Epidemiology, clinical characteristics and antimicrobial resistance patterns of community-acquired pneumonia in 1702 hospitalized children in Singapore

Objective and background: Childhood community‐acquired pneumonia (CAP) remains a leading cause of morbidity and mortality worldwide. The features of childhood CAP vary between countries. The aim of this study was to delineate the clinical characteristics, complications, spectrum of pathogens and patterns of antimicrobial resistance associated with hospitalized cases of childhood CAP in Singapore. Methods: A retrospective study was conducted of patients discharged from Singapore’s only children’s hospital over a 3‐year period with a principal diagnosis of CAP. Results: A total of 1702 children, with a median age of 4.2 years (range: 1 month−16.3 years) were enrolled. A pathogen was identifiable in 38.4% of cases, including Mycoplasma pneumoniae in 20.3%, typical respiratory bacteria in 10.3% (64.6%Streptococcus pneumoniae; 21.7% non‐typeable Haemophilus influenzae), viruses in 5.5% and mixed bacterial/viral infections in 2%. The majority of M. pneumoniae infections were in school‐aged children (>5 years). Severity of infection was greater in CAP caused by typical bacteria, as reflected by length of hospital stay, CRP level, white cell and absolute neutrophil counts. Mortality from typical bacterial infections (8.9%) exceeded that from M. pneumoniae (0.3%) and viral pneumonias (0%) (P