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ORIGINAL ARTICLE
Year : 2020  |  Volume : 7  |  Issue : 3  |  Page : 156-161

Clinico-bacteriological profile and outcome of children with pneumonia under 5 years of age


Department of Pediatrics, Government Medical College, Haldwani, Nainital, Uttarakhand, India

Correspondence Address:
Ritu Rakholia
Department of Pediatrics, Government Medical College, Medical College Campus, Type 4, H5, Haldwani, Nainital, Uttarakhand
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/cjhr.cjhr_20_20

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Context: India has the highest mortality due to pneumonia in the world. Despite advances in management, it still continues to be major cause of under 5 mortality in children with pneumonia. Aims: The aim of this study was to assess the clinico-bacteriological profile and outcome associated with pneumonia in Uttarakhand, India. Settings and Design: This was a prospective hospital-based observational study. Materials and Methods: Two hundred and sixteen children 1 month to 5 years of age, fulfilling the WHO criteria of pneumonia over a period of 18 months, were studied. Clinical profile, blood culture, and outcome were evaluated as per predesigned pro forma. Statistical Analysis: Data were analyzed using the Chi-square test. Results: Most of the patients were infants (65.28%, n = 141) and males (58.8%, n = 127). Cough (98.15%, n = 212), fever (91.67%, n = 198), difficulty in breathing (76.39%, n = 165), and crepitations (97.22%, n = 210) were the most common clinical pictures. Blood culture positivity was 21.3% (n = 46), more in infants (24.8%, n = 35) as compared to 1–5 years of age. Staphylococcus aureus (39.13%, n = 18) was the most common organism, followed by Gram-negative bacilli (26.09%, n = 12). Lack of exclusive breastfeeding (33.3%, n = 72), incomplete immunization (54.2%, n = 117), exposure to smoke (6.02%, n = 13), and malnutrition (26.39%, n = 57) were significantly associated with severe pneumonia (P < 0.05). Bronchopneumonia seen as fluffy infiltrates was seen in 72.2% (n = 156). Bubble Continuous Positive Airway Pressure (CPAP) was provided in 26% (n = 52), ventilation 14% (n = 28), and change of antibiotics was done in 29.5% (n = 59). Mortality was 8.8% (n = 18). Conclusions: This study highlights increasing incidence of S. aureus as a causative organism, especially in infants. We recommend updating antibiotic guidelines and liberal use of CPAP for better outcome. Infancy, lack of exclusive breastfeeding, incomplete immunization, malnutrition, anemia, and exposure to smoke are key domains that should be addressed for decreasing severity of pneumonia and its better outcome.


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