title: 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.
abstract: 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.
authors.affiliation: 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
authors.forename: Jae-Hoon
authors.initials: JH
authors.lastname: Song
authors.forename: Won Sup
authors.initials: WS
authors.lastname: Oh
authors.forename: Cheol-In
authors.initials: CI
authors.lastname: Kang
authors.forename: Doo Ryeon
authors.initials: DR
authors.lastname: Chung
authors.forename: Kyong Ran
authors.initials: KR
authors.lastname: Peck
authors.forename: Kwan Soo
authors.initials: KS
authors.lastname: Ko
authors.forename: Joon Sup
authors.initials: JS
authors.lastname: Yeom
authors.forename: Choon Kwan
authors.initials: CK
authors.lastname: Kim
authors.forename: Shin Woo
authors.initials: SW
authors.lastname: Kim
authors.forename: Hyun-Ha
authors.initials: HH
authors.lastname: Chang
authors.forename: Yeon-Sook
authors.initials: YS
authors.lastname: Kim
authors.forename: Sook-In
authors.initials: SI
authors.lastname: Jung
authors.forename: Zhaohui
authors.initials: Z
authors.lastname: Tong
authors.forename: Qingtao
authors.initials: Q
authors.lastname: Wang
authors.forename: Shao-Guang
authors.initials: SG
authors.lastname: Huang
authors.forename: Jien-Wei
authors.initials: JW
authors.lastname: Liu
authors.forename: M K
authors.initials: MK
authors.lastname: Lalitha
authors.forename: Ban-Hock
authors.initials: BH
authors.lastname: Tan
authors.forename: Pham Hung
authors.initials: PH
authors.lastname: Van
authors.forename: Celia C
authors.initials: CC
authors.lastname: Carlos
authors.forename: Thomas
authors.initials: T
authors.lastname: So
mesh_terms: 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
chemical_list: D000900:Anti-Bacterial Agents; D000942:Antigens, Bacterial