Results of treatment for lobar pneumonia based on bacterial etiology from nasopharyngeal samples at the Vietnam National Children’s Hospital (March 2023 - February 2024)

Abstract

Lobar pneumonia is a disease of severe lung damage in children that often progresses acutely. However, diagnosing the cause of lobar pneumonia is challenging when collecting specimens at the lesion site. Aims and methods: Evaluate the results of treatment of lobar pneumonia based on the bacterial etiology in nasopharyngeal samples determined by real-time PCR, NPS culture and specific Mycoplasma IgM antibodies. Results: The study involved 777 out of 835 children with lobar pneumonia treated according to the bacteria found in nasopharyngeal samples by real-time polymerase chain reaction (PCR) and nasopharyngeal samples culture. The cause determined by PCR: Mycoplasma pneumoniae (MP) was the most common 32.1%, followed by Haemophilus influenzae 28.1%, Streptococcus pneumoniae at 21.9%. The etiology was determined by nasopharyngeal culture: H. influenzae at 17.5%, S. pneumoniae at 7.4% and Moraxella catarrhalis at 7.9%. 100% of patients with real-time PCR MP (+) were successfully treated with Macrolide or Quinolone regimen, 159/211 (75.4%) patients with lobar pneumonia were cured according to the antibiogram, while 52/211 (24, 6%) recovered without following the antibiogram. Conclusion: Treatment of lobar pneumonia by targeting the bacterial etiology in nasopharyngeal samples is highly effective, showing the value of nasopharyngeal samples in identifying the cause of lobar pneumonia. Recommendation: Use nasopharyngeal samples etiology results for reliable treatment of lobar pneumonia.