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.