title: An Asian study on the prevalence of atypical respiratory pathogens in community-acquired pneumonia.
abstract: BACKGROUND
  In many parts of Asia, the inaccessibility and high cost of diagnostic tests have hampered the study of community-acquired pneumonia (CAP) caused by atypical respiratory pathogens.
  
  
  OBJECTIVE
  This surveillance study examined the frequency of infection with Mycoplasma pneumoniae, Chlamydophila pneumoniae, and Legionella pneumophila in 1756 patients presenting with signs and symptoms of CAP at 12 medical centres in Asia, using standardised laboratory techniques and interpretation criteria in all participating centres.
  
  
  METHODS
  Diagnosis of current infection was based on significant changes in antibody titer or persisting high antibody titers, together with the presence of bacterial DNA in respiratory secretions, in the case of M. pneumoniae and C. pneumoniae infections, or bacterial antigen in urine, in the case of L. pneumophila serogroup 1 infection.
  
  
  RESULTS
  Using these criteria, results from 1374 patients with paired sera showed that, overall, 23.5% of CAP cases were associated with infection with atypical respiratory pathogens, with M. pneumoniae, C. pneumoniae, and L. pneumophila being found in 12.2%, 4.7%, and 6.6% of cases, respectively. Persisting high antibody titers indicative of past exposure to M. pneumoniae, C. pneumoniae, and L. pneumophila were seen in 10.2%, 4.8%, and 18.9% of patients, respectively.
  
  
  CONCLUSIONS
  These data reflect the overall high prevalence of these atypical pathogens among Asian patients with CAP.
authors.affiliation: University Malaya Medical Centre, Petaling Jaya, Malaysia. ngeowyf@ummc.edu.my
authors.forename: Yun-Fong
authors.initials: YF
authors.lastname: Ngeow
authors.forename: Subharee
authors.initials: S
authors.lastname: Suwanjutha
authors.forename: Teerachai
authors.initials: T
authors.lastname: Chantarojanasriri
authors.forename: Fu
authors.initials: F
authors.lastname: Wang
authors.forename: Mediadora
authors.initials: M
authors.lastname: Saniel
authors.forename: Marissa
authors.initials: M
authors.lastname: Alejandria
authors.forename: Po-Ren
authors.initials: PR
authors.lastname: Hsueh
authors.forename: Lee
authors.initials: L
authors.lastname: Ping-Ing
authors.forename: Seung-Chul
authors.initials: SC
authors.lastname: Park
authors.forename: Jang-Wook
authors.initials: JW
authors.lastname: Sohn
authors.forename: Ahmad M
authors.initials: AM
authors.lastname: Aziah
authors.forename: Youning
authors.initials: Y
authors.lastname: Liu
authors.forename: Wing-Hong
authors.initials: WH
authors.lastname: Seto
authors.forename: Cecilia C L
authors.initials: CC
authors.lastname: Ngan
authors.forename: Mangunnegoro
authors.initials: M
authors.lastname: Hadiarto
authors.forename: Alsagaff
authors.initials: A
authors.lastname: Hood
authors.forename: Yuet-Meng
authors.initials: YM
authors.lastname: Cheong
mesh_terms: D000293:Adolescent; D000328:Adult; D000372:Agglutination Tests; D002648:Child; D002675:Child, Preschool; D016993:Chlamydophila pneumoniae / Q000235:genetics / Q000302:isolation & purification*; D017714:Community-Acquired Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology*; D004269:DNA, Bacterial / Q000737:chemistry / Q000235:genetics; D005202:Asia, Eastern / Q000453:epidemiology; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D006801:Humans; D016952:Legionella pneumophila / Q000302:isolation & purification*; D008297:Male; D008875:Middle Aged; D009177:Mycoplasma pneumoniae / Q000235:genetics / Q000302:isolation & purification*; D018410:Pneumonia, Bacterial / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology*; D016133:Polymerase Chain Reaction; D015995:Prevalence
chemical_list: D004269:DNA, Bacterial