• Judith Ju Ming Wong, Qalab Abbas, Justin Qi Yuee Wang, Wei Xu, Hongxing Dang, Phuc Huu Phan, Liang Guo, Pei Chuen Lee, Xuemei Zhu, Suresh Kumar Angurana, Minchaya Pukdeetraipop, Pustika Efar, Saptadi Yuliarto, Insu Choi, Lijia Fan, Alvin Wun Fung Hui, Chin Seng Gan, Chunfeng Liu, Rujipat Samransamruajkit, Hwa Jin Cho, Jacqueline Soo May Ong, Jan Hau Lee, and Pediatric Acute and Critical Care Asian Network (PACCMAN).
• Children's Intensive Care Unit, Department of Pediatric Subspecialties, KK Women's and Children's Hospital, Singapore.
• Pediatr Crit Care Me. 2024 Nov 1; 25 (11): 103510441035-1044.

ObjectivesMortality from pneumonia is three times higher in Asia compared with industrialized countries. We aimed to determine the epidemiology, microbiology, and outcome of severe pneumonia in PICUs across the Pediatric Acute and Critical Care Medicine Asian Network (PACCMAN).DesignProspective multicenter observational study from June 2020 to September 2022.SettingFifteen PICUs in PACCMAN.PatientsAll children younger than 18 years old diagnosed with pneumonia and admitted to the PICU.InterventionsNone.Measurements And Main ResultsClinical, microbiologic, and outcome data were recorded. The primary outcome was PICU mortality. Univariate and multivariable logistic regression was performed to investigate associations between PICU mortality and explanatory risk factors on presentation to the PICU. Among patients screened, 846 of 11,778 PICU patients (7.2%) with a median age of 1.2 years (interquartile range, 0.4-3.7 yr) had pneumonia. Respiratory syncytial virus was detected in 111 of 846 cases (13.1%). The most common bacteria were Staphylococcus species (71/846 [8.4%]) followed by Pseudomonas species (60/846 [7.1%]). Second-generation cephalosporins (322/846 [38.1%]) were the most common broad-spectrum antibiotics prescribed, followed by carbapenems (174/846 [20.6%]). Invasive mechanical ventilation and noninvasive respiratory support was provided in 438 of 846 (51.8%) and 500 of 846 (59.1%) patients, respectively. PICU mortality was 65 of 846 (7.7%). In the multivariable logistic regression model, age (adjusted odds ratio [aOR], 1.08; 95% CI, 1.00-1.16), Pediatric Index of Mortality 3 score (aOR, 1.03; 95% CI, 1.02-1.05), and drowsiness (aOR, 2.73; 95% CI, 1.24-6.00) were associated with greater odds of mortality.ConclusionsIn the PACCMAN contributing PICUs, pneumonia is a frequent cause for admission (7%) and is associated with a greater odds of mortality.Copyright © 2024 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.

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