Bacterial pathogens associated with community-acquired pneumonia in children aged from 28 days to 10 years admitted in Dakahlia Governorate hospitals: a cross-sectional study

Abstract

Background Community-acquired pneumonia (CAP) constitutes a significant public health burden, accounting for a substantial proportion of childhood hospital admissions. However, accurately diagnosing the specific bacterial etiology of CAP solely based on clinical presentation remains a substantial challenge. This study aimed to elucidate the spectrum and prevalence of bacterial pathogens responsible for CAP in a well-defined pediatric population. Methods A cross-sectional design was employed to investigate a cohort of 100 children diagnosed with CAP and admitted to hospitals across Dakahlia Governorate between January and August 2021. The inclusion criteria stipulated that participants be between 28 days and 10 years of age. Children younger than 28 days, exceeding 10 years of age, or with pre-existing chronic lung disease, immunodeficiency, documented hospital-acquired pneumonia, or other congenital anomalies were excluded from the study. All participants underwent comprehensive laboratory investigations, including C-reactive protein (CRP) measurement, blood culture, and either gastric lavage culture or sputum culture, as deemed clinically appropriate. Chest X-rays (CXR) were also performed for each participant. Results Analysis of blood culture isolates revealed Klebsiella pneumoniae (7%) as the most prevalent pathogen, followed by Staphylococcus aureus (5%) and Streptococcus pneumoniae (3%). Notably, Gram-negative bacteria exhibited a higher detection rate (52.7%) compared to Gram-positive bacteria (47.05%) within blood cultures. Klebsiella pneumoniae (13%) maintained its dominance in gastric lavage/sputum cultures, followed by Staphylococcus aureus (16%) and Streptococcus pneumoniae (3%). A significant proportion of patients (64%) exhibited no bacterial growth in these cultures. Conclusion This investigation identified Klebsiella pneumoniae and Staphylococcus aureus as the predominant bacterial pathogens associated with CAP in the study population. These findings contribute valuable preliminary data regarding the spectrum and frequency of bacterial etiologic agents in CAP among Egyptian children under 10 years of age. Future research endeavors with larger sample sizes and potentially incorporating molecular diagnostic techniques could provide more comprehensive insights into the evolving epidemiology of childhood CAP. Trial registration Our study was registered retrospectively with Clinicaltrials.gov under the identifier NCT06377163 on 19 April 2024.