Lower Respiratory Tract Infections in Multiple Subgroups of Immunocompromised Children: A Retrospective Cohort Study

Abstract

Lower respiratory tract infections (LRTIs) are more likely to have severe impact on immunocompromised children. Hence, we determined among immunocompromised children (1) the incidence of LRTI hospitalizations, (2) microbiological etiology and clinical burden of LRTI hospitalizations, and (3) association between baseline characteristics and LRTI hospitalizations. A retrospective cohort study of children age < 16 years treated at IWK Health Center 2004-2014 for immunocompromising conditions was conducted. We followed them from date of diagnosis of immunocompromise until first LRTI hospitalization or death or end of study period or immunocompromised status. The incidence proportion and crude incidence of LRTI hospitalizations was 15.8% and 52.4 per 1,000 person-years. The incidence was relatively higher among immunology, oncology and hematology groups. Viruses were most common, followed by bacteria and fungi. Clinical burden was high among patients. Log-rank tests and hazard ratios were statistically significant for types of immunocompromising disorders, age at diagnosis, and gender.