M.R. GATAULLIN¹, S.V. KHALIULLINA², V.A. ANOKHIN², D.R. SEMENOVA¹, G.S. SHAIKHIEVA¹, A.E. EVDOKIMOVA²

 ¹Republican Clinical Infectious Diseases Hospital named after Prof. A.F. Agafonov, Kazan

²Kazan State Medical University, Kazan

 Contact details:

Khaliullina Svetlana Viktorovna — MD, Professor of the Department of Childhood Infections

Address: 49 Butlerova St., Kazan, Russian Federation, 420012, tel.: +7 (843) 267-80-06, e-mail: svekhal@mail.ru

Today, viruses predominate in the overall structure of pathogens causing community-acquired pneumonia (CAP) in children. The «share contribution» of pathogens, according to epidemiological studies, is as follows: 30–70% are respiratory viruses, 7–17% are atypical bacteria, 2–8% are pyogenic bacteria. In children of the first two years of life (except for newborns), pneumonia is most often caused by respiratory viruses; typical bacterial pathogens are more often registered in preschoolers; the significance of atypical bacteria sharply increases starting from the age of 5. The increase in the incidence of viral and classical bacterial pneumonia occurs throughout the cold season, of atypical one — in September to December. The incidence of respiratory mycoplasmosis is often outbreak-like with intervals of 3–7 years and a total duration of 1–3 years.

The introduction of specific prophylaxis of pneumococcal and hemophilic infections has led to a reduction in the registered cases of CAP by 5–10 times and the frequency of hospitalizations by 15–65%.

Experts are unanimous that it is impossible to speak unequivocally about the etiology of CAP based on the disease clinical picture only. WHO uses this indicator (> 60 breaths/min in children under 2 months; > 50 breaths/min in infants 2 to 12 months; > 40 breaths/min in children of 1 to 5 years; > 20 breaths/min in children ≥ 5 years) as the only criterion for defining pneumonia in children with cough or difficulty breathing when chest X-ray is not possible. Developers of pneumonia risk scales at the «pre-X-ray» stage define the following as the main positions for making a diagnosis: fever, wheezing, and hemoglobin oxygen saturation level.

Key words: community-acquired pneumonia, etiological structure, clinical picture, children.

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