Prevalence and Viral Etiology of Community-Acquired Pneumonia in Children in Suzhou, China

Author(s): Ting Shi, Linlin Huang, Weiming Li, Jianmei Tian

Introduction: Children with community-acquired pneumonia (CAP) in Soochow University Affiliated Children's Hospital account for 85% of the annual pediatric CAP cases in Suzhou, China. It is essential to explore viral etiology in children with CAP in the local place. In this study, we aimed to expand our understanding of the viral epidemiology in children with CAP in this area by comparing seasonal and clinical characteristics of respiratory viruses from patients at this hospital.

Methods: Clinical and laboratory data were collected for 22,825 children with radiologically-confirmed CAP who were admitted to our hospital from January 2010 to December 2014. On the day of admission, sputum specimens were cultured as per routine practice and tested for the respiratory syncytial virus (RSV), influenza A and B (Inf-A and Inf-B), parainfluenza virus 1 to 3 (PInf1-3), and adenovirus (ADV) by direct fluorescent antibody tests and for human bocavirus (HBoV), Mycoplasma pneumonia (MP) and Chlamydophila pneumonia (CP) by real-time fluorescence quantitative polymerase chain reaction. Bacterial infection was examined by conventional bacteriological identification methods.

Results: Of the 22,825 nasopharyngeal secretion samples, 6,314 (27.66%) had evidence of viral infection. Respiratory viruses caused CAP at a high rate in children under 1 year of age (66.7%). The peak rate of respiratory virus detection occurs in winter. RSV, HBoV, and PInf3 are the most common viral pathogens of CAP in children in the Soochow area. The epidemic season of RSV was winter and autumn, that of HBoV was summer and autumn, and that of Pinf3 was summer.

Conclusion: In the Soochow area, a substantial proportion of childhood CAP is due to viruses. The viral pathogens vary by season and clinical fe