Community-acquired pneumonia in pediatric patients with acute neuromuscular respiratory failure: A microbiologic perspective

摘要

We are grateful to read the comments sent to the journal by Dr. Massimiliano Don regarding our article "Combined noninvasive ventilation and mechanical in-exsufflator in the treatment of pediatric acute neuromuscular respiratory failure".1 These valuable comments bring our attention to the microbiologic aspect of pneumonia in pediatric patients with neuromuscular diseases (NMD), an important issue that has not been well addressed. To date, early or prophylactic use of antibiotics as clinical management plans for community-acquired pneumonia (CAP) in NMD children are suggested.2"4 However, the literature is sparse regarding the etiology of CAP in these children and beneficial evidence of empiric antibiotics in these populations is still lacking. Thus, we are in line with Dr. Massimiliano Don that investigations elucidating the etiology of CAP may improve outcome of these patients and avoid adverse effects of unnecessary antibiotics. To this end, we re-analyzed our data in our article,1 and tried to explore possible microbial factors associated with the outcome of these patients receiving noninvasive ventilation (NTV) and mechanical in-exsufflator (ME) due to pneumonia.