Hani Mahmoud Adel, Marwa Ahmed Meheissen, Asmaa Mahmoud Mohamed Gnina, Nirvana Mahmoud Abdel Fattah, Eman Hamza Hassan
Alexandria University.
Egypt
BioMedical Central infectious Diseases
BMC Infect Dis 2025; 25:
DOI: 10.1186/s12879-025-11856-9
Abstract
Background: Pneumonia is a significant cause of morbidity and mortality among children with congenital heart diseases (CHD). Consequently, the current study aimed to identify the prevalent pathogens causing pneumonia among children with CHD, as well as risk factors for mortality among this vulnerable group.
Method: Over a period of one year, all children with CHD who were hospitalized due to pneumonia, including both community-acquired (CAP) and hospital-acquired pneumonia (HAP) were enrolled. Samples of non-bronchoscopic bronchoalveolar lavage (NB-BAL) or induced sputum were collected to identify pathogens using both FTD® (Fast Track Diagnostics) real-time multiplex PCR and traditional culture methods. The VITEK 2 compact system (BioMérieux, Durham, NC, USA) was employed for the complete identification of all bacterial species and for assessing the antimicrobial resistance of all isolated bacteria by culture methods.
Results: The present study included 99 children with CHD and pneumonia; 88.9% had CAP and 11.1% had HAP. Viral pneumonia represented 46.5% of cases; Respiratory Syncytial Virus (31.1%), Rhinovirus (15.6%), and adenoviruses (12.2%) were the most common. Bacterial pneumonia was found in 23.23% of cases; Klebsiella pneumoniae (56.3%) and Streptococcus pneumoniae (17.2%) were the most common. Out of the studied cases, 75.76% survived and 24.24% deceased. Pulmonary hypertension (95% CI: 1.045-14.907, p=0.027), complications (95% CI: 7.45-162.723, p=0.026), and the need for mechanical ventilation (95% CI: 12.711-207.308, p<0.001) were independent risk factors of mortality.
Conclusion: RSV, Klebsiella pneumoniae , and Rhinovirus are common causes of pneumonia in CHD in our setting. The combination of culture techniques and multiplex PCR was beneficial for the accurate and timely identification of the causative agents of pneumonia in this vulnerable population that helps in guiding antimicrobial therapy.
Category
Class I. Pulmonary Hypertension Associated with Congenital Cardiovascular Disease
Class I. Pulmonary Hypertension Associated with Infection
Age Focus: Pediatric Pulmonary Vascular Disease
Fresh or Filed Publication: Fresh (PHresh). Less than 1-2 years since publication
Article Access
Free PDF File or Full Text Article Available Through PubMed or DOI: Yes