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

Jae Hoon Song, Won Sup Oh, Cheol In Kang, Doo Ryeon Chung, Kyong Ran Peck, Kwan Soo Ko, Joon Sup Yeom, Choon Kwan Kim, Shin Woo Kim, Hyun Ha Chang, Yeon Sook Kim, Sook In Jung, Zhaohui Tong, Qingtao Wang, Shao Guang Huang, Jien Wei Liu, M. K. Lalitha, Ban Hock Tan, Pham Hung Van, Celia C. CarlosThomas So

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161 Scopus citations

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.

Original languageEnglish
Pages (from-to)107-114
Number of pages8
JournalInternational Journal of Antimicrobial Agents
Volume31
Issue number2
DOIs
StatePublished - Feb 2008

Keywords

  • Aetiology
  • Clinical outcome
  • Community-acquired pneumonia
  • Epidemiology

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