. children

Seema Jain, Derek J. Williams, Sandra Arnold, Krow Ampofo, Anna M. Bramley, Carrie Reed, Chris Stockmann, Evan J. Anderson, Carlos G. Grijalva, Wesley H. Self, Yuwei Zhu, Anami Patel, Weston Hymas, James D. Chappell, Robert A. Kaufman, J. Herman Kan, David Dansie, Noel Lenny, David R. Hillyard, Lia M. HaynesMin Levine, Stephen Lindstrom, Jonas M. Winchell, Jacqueline M. Katz, Dean Erdman, Eileen Schneider, Lauri A. Hicks, Richard G. Wunderink, Kathryn M. Edwards, Andrew T. Pavia, Jonathan Mccullers, Lyn Finelli

Research output: Contribution to journalArticle

363 Citations (Scopus)

Abstract

Background: Incidence estimates of hospitalizations for community-acquired pneumonia among children in the United States that are based on prospective data collection are limited. Updated estimates of pneumonia that has been confirmed radiographically and with the use of current laboratory diagnostic tests are needed. Methods: We conducted active population-based surveillance for community-acquired pneumonia requiring hospitalization among children younger than 18 years of age in three hospitals in Memphis, Nashville, and Salt Lake City. We excluded children with recent hospitalization or severe immunosuppression. Blood and respiratory specimens were systematically collected for pathogen detection with the use of multiple methods. Chest radiographs were reviewed independently by study radiologists. Results: From January 2010 through June 2012, we enrolled 2638 of 3803 eligible children (69%), 2358 of whom (89%) had radiographic evidence of pneumonia. The median age of the children was 2 years (interquartile range, 1 to 6); 497 of 2358 children (21%) required intensive care, and 3 (<1%) died. Among 2222 children with radiographic evidence of pneumonia and with specimens available for bacterial and viral testing, a viral or bacterial pathogen was detected in 1802 (81%), one or more viruses in 1472 (66%), bacteria in 175 (8%), and both bacterial and viral pathogens in 155 (7%). The annual incidence of pneumonia was 15.7 cases per 10,000 children (95% confidence interval [CI], 14.9 to 16.5), with the highest rate among children younger than 2 years of age (62.2 cases per 10,000 children; 95% CI, 57.6 to 67.1). Respiratory syncytial virus was more common among children younger than 5 years of age than among older children (37% vs. 8%), as were adenovirus (15% vs. 3%) and human metapneumovirus (15% vs. 8%). Mycoplasma pneumoniae was more common among children 5 years of age or older than among younger children (19% vs. 3%). Conclusions: The burden of hospitalization for children with community-acquired pneumonia was highest among the very young, with respiratory viruses the most commonly detected causes of pneumonia.

Original languageEnglish (US)
Pages (from-to)835-845
Number of pages11
JournalNew England Journal of Medicine
Volume372
Issue number9
DOIs
StatePublished - Feb 26 2015

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Pneumonia
Hospitalization
Population Surveillance
Metapneumovirus
Confidence Intervals
Viruses
Mycoplasma pneumoniae
Respiratory Syncytial Viruses
Incidence
Critical Care
Routine Diagnostic Tests
Adenoviridae
Immunosuppression
Thorax
Bacteria

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Jain, S., Williams, D. J., Arnold, S., Ampofo, K., Bramley, A. M., Reed, C., ... Finelli, L. (2015). Community-acquired pneumonia requiring hospitalization among U.S. children. New England Journal of Medicine, 372(9), 835-845. https://doi.org/10.1056/NEJMoa1405870

Community-acquired pneumonia requiring hospitalization among U.S. children. / Jain, Seema; Williams, Derek J.; Arnold, Sandra; Ampofo, Krow; Bramley, Anna M.; Reed, Carrie; Stockmann, Chris; Anderson, Evan J.; Grijalva, Carlos G.; Self, Wesley H.; Zhu, Yuwei; Patel, Anami; Hymas, Weston; Chappell, James D.; Kaufman, Robert A.; Kan, J. Herman; Dansie, David; Lenny, Noel; Hillyard, David R.; Haynes, Lia M.; Levine, Min; Lindstrom, Stephen; Winchell, Jonas M.; Katz, Jacqueline M.; Erdman, Dean; Schneider, Eileen; Hicks, Lauri A.; Wunderink, Richard G.; Edwards, Kathryn M.; Pavia, Andrew T.; Mccullers, Jonathan; Finelli, Lyn.

In: New England Journal of Medicine, Vol. 372, No. 9, 26.02.2015, p. 835-845.

