Usefulness of the Japanese Respiratory Society guidelines for community pneumonia: a retrospective analysis of community-acquired pneumonia between 2000 and 2002 in a general hospital.
OBJECTIVE
The aim of this study was to investigate the causative organisms of community-acquired pneumonia (CAP) diagnosed between 2000 and 2002 and to evaluate the Japanese Respiratory Society (JRS) guidelines.


METHODS
A total of 124 cases of CAP diagnosed during the study period were analyzed, and the results were compared with those of a previous study by the authors' research group. Determination of the causative organisms of CAP was based on Gram stain, morphology of colonies, quantitative culture of sputum, identification of bacterial isolates, and serological tests.


RESULTS
During the study period, the causative organisms were identified in 42 cases (33.8%). Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis were the major causative organisms. Patients were classified into three groups based on the severity of CAP according to the JRS guidelines. The survival rates of patients with moderate and severe CAP were significantly lower than those of the mild group as evaluated by the Kaplan-Meier method (moderate vs mild, 70% vs 100%; severe vs mild, 40% vs 100%; P < 0.001 for both). Seven patients died during the study, and the risk factors were old age, bedridden status with cerebral infarction, and microaspiration, which was associated with recurrent pneumonia within 17 days.


CONCLUSIONS
This study indicates that the JRS guidelines for CAP are useful for treating patients with CAP in Japan.
Motomura
Kazushi
K
Department of Internal Medicine, Tagami Hospital, Tagami, Nagasaki, Japan. k.motomura@themis.ocn.ne.jp
Masaki
Hironori
H
Terada
Mayumi
M
Onizuka
Tomoko
T
Furumoto
Akitsugu
A
Asoh
Norichika
N
Oishi
Kazunori
K
Nagatake
Tsuyoshi
T
D000293:Adolescent; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D017714:Community-Acquired Infections / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D005260:Female; D006769:Hospitals, General; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D017410:Practice Guidelines as Topic / Q000592:standards; D012189:Retrospective Studies; D013296:Streptococcus pneumoniae / Q000302:isolation & purification; D015996:Survival Rate; D014505:Urban Population