Etiology of community acquired pneumonia among adult patients requiring hospitalization in Taiwan.
BACKGROUND
There has not been a comprehensive multi-center study investigating the microbial profile of community acquired pneumonia (CAP) in Taiwan.


METHODS
A prospective study of adult CAP patients requiring hospitalization between December 2001 and April 2002 was carried out in 13 hospitals in Taiwan. Etiology was determined based on laboratory data from blood and sputum cultures plus serology from paired serum and urine antigen detection tests.


RESULTS
Etiology was assigned to 99 (58.9%) of the 168 patients having the most complete data for etiology determination, with mixed infection in 21 (12.5%) patients. More than half (51.8%) of the patients were>60 years and 63.7% of the patients were males. The most common etiologic agent was Streptococcus pneumoniae (40, 23.8%), the majority (60%, 24 cases) of which was detected by positive urine antigen test. Other common agents included Mycoplasma pneumoniae (24, 14.3%), Chlamydia pneumoniae (12, 7.1%), Influenza A virus (11, 6.5%), Klebsiella pneumoniae (8, 4.8%) and Haemophilus influenzae (8, 4.8%). The prevalence of S. pneumoniae and M. pneumoniae was highest in patients>60 years (25/87, 28.7%), and<44 years (12/59, 19%), respectively; while K. pneumoniae comprised a larger proportion (4/22, 18%) in the 45-59 years group.


CONCLUSIONS
S. pneumoniae was the most common etiology agent in adult patients hospitalized due to CAP in Taiwan and the spectrum of other major pathogens was similar to studies conducted elsewhere in the world. Empiric treatment recommendations developed in other parts of the world may be appropriately adapted for local use after taking into account local resistance profiles. Our data also support the recommendation that urine antigen test be added as an adjunct to adult CAP etiology diagnosis protocol.
Lauderdale
Tsai-Ling
TL
Division of Clinical Research, National Health Research Institutes, Taipei, Taiwan.
Chang
Feng-Yee
FY
Ben
Ren-Jy
RJ
Yin
Hsiao-Chuan
HC
Ni
Yuen-Hua
YH
Tsai
Jen-Wen
JW
Cheng
Shu-Hsing
SH
Wang
Jann-Tay
JT
Liu
Yung-Ching
YC
Cheng
Yan-Wan
YW
Chen
Shu-Ting
ST
Fung
Chang-Phone
CP
Chuang
Yin-Ching
YC
Cheng
Hsiao-Pei
HP
Lu
Daniel C T
DC
Liu
Chieh-Ju
CJ
Huang
I-Wen
IW
Hung
Che-Lun
CL
Hsiao
Chin-Fu
CF
Ho
Monto
M
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000382:microbiology; D015897:Comorbidity; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000453:epidemiology / Q000382:microbiology*; D018410:Pneumonia, Bacterial / Q000453:epidemiology / Q000382:microbiology; D011018:Pneumonia, Pneumococcal / Q000453:epidemiology; D011024:Pneumonia, Viral / Q000453:epidemiology / Q000382:microbiology; D013624:Taiwan / Q000453:epidemiology