Research output: Contribution to journalArticle

Jain, S, Williams, DJ, Arnold, S, Ampofo, K, Bramley, AM, Reed, C, Stockmann, C, Anderson, EJ, Grijalva, CG, Self, WH, Zhu, Y, Patel, A, Hymas, W, Chappell, JD, Kaufman, RA, Kan, JH, Dansie, D, Lenny, N, Hillyard, DR, Haynes, LM, Levine, M, Lindstrom, S, Winchell, JM, Katz, JM, Erdman, D, Schneider, E, Hicks, LA, Wunderink, RG, Edwards, KM, Pavia, AT, Mccullers, J & Finelli, L 2015, 'Community-acquired pneumonia requiring hospitalization among U.S. children', New England Journal of Medicine, vol. 372, no. 9, pp. 835-845. https://doi.org/10.1056/NEJMoa1405870
Jain, Seema ; Williams, Derek J. ; Arnold, Sandra ; Ampofo, Krow ; Bramley, Anna M. ; Reed, Carrie ; Stockmann, Chris ; Anderson, Evan J. ; Grijalva, Carlos G. ; Self, Wesley H. ; Zhu, Yuwei ; Patel, Anami ; Hymas, Weston ; Chappell, James D. ; Kaufman, Robert A. ; Kan, J. Herman ; Dansie, David ; Lenny, Noel ; Hillyard, David R. ; Haynes, Lia M. ; Levine, Min ; Lindstrom, Stephen ; Winchell, Jonas M. ; Katz, Jacqueline M. ; Erdman, Dean ; Schneider, Eileen ; Hicks, Lauri A. ; Wunderink, Richard G. ; Edwards, Kathryn M. ; Pavia, Andrew T. ; Mccullers, Jonathan ; Finelli, Lyn. / Community-acquired pneumonia requiring hospitalization among U.S. children. In: New England Journal of Medicine. 2015 ; Vol. 372, No. 9. pp. 835-845.
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abstract = "Background: Incidence estimates of hospitalizations for community-acquired pneumonia among children in the United States that are based on prospective data collection are limited. Updated estimates of pneumonia that has been confirmed radiographically and with the use of current laboratory diagnostic tests are needed. Methods: We conducted active population-based surveillance for community-acquired pneumonia requiring hospitalization among children younger than 18 years of age in three hospitals in Memphis, Nashville, and Salt Lake City. We excluded children with recent hospitalization or severe immunosuppression. Blood and respiratory specimens were systematically collected for pathogen detection with the use of multiple methods. Chest radiographs were reviewed independently by study radiologists. Results: From January 2010 through June 2012, we enrolled 2638 of 3803 eligible children (69{\%}), 2358 of whom (89{\%}) had radiographic evidence of pneumonia. The median age of the children was 2 years (interquartile range, 1 to 6); 497 of 2358 children (21{\%}) required intensive care, and 3 (<1{\%}) died. Among 2222 children with radiographic evidence of pneumonia and with specimens available for bacterial and viral testing, a viral or bacterial pathogen was detected in 1802 (81{\%}), one or more viruses in 1472 (66{\%}), bacteria in 175 (8{\%}), and both bacterial and viral pathogens in 155 (7{\%}). The annual incidence of pneumonia was 15.7 cases per 10,000 children (95{\%} confidence interval [CI], 14.9 to 16.5), with the highest rate among children younger than 2 years of age (62.2 cases per 10,000 children; 95{\%} CI, 57.6 to 67.1). Respiratory syncytial virus was more common among children younger than 5 years of age than among older children (37{\%} vs. 8{\%}), as were adenovirus (15{\%} vs. 3{\%}) and human metapneumovirus (15{\%} vs. 8{\%}). Mycoplasma pneumoniae was more common among children 5 years of age or older than among younger children (19{\%} vs. 3{\%}). Conclusions: The burden of hospitalization for children with community-acquired pneumonia was highest among the very young, with respiratory viruses the most commonly detected causes of pneumonia.",
author = "Seema Jain and Williams, {Derek J.} and Sandra Arnold and Krow Ampofo and Bramley, {Anna M.} and Carrie Reed and Chris Stockmann and Anderson, {Evan J.} and Grijalva, {Carlos G.} and Self, {Wesley H.} and Yuwei Zhu and Anami Patel and Weston Hymas and Chappell, {James D.} and Kaufman, {Robert A.} and Kan, {J. Herman} and David Dansie and Noel Lenny and Hillyard, {David R.} and Haynes, {Lia M.} and Min Levine and Stephen Lindstrom and Winchell, {Jonas M.} and Katz, {Jacqueline M.} and Dean Erdman and Eileen Schneider and Hicks, {Lauri A.} and Wunderink, {Richard G.} and Edwards, {Kathryn M.} and Pavia, {Andrew T.} and Jonathan Mccullers and Lyn Finelli",
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T1 - Community-acquired pneumonia requiring hospitalization among U.S. children

AU - Jain, Seema

AU - Williams, Derek J.

