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Virus and Mycoplasma pneumoniae are the main etiological agents of community-acquired pneumonia in hospitalized pediatric patients in Spain
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  • Enrique Otheo,
  • Mario Rodríguez,
  • CINTA MORALEDA,
  • Sara Domínguez-Rodríguez,
  • María Dolores Martín,
  • Maria Luisa Herreros,
  • Carmen Vázquez,
  • María Dolores Folgueira,
  • Alfredo Pérez-Rivilla,
  • Julia Jensen,
  • Agustín López,
  • Arantxa Berzosa,
  • Francisco José Sanz de Santaeufemia,
  • Ana Belén Jiménez,
  • Talia Sainz,
  • Marta Llorente,
  • Mar Santos,
  • Elisa Garrote,
  • Cristina Muñoz,
  • Paula Sánchez,
  • Marta Illán,
  • Ana Coca,
  • Ana Barrios,
  • Mónica Pacheco,
  • Carmen Arquero,
  • Lourdes Gutiérrez,
  • CRISTINA EPALZA,
  • Pablo Rojo,
  • Miquel Serna,
  • Inmaculada Mota,
  • Santiago Moreno,
  • Juan Carlos Galán,
  • ALFREDO TAGARRO
Enrique Otheo
Hospital Universitario Ramón y Cajal

Corresponding Author:[email protected]

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Mario Rodríguez
Hospital Universitario Ramón y Cajal
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CINTA MORALEDA
Hospital Universitario Doce de Octubre
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Sara Domínguez-Rodríguez
Instituto de Investigación Sanitaria Hospital 12 de Octubre (IMAS12)
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María Dolores Martín
Laboratorio BR Salud. Hospital Universitario Infanta Sofía. San Sebastián de los Reyes
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Maria Luisa Herreros
HOSPITAL UNIVERSITARIO INFANTA SOFIA
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Carmen Vázquez
Hospital Universitario Ramón y Cajal
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María Dolores Folgueira
Hospital Universitario 12 de Octubre
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Alfredo Pérez-Rivilla
Hospital Universitario 12 de Octubre
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Julia Jensen
Hospital Infanta Cristina
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Agustín López
Hospital Universitario Puerta de Hierro
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Arantxa Berzosa
Hospital Universitario de Getafe
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Francisco José Sanz de Santaeufemia
Hospital Universitario Niño Jesús
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Ana Belén Jiménez
Fundación Jiménez Díaz
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Talia Sainz
Hospital Universitario La Paz
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Marta Llorente
Hospital Universitario del Sureste
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Mar Santos
Hospital General Universitario Gregorio Maranon
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Elisa Garrote
Hospital Universitario Basurto Servicio de Cardiología
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Cristina Muñoz
Hospital General de Villalba
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Paula Sánchez
Hospital Universitario Virgen del Rocío
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Marta Illán
Hospital Clínico San Carlos
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Ana Coca
Hospital Universitario Ramón y Cajal
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Ana Barrios
Hospital Universitario Infanta Sofía
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Mónica Pacheco
Hospital Universitario Infanta Sofía
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Carmen Arquero
Hospital Universitario Infanta Sofía
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Lourdes Gutiérrez
Instituto de Investigación Sanitaria Hospital 12 de Octubre (IMAS12)
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CRISTINA EPALZA
Hospital Universitario Doce de Octubre
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Pablo Rojo
Hospital Universitario 12 de Octubre
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Miquel Serna
Instituto de Investigación Sanitaria Hospital 12 de Octubre (IMAS12)
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Inmaculada Mota
Hospital Universitario Ramón y Cajal
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Santiago Moreno
Hospital Universitario Ramón y Cajal
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Juan Carlos Galán
Hospital Universitario Ramón y Cajal
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ALFREDO TAGARRO
Hospital Universitario Infanta Sofía
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Abstract

Objetives. To perform a description of the etiology of hospitalized children with community-acquired pneumonia (CAP) in Spain and analyze predictors related to etiology. Hypothesis. The different etiological groups of pediatric CAP are associated to different clinical, radiographic and analytical data. Design. Observational, multi-center, prospective study. Patient selection. Patients from 1 month to 17 years admitted because of CAP from April 2012 to May 2019. Methods. An extensive microbiological workup was done. Clinical, radiographic and analytical parameters were analyzed in order to differentiate viral, atypical bacteria (AB) and typical bacteria (TyB) pneumonia. Results. 495 children were enrolled. At least one likely causative pathogen was identified in 262 (52.9%). Pathogenic viruses in 155/262 (59.2%), AB in 84/262 (32.1%) and TyB in 40/262 (15.3%). Consolidation was found in 89/138 (64.5%) CAP attributed to virus only, in 74/84 (88.1%) of CAP attributed to AB and 40/40 (100%) of CAP attributed to TyB. Para-pneumonic pleural effusion (PPE) was found in 112/495 (22.6%) patients, 61/112 (54.5%) with a likely causative pathogen: virus 12/61 (19.7%), AB 23/61 (37.7%) and TyB 26/61 (42.6%). Viral etiology was significantly more frequent in younger patients and those with lower oxygen saturation, wheezing, no-consolidation and higher lymphocyte counts. Patients with AB were significantly more likely to have more days of fever at admission and a higher rate of use of antibiotics before admission. Conclusions. Viruses and AB are the main cause of pediatric CAP in Spain. Wheezing, younger age and no-consolidation on the X-ray support viral etiology. Viruses and AB can also cause PPE. The use of antibiotic in pediatric CAP can be restricted.
27 Jun 2021Submitted to Pediatric Pulmonology
28 Jun 2021Submission Checks Completed
28 Jun 2021Assigned to Editor
03 Jul 2021Reviewer(s) Assigned
30 Jul 2021Review(s) Completed, Editorial Evaluation Pending
31 Jul 2021Editorial Decision: Revise Major
27 Aug 20211st Revision Received
27 Aug 2021Assigned to Editor
27 Aug 2021Submission Checks Completed
27 Aug 2021Reviewer(s) Assigned
28 Aug 2021Review(s) Completed, Editorial Evaluation Pending
29 Aug 2021Editorial Decision: Revise Minor
22 Sep 20212nd Revision Received
23 Sep 2021Submission Checks Completed
23 Sep 2021Assigned to Editor
23 Sep 2021Reviewer(s) Assigned
07 Oct 2021Review(s) Completed, Editorial Evaluation Pending
09 Oct 2021Editorial Decision: Accept