Pediatric Unit, Division of Pulmonology, Allergy, and Immunology, AOU "Policlinico-Giovanni XXIII", Bari, Italy.
Early Hum Dev. 2013 Oct;89 Suppl 3:S49-52. doi: 10.1016/j.earlhumdev.2013.07.023. Epub 2013 Aug 17.
Community-acquired pneumonia (CAP) remains a frequent cause of morbidity and mortality worldwide even in industrialised countries, and its incidence is highest among children aged <5 years. Over the last two years, three international guidelines have been updated with new evidence concerning the incidence, aetiology and management of childhood CAP, but there are still some major problems in standardisation. The main aim of this review is to consider the available data concerning the aetiology, diagnosis, evaluation of severity, and treatment of paediatric CAP. Analysis of the literature shows that there are a number of unanswered questions concerning the management of CAP, including its definition, the absence of a paediatric CAP severity score, the difficulty of identifying its aetiology, the emergence of resistance of the most frequent respiratory pathogens to the most widely used anti-infectious agents, and the lack of information concerning the changes in CAP epidemiology following the introduction of vaccines against respiratory pathogens. More research is clearly required in various areas, and further efforts are needed to increase vaccination coverage with the already available vaccines in order to reduce the occurrence of the disease.
社区获得性肺炎(CAP)仍然是全世界发病率和死亡率的一个重要原因,即使在工业化国家也是如此,其发病率在 5 岁以下的儿童中最高。在过去两年中,有三个国际指南根据关于儿童 CAP 的发病率、病因学和管理的新证据进行了更新,但在标准化方面仍然存在一些主要问题。本综述的主要目的是考虑有关儿科 CAP 的病因学、诊断、严重程度评估和治疗的现有数据。对文献的分析表明,在 CAP 的管理方面仍有许多未解决的问题,包括其定义、缺乏儿科 CAP 严重程度评分、确定其病因的困难、最常见呼吸道病原体对最广泛使用的抗感染药物的耐药性的出现,以及在引入针对呼吸道病原体的疫苗后 CAP 流行病学变化方面的信息缺乏。显然,在各个领域都需要进行更多的研究,并需要进一步努力提高现有疫苗的接种覆盖率,以减少疾病的发生。