title: Community-Acquired Pneumonia Hospitalization among Children with Neurologic Disorders.
abstract: OBJECTIVE
  To describe and compare the clinical characteristics, outcomes, and etiology of pneumonia among children hospitalized with community-acquired pneumonia (CAP) with neurologic disorders, non-neurologic underlying conditions, and no underlying conditions.
  
  
  METHODS
  Children <18 years old hospitalized with clinical and radiographic CAP were enrolled at 3 US children's hospitals. Neurologic disorders included cerebral palsy, developmental delay, Down syndrome, epilepsy, non-Down syndrome chromosomal abnormalities, and spinal cord abnormalities. We compared the epidemiology, etiology, and clinical outcomes of CAP in children with neurologic disorders with those with non-neurologic underlying conditions, and those with no underlying conditions using bivariate, age-stratified, and multivariate logistic regression analyses.
  
  
  RESULTS
  From January 2010-June 2012, 2358 children with radiographically confirmed CAP were enrolled; 280 (11.9%) had a neurologic disorder (52.1% of these individuals also had non-neurologic underlying conditions), 934 (39.6%) had non-neurologic underlying conditions only, and 1144 (48.5%) had no underlying conditions. Children with neurologic disorders were older and more likely to require intensive care unit (ICU) admission than children with non-neurologic underlying conditions and children with no underlying conditions; similar proportions were mechanically ventilated. In age-stratified analysis, children with neurologic disorders were less likely to have a pathogen detected than children with non-neurologic underlying conditions. In multivariate analysis, having a neurologic disorder was associated with ICU admission for children ≥2 years of age.
  
  
  CONCLUSIONS
  Children with neurologic disorders hospitalized with CAP were less likely to have a pathogen detected and more likely to be admitted to the ICU than children without neurologic disorders.
authors.affiliation: Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA. Electronic address: amillman@cdc.gov.
authors.forename: Alexander J
authors.initials: AJ
authors.lastname: Millman
authors.affiliation: Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA.
authors.forename: Lyn
authors.initials: L
authors.lastname: Finelli
authors.affiliation: Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA.
authors.forename: Anna M
authors.initials: AM
authors.lastname: Bramley
authors.affiliation: National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA.
authors.forename: Georgina
authors.initials: G
authors.lastname: Peacock
authors.affiliation: Vanderbilt University School of Medicine, Nashville, TN.
authors.forename: Derek J
authors.initials: DJ
authors.lastname: Williams
authors.affiliation: Le Bonheur Children's Hospital, Memphis, TN; University of Tennessee Health Science Center, Memphis, TN.
authors.forename: Sandra R
authors.initials: SR
authors.lastname: Arnold
authors.affiliation: Vanderbilt University School of Medicine, Nashville, TN.
authors.forename: Carlos G
authors.initials: CG
authors.lastname: Grijalva
authors.affiliation: Emory University School of Medicine, Atlanta, GA.
authors.forename: Evan J
authors.initials: EJ
authors.lastname: Anderson
authors.affiliation: Le Bonheur Children's Hospital, Memphis, TN; University of Tennessee Health Science Center, Memphis, TN; St. Jude Children's Research Hospital, Memphis, TN.
authors.forename: Jonathan A
authors.initials: JA
authors.lastname: McCullers
authors.affiliation: University of Utah Health Sciences Center, Salt Lake City, UT.
authors.forename: Krow
authors.initials: K
authors.lastname: Ampofo
authors.affiliation: University of Utah Health Sciences Center, Salt Lake City, UT.
authors.forename: Andrew T
authors.initials: AT
authors.lastname: Pavia
authors.affiliation: Vanderbilt University School of Medicine, Nashville, TN.
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Edwards
authors.affiliation: Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA.
authors.forename: Seema
authors.initials: S
authors.lastname: Jain
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002547:Cerebral Palsy / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D002869:Chromosome Aberrations; D017714:Community-Acquired Infections / Q000453:epidemiology*; D002658:Developmental Disabilities / Q000453:epidemiology; D004314:Down Syndrome / Q000453:epidemiology; D004827:Epilepsy / Q000453:epidemiology; D005260:Female; D006760:Hospitalization; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D010343:Patient Admission / Q000706:statistics & numerical data; D011014:Pneumonia / Q000453:epidemiology*; D013116:Spinal Cord / Q000002:abnormalities; D013714:Tennessee / Q000453:epidemiology; D014589:Utah / Q000453:epidemiology
keywords: Community-acquired pneumonia; neurological disorders