Clinical Characteristics of Necrotizing Pneumonia Caused by Different Pathogens

Yonghan Luo; Yanchun Wang

doi:10.2147/IDR.S419294

Clinical Characteristics of Necrotizing Pneumonia Caused by Different Pathogens

Infect Drug Resist. 2023 Jun 14:16:3777-3786. doi: 10.2147/IDR.S419294. eCollection 2023.

Authors

Yonghan Luo¹, Yanchun Wang¹

Affiliation

¹ Second Department of Infectious Disease, Kunming Children's Hospital, Kunming, Yunnan, People's Republic of China.

Abstract

Objective: To explore the clinical characteristics of necrotizing pneumonia (NP) caused by different pathogens.

Methods: A total of 282 children with NP admitted to Kunming Children's Hospital from January 2014 to November 2022 were enrolled. The clinical data of all children was collected. According to the different pathogens causing NP, the children were divided into three groups: the Mycoplasma pneumoniae necrotizing pneumonia (MPNP) group, the bacterial necrotizing pneumonia (BNP) group, and necrotizing pneumonia with no pathogen detected (NNP) group. The basic information, symptoms, signs, laboratory tests, radiological features, treatment, and prognosis of the three groups were compared.

Results: Among the 282 cases of NP, there were 62 (22.0%) cases of MPNP, 98 (34.75%) cases of BNP, and 142 (50.35%) cases of NNP. The most common bacteria causing NP were Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae, and Acinetobacter baumannii, respectively. Most clinical features of the three groups were statistically significant. The area under the concentration curve of white blood cell, C-reactive protein, albumin, neutrophil percentage, and fibrinogen in differentiating MPNP from BNP were 0.743 (0.638-0.849), 0.797 (0.711-0.883), 0.766 (0.671-0.861), 0.616 (0.509-0.724), and 0.634 (0.523-0.744), respectively. The decision curve showed that white blood cells, albumin, and C-reactive protein had good clinical application in differentiating MPNP from BNP. All patients were improved and discharged without death.

Conclusion: Bacteria are the most common cause of NP, and the most common bacteria are Streptococcus pneumoniae, Staphylococcus aureus, and Haemophilus influenzae. NP with no pathogen detected accounted for a large proportion. white blood, C-reactive protein, and albumin can identify the pathogens of NP. Patients with BNP were more severe, had a longer hospital stay, and were more likely to undergo closed drainage and surgery.

Keywords: children; clinical features; necrotizing pneumonia; pathogen.

Grants and funding

This work was supported by the Joint project of Yunnan Science and Technology Department Kunming Medical University (202101AY070001—217); Kunming Health Science and technology personnel training project (2020(Province)-21); Yunnan key specialty of pediatric infection(Training and education program/Kunming key specialty of pediatric infection; Key Science and Technology Program of Yunnan Province (No.202102AA100019).