Community-acquired pneumonia in young children living in various climatogeographic zones of the Republic of Dagestan

Abstract

Introduction. Community-acquired pneumonia (CAP) in early childhood continues to cause significant morbidity and remains one of the most common serious infections in childhood. Each region of the Russian Federation exhibits specific manifestations of CAP morbidity. Knowledge of CAP etiology is crucial for planning therapeutic and preventive measures. Aim. To determine the etiological and immunological features of CAP in early childhood, residing in various climatogeographical zones of the Republic of Dagestan. Materials and methods. The material includes the results of examination and treatment of CAP 204 young children. living in lowland, foothill and mountain climatogeographical zones of the Republic of Dagestan. The selection criterion was the clinical-radiological diagnosis of CAP, using the classification of clinical forms of bronchopulmonary diseases in children. Results. The study revealed a rise in the incidence of respiratory organ diseases, including CAP, among children in the Republic of Dagestan (RD) over the past 5 years. Among infants under one year, the CAP rate was twice as high. The prevalence can be attributed to the climatogeographical conditions of children’s living environments. Streptococcal infection was also observed to predominate in the ethnostructure of CAP in early childhood across all climatogeographical zones. Streptococcus pneumoniae (48.1%) was more frequently isolated in all climatogeographical zones, while Staphylococcus aureus (13.3%) dominated in the mid-mountain zone. In mild pneumonia, cellular immunity components, represented by reduced CD3, CD4, CD25, CD71, react primarily. Disease exacerbation leads to depletion of CD8, CD16, CD20. Severe pneumonia triggers the involvement of humoral immunity, leading to changes in clinical blood analysis — leukocytosis and an increase in mature and immature forms of neutrophils. The levels of IL-1, IL-6, IL-8 in blood serum increase depending on the area of inflammation and the CAP severity. In observed children with focal-draining and segmental CAP, their levels significantly increased. For empirical antibacterial therapy of CAP, recommendations include amoxicillin, protected ampicillins, third-generation cephalosporins, macrolides, and vancomycin in mono- or combination therapy. Conclusion. The conducted research highlights the need for managing ethnological monitoring with antibiotic sensitivity testing of infectious agents causing CAP in children.