Identification of bacterial pathogens in pediatric community-acquired lower respiratory tract infection using a simplified procedure of sputum sampling and examination: comparison between hospitalized children with and without underlying diseases.

The aim of this study is to confirm the usefulness of sputum sampling from the hypopharynx through the nose to identify causative bacteria of pediatric community-acquired lower respiratory tract infection (CA-LRTI) and compare its features between the patients with and without underlying diseases. A retrospective study was performed on 244 pediatric patients hospitalized for CA-LRTI of suspected bacterial etiology. Sputum sample was obtained from these patients by aspirating airway secretion through the nose or the tracheostomy orifice, or coughing up by themselves. Sputum samples were assessed as suitable in 119 (74.4%) of 160 patients with CA-LRTI of suspected pure bacterial etiology. Ninety-six (70.1%) of 137 samples suctioned from the hypopharynx through the nose were suitable for bacterial examination. Seventy-eight (73.6%) of 106 patients identified with causative bacteria had some underlying diseases, and the other 28 patients did not have any underlying diseases. Proportions and antibiotics susceptibility profiles of the identified causative bacteria were almost similar in the patients with and without underlying diseases. Sputum sampling from the hypopharynx through the nose might be significant in pediatric CA-LRTI of suspected bacterial etiology. The initial treatment for patients without underlying diseases would be applicable to those with underlying diseases in the CA-LRTI of children.