The rapid detection of respiratory pathogens in critically ill children

Clark, John A.; Conway Morris, Andrew; Curran, Martin D.; White, Deborah; Daubney, Esther; Kean, Iain R. L.; Navapurkar, Vilas; Bartholdson Scott, Josefin; Maes, Mailis; Bousfield, Rachel; Török, M. Estée; Inwald, David; Zhang, Zhenguang; Agrawal, Shruti; Kanaris, Constantinos; Khokhar, Fahad; Gouliouris, Theodore; Baker, Stephen; Pathan, Nazima

doi:10.1186/s13054-023-04303-1

Critical Care

Table 1 Demographic and clinical features of study participants

From: The rapid detection of respiratory pathogens in critically ill children

Variable	Total	Suspected CAP	Suspected HAP/VAP	p-value
Variable	N = 100	N = 80	N = 20	p-value
Demographics
Age (years)—median (IQR)	1.2 (0.3–5.2)	1.1 (0.3–4.8)	2.8 (0.9–15.0)	0.072^a
Sex (male)—n (%)	58	44 (55)	14 (70)	0.224^b
Weight (kilograms)—median (IQR)	10.6 (5.3–19.7)	9.8 (5.0–18.5)	12.9 (9.0–41.2)	0.066^a
Significant co-morbidity—n (%)	33	24 (30)	10 (50)	0.091^b
PIM3 score—median (IQR)	3.2 (0.5–5.0)	2.0 (0.5–5.0)	3.6 (2.1–5.0)	0.099^a
Primary diagnostic category—n (%)
Respiratory	62	55 (69)	7 (35)	0.005^b
Neurological	11	9 (11)	2 (10)	0.873^b
Cardiovascular	7	5 (6)	2 (10)	0.346^b
Trauma	6	4 (5)	2 (10)	0.709^b
Post-operative care	6	1 (1)	5 (25)	< 0.001^b
Other	8	6 (8)	2 (10)	0.712^b
Admission source—n (%)
Retrieval team	67	57 (71)	10 (50)	0.071^b
Emergency department	16	14 (18)	2 (10)	0.670^b
Paediatric ward	10	7 (9)	3 (15)	0.694^b
Theatre and recovery	7	2 (3)	5 (25)	< 0.001^b
Clinical factors at time of sampling
Observations—mean (SD)
Temperature (°C)	36.9 (1.1)	36.9 (1.2)	37.0 (0.7)	0.890^c
Fraction of inspired oxygen (%)	44.1 (19.7)	43.2 (18.5)	47.6 (24.2)	0.450^c
Mean airway pressure (cm H₂O)	12.0 (3.3)	11.9 (3.2)	12.4 (3.8)	0.617^c
Secretions—n (%)*
Absent/minimal	29	27 (34)	2 (10)	0.034^b
Present non-purulent	56	41 (52)	15 (75)	0.063^b
Present purulent	14	11 (14)	3 (15)	0.902^b
Chest X-ray—n (%)*
Diffuse/patchy infiltrate	29	25 (32)	4 (20)	0.307^b
Localised infiltrate	29	22 (28)	7 (35)	0.394^b
No infiltrate	25	22 (28)	3 (15)	0.237^b
Other	16	10 (13)	6 (30)	0.060^b
Haematology and biochemistry—median (IQR)
White cell count (10⁹/L)	8.5 (5.8–14.0)	8.6 (5.8–14.7)	8.0 (5.8–11.1)	0.520^a
Neutrophils (10⁹/L)	4.7 (2.7–10.3)	5.0 (2.7–10.7)	4.3 (3.1–7.6)	0.597^a
Lymphocytes (10⁹/L)	2.1 (1.0–3.2)	2.1 (1.0–3.2)	2.3 (1.1–3.3)	0.856^a
Platelets (10⁹/L)	280 (183–413)	301 (217–423)	220 (112–259)	0.007^a
C-reactive protein (mg/L)	28 (7–93)	26 (6–83)	58 (10–186)	0.210^a
Outcomes
Days free of treatment at 28 days–mean (SD)
Antimicrobial therapy	16.8 (7.9)	21.1 (6.7)	13.6 (8.3)	0.002^c
Mechanical ventilation	19.1 (7.2)	20.1 (6.5)	14.8 (8.6)	0.016^c
Inotropes	26.1 (5.1)	26.2 (4.9)	25.6 (5.6)	0.640^c
PICU admission	16.8 (7.9)	17.9 (7.6)	11.4 (7.6)	0.003^c
Survival to hospital discharge—n (%)	94	77 (96)	17 (85)	0.058^b

CAP community acquired pneumonia; HAP hospital acquired pneumonia; IQR interquartile range; LRTI lower respiratory tract infection; PICU paediatric intensive care unit; SD standard deviation; VAP ventilator-associated pneumonia
*Data missing for one patient in the medical record
^aMann–Whitney U test
^bChi-square test for independence
^cStudent’s t-test for equality of means, two-sided p, equal variance not assumed

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