Ruihan Liu

and 12 more

Objective: To identify the pathogens and compare the clinical characteristics between different type pathogen infection among children with community-acquired pneumonia (CAP) requiring bronchoalveolar lavage. Study design: Children <14 years old hospitalized with CAP requiring bronchoalveolar lavage were enrolled between February 2019 to January 2020. Multiplex reverse transcription polymerase chain reaction (mRT-PCR) and loop-mediated isothermal amplification (LAMP) were used for pathogen detection. The demographic and clinical characteristics were compared between different type pathogen infection groups. Results: Among 1166 children studied, ≥1 pathogen was detected in 1084 (93.0%) children and co-infection was detected in 215 (18.4%) children. Mycoplasma pneumoniae, Streptococcus pneumoniae and adenovirus were the most frequently detected pathogens. Children infected with atypical bacteria alone were older and more likely to display a fever, cough, decreased breath sounds, consolidation, single lobar infiltration, mucosal erosion and/or necrosis and plastic bronchitis. Children with virus-atypical bacteria co-infection were more prone to manifest fatigue, chest pain, tachypnea, chest indrawing, and mucosal erosion and/or necrosis. Those infected with virus alone or co-infected with ≥3 pathogens were liable to display changes in bronchial morphology. Conclusions: Pathogens were detected in 93.0% of enrolled children. M. pneumoniae infection might be the greatest pediatric disease burden due to CAP in North China. Keywords: Children; community-acquired pneumonia; bronchoalveolar lavage fluid; etiology; co-infection.