Features of community-acquired pneumonia in children depending on vaccination
AbstractDespite the successes achieved in the diagnosis and treatment of community-acquired pneumonia in the Republic of Kazakhstan, as well as throughout the world, the incidence, number of complications and mortality from community-acquired pneumonia are increasing.
The aim of the study was to assess the clinical and bacteriological features of community-acquired pneumonia and the severity of its course in vaccinated children.
Material and methods. On the basis of the Regional Children’s Clinical Hospital, Karaganda, 132 children aged 2 months to 3 years with community-acquired pneumonia were examined, who were divided into 2 groups: children vaccinated with pneumococcal vaccine and children with impaired immunization regimen. To establish the etiology of community-acquired pneumonia, sputum analysis for microflora was carried out in all children.
Results. The results indicate that in severe community-acquired pneumonia, febrile hyperthermia was observed in 100% of children with impaired immunization – in 90% (p=0.001). Subfebrile temperature in 54.5% with impaired immunization with mild community-acquired pneumonia. The study of the etiological structure of community-acquired pneumonia revealed the predominance of gram-positive flora in group 2 children with a violation of the immunization regimen of 62.5% (p<0.05). The analysis confirms the significant role of S. pneumoniae in the etiology of community-acquired pneumonia in children, the proportion of which was 37.5% in children of the second group, compared with 7.14% among vaccinated children of the first group (p<0.05).
Conclusion. In the groups of children who received a full course of vaccination against pneumococcal infection and children with a violation of the immunization scheme, the course of community-acquired pneumonia differed in the nature of the onset of the disease, the severity of respiratory failure, fever and shortness of breath. In the second group of patients, higher levels of ESR, leukocytes and CRP were noted. The study of the etiological structure of community-acquired pneumonia, taking into account age groups, allowed us to establish that in children from 2 months to 3 years, S. pneumoniae and S. aureus occupied the leading place. Among older children (from 1 to 3 years), the most significant etiological agents of community-acquired pneumonia were S. pneumococcus, S. aureus, M. pneumonia.
Keywords:community-acquired pneumonia; children; vaccination; pathogenic strains
Funding. The study had no sponsor support.
Conflict of interest. The authors declare no conflict of interest.
Contribution. Concept and design – Kizatova S.T., Akhayeva A.S.; material collection and processing – Zhanpeissova A.A., Sarmankulova G.A.; statistical data processing – Tlegenova K.S. Kysabekova A.B.; text writing – Zeynebekova A.B.; editing, approval of the final version of the article – Dyussenova S.B.; responsibility for the integrity of all parts of the article – Kiryanova T.A.
For citation: Zeynebekova A.B., Dyussenova S.B., Kizatova S.T., Sarmankulova G.A., Kiryanova T.A., Tlegenova K.S., Zhanpeissova A.A., Akhayeva А.S., Kysabekova А.B. Features of community-acquired pneumonia in children depending on vaccination. Infektsionnye bolezni: novosti, mneniya, obuchenie [Infectious Diseases: News, Opinions, Training]. 2023; 12 (2): 69–74. DOI: https://doi.org/10.33029/2305-3496-2023-12-2-69-74 (in Russian)
REFERENCES
1. Fatullaeva G.A., Bogdanova Т.М. Pneumonia is an urgent problem of medicine. Mezhdunarodniy studencheskiy nauchniy vestnik [International Student Scientific Bulletin]. 2018; (5). URL: https://eduherald.ru/ru/article/view?id=19158 (date of access April 14, 2023). (in Russian)
