Epidemiology and clinical outcomes of community-acquired pneumonia in adult patients in Asian countries: a prospective study by the Asian network for surveillance of resistant pathogens.
Appropriate antimicrobial treatment of community-acquired pneumonia (CAP) should be based on the distribution of aetiological pathogens, antimicrobial resistance of major pathogens, clinical characteristics and outcomes. We performed a prospective observational study of 955 cases of adult CAP in 14 hospitals in eight Asian countries. Microbiological evaluation to determine etiological pathogens as well as clinical evaluation was performed. Bronchopulmonary disease (29.9%) was the most frequent underlying disease, followed by cardiovascular diseases (19.9%), malignancy (11.7%) and neurological disorder (8.2%). Streptococcus pneumoniae (29.2%) was the most common isolate, followed by Klebsiella pneumoniae (15.4%) and Haemophilus influenzae (15.1%). Serological tests were positive for Mycoplasma pneumoniae (11.0%) and Chlamydia pneumoniae (13.4%). Only 1.1% was positive for Legionella pneumophila by urinary antigen test. Of the pneumococcal isolates, 56.1% were resistant to erythromycin and 52.6% were not susceptible to penicillin. Seventeen percent of CAP had mixed infection, especially S. pneumoniae with C. pneumoniae. The overall mortality rate was 7.3%, and nursing home residence, mechanical ventilation, malignancy, cardiovascular diseases, respiratory rate>30/min and hyponatraemia were significant independent risk factors for mortality by multivariate analysis (P<0.05). The current data provide relevant information about pathogen distribution and antimicrobial resistance of major pathogens of CAP as well as clinical outcomes of illness in Asian countries.
Song
Jae-Hoon
JH
Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-gu, Seoul 135-710, South Korea. songjh@skku.edu
Oh
Won Sup
WS
Kang
Cheol-In
CI
Chung
Doo Ryeon
DR
Peck
Kyong Ran
KR
Ko
Kwan Soo
KS
Yeom
Joon Sup
JS
Kim
Choon Kwan
CK
Kim
Shin Woo
SW
Chang
Hyun-Ha
HH
Kim
Yeon-Sook
YS
Jung
Sook-In
SI
Tong
Zhaohui
Z
Wang
Qingtao
Q
Huang
Shao-Guang
SG
Liu
Jien-Wei
JW
Lalitha
M K
MK
Tan
Ban-Hock
BH
Van
Pham Hung
PH
Carlos
Celia C
CC
So
Thomas
T
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000942:Antigens, Bacterial / Q000276:immunology*; D001208:Asia / Q000453:epidemiology; D017714:Community-Acquired Infections / Q000175:diagnosis* / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D016021:Epidemiologic Studies; D006801:Humans; D016952:Legionella pneumophila / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification; D018410:Pneumonia, Bacterial / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D011018:Pneumonia, Pneumococcal / Q000175:diagnosis; D011159:Population Surveillance / Q000379:methods*; D011446:Prospective Studies; D013296:Streptococcus pneumoniae / Q000187:drug effects* / Q000302:isolation & purification / Q000378:metabolism; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D000942:Antigens, Bacterial