title: Pseudomonas aeruginosa identified as a key pathogen in hospitalised children with aspiration pneumonia and a high aspiration risk.
abstract: OBJECTIVE
  Data on the causative pathogens and optimal empirical therapy of aspiration pneumonia in children are limited. This study sought to describe the bacteriology of aspiration pneumonia in hospitalised children with a high aspiration risk.
  
  
  METHODS
  Respiratory tract specimens were prospectively collected using the induced sputum technique from children with a high aspiration risk who were hospitalised for aspiration pneumonia in a tertiary paediatric medical centre from 2009 to 2014. Clinical, microbiological and treatment data were recorded and analysed for each admission.
  
  
  RESULTS
  The cohort comprised 50 children with 235 hospital admissions. Of the 183 respiratory tract cultures performed, 110 were positive for bacteria, with 169 isolates, mostly Gram-negative. The most common Gram-negative pathogen was Pseudomonas aeruginosa. If patients had Pseudomonas aeruginosa isolation, the risk of them having the pathogen again was 81%. The multivariate analysis showed that the use of antibiotic prophylaxis and number of hospitalisations were significantly associated with Pseudomonas aeruginosa isolation.
  
  
  CONCLUSIONS
  Gram-negative bacilli, especially Pseudomonas aeruginosa, were the major causative agents of paediatric aspiration pneumonia in our study. Empiric antipseudomonas treatment should be considered, particularly in patients who are receiving antibiotic prophylaxis, have experienced recurrent hospitalisations or with previous respiratory cultures that showed Pseudomonas aeruginosa isolation.
authors.affiliation: Department of Pediarics B&C, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Liat
authors.initials: L
authors.lastname: Ashkenazi-Hoffnung
authors.affiliation: Department of Pediarics B&C, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.
authors.forename: Anne
authors.initials: A
authors.lastname: Ari
authors.affiliation: Department of Pediarics B&C, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Efraim
authors.initials: E
authors.lastname: Bilavsky
authors.affiliation: Department of Pediarics B&C, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Oded
authors.initials: O
authors.lastname: Scheuerman
authors.affiliation: Department of Pediarics B&C, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Jacob
authors.initials: J
authors.lastname: Amir
authors.affiliation: Department of Pediarics B&C, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Dario
authors.initials: D
authors.lastname: Prais
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D002673:Child, Hospitalized / Q000706:statistics & numerical data; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D011015:Pneumonia, Aspiration / Q000188:drug therapy / Q000382:microbiology*; D011446:Prospective Studies; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification*; D017211:Treatment Failure
chemical_list: D000900:Anti-Bacterial Agents
keywords: 
  Pseudomonas aeruginosa
  ; Induced sputum; Neurologically impaired children; Respiratory infection; Respiratory tract culture