2. Shirinova M., Kulbalieva Zh.Zh., Doltayeva B.Z. Assessment of the incidence of pneumonia in children under 5 years of age in the Republic of Kazakhstan. Zdravookhranenie i meditsina [Healthcare and Medicine]. 2017; Jan 16. (in Russian)
3. Bokonbaeva S.Dj., Alieva J.K., Etiological structure’s and clinics’ features of community acquired pneumonia in young children from large families. Sovremennye problemy nauki i obrazovaniya [Modern Problems of Science and Education]. 2018; (4): 14–8. (in Russian)
4. Korovina N., Zaplatnikov A., Zakharova I. Principles of the antibacterial therapy for the community_acquired pneumonia among infants. Voprosy sovremennoy pediatrii [Current Pediatrics]. 2007; 6 (1): 55–61. (in Russian)
5. The health of the population of the Republic of Kazakhstan and the activities of healthcare organizations in 2018. Statisticalyk zhinak statistical collection. Nursultan, 2019. (in Russian)
6. Yakovlev S.V., Aleksandrova M.A., Suvorova M.P., Kostina S.A. Evaluation of efficacy and safety of josamycin (vilprafen) in the treatment of patients with community-acquired pneumonia. Antibiotiki i khimioterapiya [Antibiotics and Chemotherapy]. 2006; 51 (3-4): 47–52. (in Russian)
7. Health protection and healthy lifestyle. Primary morbidity in children under 5. URL: https://bala.stat.gov.kz/pervichnaya-zabolevaemost (date of access 16.04.2020). (in Russian)
8. Lyutina E.I., Manerov F.K. Morbidity and mortality of community-acquired pneumonia in children and adolescents living in Kuzbass Region. Pediatriya. Zhurnal imeni G.N. Speranskogo [Pediatrics. Journal named after G.N. Speransky]. 2015; 94 (2): 203–6. (in Russian)
9. WHO. Estimates of disease burden and cost-effectiveness. URL: http://www.who.int/immunization_monitoring/data/en
10. Geppe N.A., Rozinova N.N., Kozlova N.V., et al. Rational antibacterial therapy for community-acquired pneumonia in children. Klinicheskaya i neotlozhnaya pediatriya [Clinical and Emergency Pediatrics]. 2015; 1 (1): 24–9. (in Russian)
11. Pneumonia in children: wedge. protocol: approved. Joint Commission on the Quality of Medical Services of the Ministry of Health of the Republic of Kazakhstan on October 5, 2017, No. 29. URL: https://diseases.medelement (date of access March 03, 2021). (in Russian)
12. Provision of inpatient care for children: rukov. on the management of the most common diseases of childhood. WHO. 2nd ed. Geneva, 2013: 438 p.
13. Azyzov I.S., Lavrinenko A.V., Kolesnichenko S.I., Shambilova N.A., et al. Antimicrobial susceptibility of Streptococcus pneumoniae in Kazakhstan. Klinicheskaya mikrobiologiya i antimikrobnaya khimioterapiya [Clinical Microbiology and Antimicrobial Chemotherapy]. 2019; 21 (2): 187–91. (in Russian)
14. Popov D.A., Ovseenko S.T., Vostrikova T.Yu. Express identification of positive blood cultures using direct maldi-tof mass spectrometry. Anesteziologiya i reanimatologiya [Anesthesiology and Reanimatology]. 2015; 60 (5): 71–5. (in Russian)
15. Esposito S., Patria M.F., Tagliabue C., et al. CAP in children. In: J. Chalmers, M. Pletz, S. Aliberti (eds). European Respiratory Monograph 63: Community-Acquired Pneumonia. 2014: 130–9.
16. Sergeeva E.V., Petrova S.I. Community-acquired pneumonia in children. The modern features. Pediatr [Pediatrician]. 2016; 7 (3): 6–10. (in Russian)
17. Leung A.K.С., Wong A.H.C, Hon K.L. Community-acquired pneumonia in children. Recent Pat Inflamm Allergy Drug Discov. 2018; 12 (2): 136–44.
18. Nadeev A.P., Kozyaev M.A., Abyshev A.A., Chekanov M.N., et al. Community-acquired pneumonia: epidemiology, etiology and clinical-morphological parallels. Journal of Siberian Medical Sciences. 2019; (4): 20–9. (in Russian)