AU - Arnold, Sandra

AU - Ampofo, Krow

AU - Bramley, Anna M.

AU - Reed, Carrie

AU - Stockmann, Chris

AU - Anderson, Evan J.

AU - Grijalva, Carlos G.

AU - Self, Wesley H.

AU - Zhu, Yuwei

AU - Patel, Anami

AU - Hymas, Weston

AU - Chappell, James D.

AU - Kaufman, Robert A.

AU - Kan, J. Herman

AU - Dansie, David

AU - Lenny, Noel

AU - Hillyard, David R.

AU - Haynes, Lia M.

AU - Levine, Min

AU - Lindstrom, Stephen

AU - Winchell, Jonas M.

AU - Katz, Jacqueline M.

AU - Erdman, Dean

AU - Schneider, Eileen

AU - Hicks, Lauri A.

AU - Wunderink, Richard G.

AU - Edwards, Kathryn M.

AU - Pavia, Andrew T.

AU - Mccullers, Jonathan

AU - Finelli, Lyn

PY - 2015/2/26

Y1 - 2015/2/26

N2 - Background: Incidence estimates of hospitalizations for community-acquired pneumonia among children in the United States that are based on prospective data collection are limited. Updated estimates of pneumonia that has been confirmed radiographically and with the use of current laboratory diagnostic tests are needed. Methods: We conducted active population-based surveillance for community-acquired pneumonia requiring hospitalization among children younger than 18 years of age in three hospitals in Memphis, Nashville, and Salt Lake City. We excluded children with recent hospitalization or severe immunosuppression. Blood and respiratory specimens were systematically collected for pathogen detection with the use of multiple methods. Chest radiographs were reviewed independently by study radiologists. Results: From January 2010 through June 2012, we enrolled 2638 of 3803 eligible children (69%), 2358 of whom (89%) had radiographic evidence of pneumonia. The median age of the children was 2 years (interquartile range, 1 to 6); 497 of 2358 children (21%) required intensive care, and 3 (<1%) died. Among 2222 children with radiographic evidence of pneumonia and with specimens available for bacterial and viral testing, a viral or bacterial pathogen was detected in 1802 (81%), one or more viruses in 1472 (66%), bacteria in 175 (8%), and both bacterial and viral pathogens in 155 (7%). The annual incidence of pneumonia was 15.7 cases per 10,000 children (95% confidence interval [CI], 14.9 to 16.5), with the highest rate among children younger than 2 years of age (62.2 cases per 10,000 children; 95% CI, 57.6 to 67.1). Respiratory syncytial virus was more common among children younger than 5 years of age than among older children (37% vs. 8%), as were adenovirus (15% vs. 3%) and human metapneumovirus (15% vs. 8%). Mycoplasma pneumoniae was more common among children 5 years of age or older than among younger children (19% vs. 3%). Conclusions: The burden of hospitalization for children with community-acquired pneumonia was highest among the very young, with respiratory viruses the most commonly detected causes of pneumonia.

AB - Background: Incidence estimates of hospitalizations for community-acquired pneumonia among children in the United States that are based on prospective data collection are limited. Updated estimates of pneumonia that has been confirmed radiographically and with the use of current laboratory diagnostic tests are needed. Methods: We conducted active population-based surveillance for community-acquired pneumonia requiring hospitalization among children younger than 18 years of age in three hospitals in Memphis, Nashville, and Salt Lake City. We excluded children with recent hospitalization or severe immunosuppression. Blood and respiratory specimens were systematically collected for pathogen detection with the use of multiple methods. Chest radiographs were reviewed independently by study radiologists. Results: From January 2010 through June 2012, we enrolled 2638 of 3803 eligible children (69%), 2358 of whom (89%) had radiographic evidence of pneumonia. The median age of the children was 2 years (interquartile range, 1 to 6); 497 of 2358 children (21%) required intensive care, and 3 (<1%) died. Among 2222 children with radiographic evidence of pneumonia and with specimens available for bacterial and viral testing, a viral or bacterial pathogen was detected in 1802 (81%), one or more viruses in 1472 (66%), bacteria in 175 (8%), and both bacterial and viral pathogens in 155 (7%). The annual incidence of pneumonia was 15.7 cases per 10,000 children (95% confidence interval [CI], 14.9 to 16.5), with the highest rate among children younger than 2 years of age (62.2 cases per 10,000 children; 95% CI, 57.6 to 67.1). Respiratory syncytial virus was more common among children younger than 5 years of age than among older children (37% vs. 8%), as were adenovirus (15% vs. 3%) and human metapneumovirus (15% vs. 8%). Mycoplasma pneumoniae was more common among children 5 years of age or older than among younger children (19% vs. 3%). Conclusions: The burden of hospitalization for children with community-acquired pneumonia was highest among the very young, with respiratory viruses the most commonly detected causes of pneumonia.

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