Aetiology of community-acquired pneumonia in hospitalized adult patients in New Caledonia.
OBJECTIVE
To describe the aetiology of community-acquired pneumonia (CAP) in hospitalized adult patients in New Caledonia, a French archipelago in the South Pacific.


METHODS
Confirmed CAP patients (n=137) were enrolled prospectively. Pathogens were detected by culture, molecular methods, serology on paired sera, immunofluorescence on nasopharyngeal swabs and antigen detection in urine.


RESULTS
The aetiology of CAP was determined in 82 of 137 cases (59.8%), of which 31 exhibited two or more pathogens (37.8%). Hundred and seventeen pathogens were detected: Streptococcus pneumoniae was the most common one (41.0%), followed by influenza virus A (22.1%) and Haemophilus influenzae (10.2%). The frequency of atypical bacteria was low (6.0%). The most frequent and significant coinfection was S. pneumoniae with influenza A virus (P=0.004). Influenza virus was detected from nasopharyngeal swabs in four patients (15.4% of patients tested for influenza) and by PCR from pulmonary specimens in 15 patients (57.7%). CONCLUSIONS : Pneumoniae is the leading cause of CAP in New Caledonian adults. Viral-bacterial co-infections involving S. pneumoniae and influenza virus are very common during the winter. Such adult patients hospitalized with CAP are a clear sentinel group for surveillance of influenza. Vaccination against influenza and S. pneumoniae should be strengthened when risk factors are identified.
Mermond
Sylvain
S
Institut Pasteur de Nouvelle-Calédonie, Nouméa, CHT Gaston Bourret, Nouméa, New Caledonia. smermond@pasteur.nc
Berlioz-Arthaud
Alain
A
Estivals
Maurice
M
Baumann
Francine
F
Levenes
Hervé
H
Martin
Paul M V
PM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control; D005260:Female; D006760:Hospitalization; D006801:Humans; D009980:Influenza A virus / Q000302:isolation & purification; D007252:Influenza Vaccines / Q000008:administration & dosage; D007251:Influenza, Human / Q000453:epidemiology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009305:Nasopharynx / Q000821:virology; D009510:New Caledonia / Q000453:epidemiology; D022242:Pneumococcal Vaccines / Q000008:administration & dosage; D011014:Pneumonia / Q000453:epidemiology / Q000382:microbiology* / Q000517:prevention & control; D011018:Pneumonia, Pneumococcal / Q000453:epidemiology / Q000517:prevention & control; D011024:Pneumonia, Viral / Q000453:epidemiology / Q000517:prevention & control / Q000821:virology; D011446:Prospective Studies; D012621:Seasons
D007252:Influenza Vaccines; D022242:Pneumococcal Vaccines