title: Atypical pathogens as etiologic agents in hospitalized patients with community-acquired pneumonia in Korea: a prospective multi-center study.
abstract: Local epidemiologic data on the etiologies of patients hospitalized with community-acquired pneumonia (CAP) is needed to develop guidelines for clinical practice. This study was conducted prospectively to determine the proportion of atypical bacterial pathogens in adults patients hospitalized with CAP in Korea between October 2001 and December 2002. Microbiological diagnosis was determined by serology for antibodies to Mycoplasma pneumoniae, Chlamydia pneumoniae, and Legionella pneumophila. Nucleic acid of M. pneumoniae and C. pneumoniae in respiratory samples and Legionella antigen in urine samples were detected. The study population consisted of 126 patients (71 males, 55 females), averaging 54.6 yr (SD+/-17.8), whose paired sera were available. An etiologic diagnosis for atypical pathogens was made in 18 patients (14.3%): C. pneumoniae 9 (7.1%), M. pneumoniae 8 (6.3%), and L. pneumophila 3 patients (2.4%). Streptococcus preumoniae and other typical pathogens were isolated from 36 patients (28.6%). Of 126 patients, 16 (12.7%) were admitted to intensive care unit and atypical pathogens were identified in 5 patients (31.3%). Initial clinical features of patients with pneumonia due to atypical, typical or undetermined pathogens were indistinguishable. We conclude that atypical pathogens should be seriously considered in hospitalized patients with CAP, when initiating empiric treatment in Korea.
authors.affiliation: Department of Internal Medicine, Korea University College of Medicine, Seongbuk-gu, Seoul, Korea.
authors.forename: Jang Wook
authors.initials: JW
authors.lastname: Sohn
authors.forename: Seung Chul
authors.initials: SC
authors.lastname: Park
authors.forename: Young-Hwa
authors.initials: YH
authors.lastname: Choi
authors.forename: Heung Jeong
authors.initials: HJ
authors.lastname: Woo
authors.forename: Yong Kyun
authors.initials: YK
authors.lastname: Cho
authors.forename: Jin Soo
authors.initials: JS
authors.lastname: Lee
authors.forename: Hee-Sun
authors.initials: HS
authors.lastname: Sim
authors.forename: Min Ja
authors.initials: MJ
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000907:Antibodies, Bacterial / Q000097:blood; D000942:Antigens, Bacterial / Q000652:urine; D016993:Chlamydophila pneumoniae / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D017714:Community-Acquired Infections / Q000382:microbiology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007723:Korea; D016952:Legionella pneumophila / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D008297:Male; D008875:Middle Aged; D009177:Mycoplasma pneumoniae / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D018410:Pneumonia, Bacterial / Q000097:blood / Q000382:microbiology* / Q000652:urine; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D012336:RNA, Ribosomal, 16S / Q000235:genetics
chemical_list: D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial; D012336:RNA, Ribosomal, 16S