Epidemiology and antimicrobial resistance of community-acquired pneumonia in children

Background: Community-acquired pneumonia (CAP) is a common serious infection in childhood. Bacterial resistance is widespread, with large geographical variations related to behaviors in antibiotics prescription. Identification of etiologic organisms of CAP and their resistance pattern must be done to guide the physicians for proper antimicrobial use. Aim: To identify the causative organisms most frequently isolated from children hospitalized for pneumonia and analyze their susceptibility to the antimicrobial agents most often used in pediatric practice. Materials and Methods: Two hundred and ninety-six immunocompetent children hospitalized in Jeddah Clinic Hospital with CAP from January 2010 to September 2011 were enrolled in the study. Their ages ranged between 6 weeks and 15 years. Chest radiograph, complete blood count test (CBC), C-reactive protein, test and sputum culture and sensitivity were done for all patients. Results: One hundred and nine (35.82%) participants were infants < 1 year, 43.58% were >1 year ≤5 years, and 20.6% were >5 years. A pathogen was identified in 34.12% of sputum cultures, 56.4% were typical respiratory pathogenic bacteria while 43.56% were normal commensals. Sputum cultures grew Streptococcus pneumonia in 8.77% of respiratory pathogens, coagulase positive Staphylococcus (19.3%), Group B β-hemolytic Streptococcus (8.77%), Escherichia coli (33.3%), Klebsiella spp. (14%), and Pseudomonas (14%). High antimicrobial resistance was recorded for penicillin, amoxicillin-clavulanate, cefaclor, cephalexin, and cefuroxime in Gram-positive organisms. Twenty-one percent of E. coli and 50% of Klebsiella spp. were resistant to spectrin. Conclusions: Higher incidence of CAP due to E. coli was recorded. There is increasing antimicrobial resistance to penicillin and second-generation cephalosporin.