分析综合医院儿科单中心住院儿童社区获得性肺炎(community-acquired pneumonia, CAP)诊疗数据，为提高儿科肺炎诊疗管理水平提供依据。

回顾性分析2019年7月至2024年1月在北京大学第三医院秦皇岛医院儿科病房住院的577例肺炎患儿流行病学信息、临床特征、病原检测、肺部影像学、抗菌药物和糖皮质激素使用情况等。

肺炎占儿科同期全部住院人数53.28%(577/1 083)，患儿中位数年龄4(3，7)岁，住院日7 d(5，8)。577例CAP患儿中，重症肺炎35例(6.07%)，行支气管镜治疗11例(1.91%)。573例(99.31%)患儿使用静脉抗菌药物，静脉输注疗程6 d(5，7)。静脉输注甲泼尼龙68例(11.78%)，平均疗程4 d(3，5)。CAP患儿肺部影像学表现为点片状模糊阴影280例(48.52 %)，大片状高密度阴影59例(10.22%)，磨玻璃影8例(1.39%)，左肺炎症97例(16.81%)，右侧炎症134例(23.22 %)，双侧炎症268例(46.45 %)，胸腔积液1例( 0.17 %)，肺不张3例(0.52%)。577例CAP患儿病原体检出阳性416例(72.10%)，其中肺炎支原体(Mycoplasma pneumonia, MP)阳性272例(47.14%)，腺病毒(Adenovirus, ADV)阳性56例(9.81%)，乙型流感病毒(Influenza B virus, Ful B)阳性53例(9.28%)及甲型流感病毒(Influenza A virus, Flu A)阳性15例(4.56%)，178例(30.85%)行痰培养，阳性3例(1.69%)，均为肺炎克雷白杆菌(Klebsiella pneumoniae, KLP)。

儿科住院患儿病种肺炎占优势，肺炎住院患儿年度波动大、轻症多，儿童CAP诊疗中在精准微生物检测方法、抗生素药物应用等存在一定问题。应提高病原学检测水平、加强抗菌药物使用监管，倡导儿童轻症肺炎门诊治疗优先。

To analyze the diagnosis and treatment data of children with community-acquired pneumonia (CAP) from a single-center pediatric department in a general hospital, and to provide a basis for improving the management of pediatric pneumonia.

A retrospective analysis was conducted on 577 children with pneumonia hospitalized in the pediatric ward of Qinhuangdao Hospital of Peking University Third Hospital from July 2019 to January 2024. Data on epidemiological information, clinical characteristics, pathogen detection, chest imaging findings, and the use of antimicrobial agents and glucocorticoids were collected.

Pneumonia accounted for 53.28% (577/1 083) of all pediatric hospitalizations during the same period. The median age of the children was 4 years (3~7), and the median length of hospital stay was 7 days (5~8). Severe pneumonia accounted for 6.07% (35/577), and 1.91% (11/577) were transferred to a higher-level hospital for bronchoscopy treatment. Intravenous antimicrobial agents were administered to 99.31% of the children, with a median treatment duration of 6 days (5~7). Intravenous methylprednisolone was used in 68 cases (11.78%), with a median treatment duration of 4 days (3~5). The overall pathogen detection rate was 25.14% (416/1655). Among pathogens detected by serum IgM antibody testing, Mycoplasma pneumoniae had the highest positivity rate (272/577, 47.14%). Sputum culture was performed in 178 cases (30.74%, 178/579), with a positivity rate of only 1.69%. Pulmonary imaging findings in children with community-acquired pneumonia (CAP) included patchy fuzzy opacities in 280 cases (48.52%), large patchy high-density opacities in 59 cases (10.22%), ground-glass opacities in 8 cases (1.39%), left lung inflammation in 97 cases (16.81%), right lung inflammation in 134 cases (23.22%), bilateral inflammation in 268 cases (46.45%), pleural effusion in 1 case (0.17%), and atelectasis in 3 cases (0.52%). Pathogens were detected in 416 cases (72.10%). Among these, Mycoplasma pneumoniae (MP) was positive in 272 cases (47.14%), Adenovirus (ADV) in 56 cases (9.81%), Influenza B virus (Flu B) in 53 cases (9.28%), and Influenza A virus (Flu A) in 15 cases (4.56%). Sputum culture was performed in 178 cases (30.85%), with positive results in 3 cases (1.69%), all of which were Klebsiella pneumoniae.

Pneumonia is the predominant cause of hospitalization in the pediatric department. The annual number of pneumonia hospitalizations fluctuates significantly, with most cases being mild. Certain issues exist in areas such as precise microbiological detection methods and the application of antimicrobial agents. Efforts should be made to improve the level of etiological detection, strengthen the supervision of antimicrobial use, and promote the prioritization of outpatient management for children with mild pneumonia.