Kanhar P, Agarwalla SK, Das RR. Clinical profile and outcome of complicated community-acquired pneumonia in children in the post-pneumococcal vaccination era. World J Clin Cases 2025; 13(32): 109094 [DOI: 10.12998/wjcc.v13.i32.109094]
Corresponding Author of This Article
Rashmi R Das, Professor, Department of Pediatrics, All India Institute of Medical Sciences, Room No - 37, OPD Block, Bhubaneswar 751019, Odisha, India. rrdas05@gmail.com
Research Domain of This Article
Infectious Diseases
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Nov 16, 2025 (publication date) through Nov 15, 2025
Times Cited of This Article
Times Cited (0)
Journal Information of This Article
Publication Name
World Journal of Clinical Cases
ISSN
2307-8960
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
Kanhar P, Agarwalla SK, Das RR. Clinical profile and outcome of complicated community-acquired pneumonia in children in the post-pneumococcal vaccination era. World J Clin Cases 2025; 13(32): 109094 [DOI: 10.12998/wjcc.v13.i32.109094]
World J Clin Cases. Nov 16, 2025; 13(32): 109094 Published online Nov 16, 2025. doi: 10.12998/wjcc.v13.i32.109094
Clinical profile and outcome of complicated community-acquired pneumonia in children in the post-pneumococcal vaccination era
Padmini Kanhar, Sunil K Agarwalla, Rashmi R Das
Padmini Kanhar, Sunil K Agarwalla, Department of Pediatrics, SCB Medical College, Cuttack 753001, Odisha, India
Rashmi R Das, Department of Pediatrics, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar 751019, Odisha, India
Author contributions: Kanhar P, Agarwalla SK, and Das RR contributed to conceptualization and design; Kanhar P and Agarwalla SK contributed to material preparation and data acquisition; Kanhar P and Das RR contributed to data analysis; All authors contributed to writing-draft manuscript and writing-revision and approved submission of the final version.
Institutional review board statement: The study was reviewed and approved by the Institute Ethics Committee, SCB Medical College & Hospital, Cuttack [Approval No. 1562].
Informed consent statement: All study participants, or their legal guardians, provided written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement – checklist of items, and the manuscript was prepared and revised according to the STROBE Statement – checklist of items.
Data sharing statement:
There is no additional data available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Rashmi R Das, Professor, Department of Pediatrics, All India Institute of Medical Sciences, Room No - 37, OPD Block, Bhubaneswar 751019, Odisha, India. rrdas05@gmail.com
Received: May 6, 2025 Revised: May 30, 2025 Accepted: October 9, 2025 Published online: November 16, 2025 Processing time: 197 Days and 15.4 Hours
Abstract
BACKGROUND
Pediatric complicated community-acquired pneumonia (CCAP) is on the rise. The three subtypes include para-pneumonic effusion (PPE), necrotizing pneumonia (NP), and empyema.
AIM
To study different sub-types of pediatric CCAP, and compare their etiology, clinical profile, and outcome in the post-pneumococcal vaccination era.
METHODS
This prospective observational study was conducted over a 2-year period. All details (demographics, clinical, management, and outcomes) were recorded. Continuous data were presented either as mean and SD, or as median and inter-quartile range. Categorical data were presented as frequencies and percentages (%). Data were analyzed by using the IBM SPSS Statistics for Windows, version 21 (IBM Corp., Armonk, NY, United States).
RESULTS
Of the 80 cases included (71% aged 4-8 years), the distribution was as follows: PPE (42%), empyema (39%), and NP (19%). Bacterial etiology was identified in 28% (empyema 63%, P = 0.012). Staphylococcus aureus (45%) was most common followed by Escherichia coli (E. coli) (22.7%), and Streptococcus pneumoniae (13.6%). Patients with empyema, compared to PPE and NP, were less likely to receive prior antibiotics (32% vs 56% and 58%, respectively, P = 0.03). Duration (days, mean ± SD) of hospitalization was longer in children with NP compared to empyema and PPE (17.7 ± 9.8, 16.1 ± 7.5, and 13.6 ± 4.2, respectively). All children recovered with the medical management except 2 children requiring decortication.
CONCLUSION
Staphylococcus aureus and E. coli are the most common bacterial etiology in the post-pneumococcal vaccination era. Empyema might be related to a delay in antibiotics administration. NP is the most severe pediatric CCAP with prolonged hospitalization.
Core Tip: Complicated community-acquired pneumonia (CCAP) follows a severe course, and involve complications such as para-pneumonic effusion, necrotizing pneumonia (NP), empyema, or lung abscess. Present study conducted 5 years after introduction of pneumococcal vaccine in India found Staphylococcus aureus and Escherichia coli as the most common bacterial etiology of pediatric CCAP. In addition, empyema was found to be due to a delay in antibiotics administration, and NP was the most severe pediatric CCAP with prolonged hospitalization. This is important as far as the empirical antibiotics as well as further management of pediatric CCAP cases are concerned.
