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Etiology of community-acquired pneumonia in hospitalized patients in chile: the increasing prevalence of respiratory viruses among classic pathogens.
Chest. 2007 Mar; 131(3):779-787.Chest

Abstract

BACKGROUND AND STUDY OBJECTIVES

The range and relative impact of microbial pathogens, particularly viral pathogens, as a cause of community-acquired pneumonia (CAP) in hospitalized adults has not received much attention. The aim of this study was to determine the microbial etiology of CAP in adults and to identify the risk factors for various specific pathogens.

METHODS

We prospectively studied 176 patients (mean [+/- SD] age, 65.8 +/- 18.5 years) who had hospitalized for CAP to identify the microbial etiology. For each patient, sputum and blood cultures were obtained as well as serology testing for Mycoplasma pneumoniae and Chlamydophila pneumoniae, urinary antigen testing for Legionella pneumophila and Streptococcus pneumoniae, and a nasopharyngeal swab for seven respiratory viruses.

RESULTS

Microbial etiology was determined in 98 patients (55%). S pneumoniae (49 of 98 patients; 50%) and respiratory viruses (32%) were the most frequently isolated pathogen groups. Pneumococcal pneumonia was associated with tobacco smoking of > 10 pack-years (odds ratio [OR], 2.6; 95% confidence interval [CI], 1.2 to 5.4; p = 0.01). Respiratory viruses were isolated more often in fall or winter (28%; p = 0.011), and as an exclusive etiology tended to be isolated in patients >/= 65 years of age (20%; p = 0.07). Viral CAP was associated with antimicrobial therapy prior to hospital admission (OR, 4.5; 95% CI, 1.4 to 14.6).

CONCLUSIONS

S pneumoniae remains the most frequent pathogen in adults with CAP and should be covered with empirical antimicrobial treatment. Viruses were the second most common etiologic agent and should be tested for, especially in fall or winter, both in young and elderly patients who are hospitalized with CAP.

Authors+Show Affiliations

Departamento de Enfermedades Respiratorias, Pontificia Universidad Católica de Chile, Santiago, Chile. Electronic address: alediazf@hotmail.com.Departamento de Enfermedades Respiratorias, Pontificia Universidad Católica de Chile, Santiago, Chile.Department of Medicine, Winthrop University Hospital, Mineola, NY.Department of Medicine, Division of Pulmonary/Critical Care Medicine, and Infectious Diseases, South Texas Veterans Health Care System, San Antonio, TX.Departamento de Enfermedades Respiratorias, Pontificia Universidad Católica de Chile, Santiago, Chile.Departamento de Enfermedades Respiratorias, Pontificia Universidad Católica de Chile, Santiago, Chile.Departamento de Enfermedades Respiratorias, Pontificia Universidad Católica de Chile, Santiago, Chile.Departamento de Enfermedades Respiratorias, Pontificia Universidad Católica de Chile, Santiago, Chile.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17356093

Citation

Díaz, Alejandro, et al. "Etiology of Community-acquired Pneumonia in Hospitalized Patients in Chile: the Increasing Prevalence of Respiratory Viruses Among Classic Pathogens." Chest, vol. 131, no. 3, 2007, pp. 779-787.
Díaz A, Barria P, Niederman M, et al. Etiology of community-acquired pneumonia in hospitalized patients in chile: the increasing prevalence of respiratory viruses among classic pathogens. Chest. 2007;131(3):779-787.
Díaz, A., Barria, P., Niederman, M., Restrepo, M. I., Dreyse, J., Fuentes, G., Couble, B., & Saldias, F. (2007). Etiology of community-acquired pneumonia in hospitalized patients in chile: the increasing prevalence of respiratory viruses among classic pathogens. Chest, 131(3), 779-787. https://doi.org/10.1378/chest.06-1800
Díaz A, et al. Etiology of Community-acquired Pneumonia in Hospitalized Patients in Chile: the Increasing Prevalence of Respiratory Viruses Among Classic Pathogens. Chest. 2007;131(3):779-787. PubMed PMID: 17356093.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Etiology of community-acquired pneumonia in hospitalized patients in chile: the increasing prevalence of respiratory viruses among classic pathogens. AU - Díaz,Alejandro, AU - Barria,Paulina, AU - Niederman,Michael, AU - Restrepo,Marcos I, AU - Dreyse,Jorge, AU - Fuentes,Gino, AU - Couble,Bernardita, AU - Saldias,Fernando, PY - 2007/3/16/pubmed PY - 2007/5/3/medline PY - 2007/3/16/entrez SP - 779 EP - 787 JF - Chest JO - Chest VL - 131 IS - 3 N2 - BACKGROUND AND STUDY OBJECTIVES: The range and relative impact of microbial pathogens, particularly viral pathogens, as a cause of community-acquired pneumonia (CAP) in hospitalized adults has not received much attention. The aim of this study was to determine the microbial etiology of CAP in adults and to identify the risk factors for various specific pathogens. METHODS: We prospectively studied 176 patients (mean [+/- SD] age, 65.8 +/- 18.5 years) who had hospitalized for CAP to identify the microbial etiology. For each patient, sputum and blood cultures were obtained as well as serology testing for Mycoplasma pneumoniae and Chlamydophila pneumoniae, urinary antigen testing for Legionella pneumophila and Streptococcus pneumoniae, and a nasopharyngeal swab for seven respiratory viruses. RESULTS: Microbial etiology was determined in 98 patients (55%). S pneumoniae (49 of 98 patients; 50%) and respiratory viruses (32%) were the most frequently isolated pathogen groups. Pneumococcal pneumonia was associated with tobacco smoking of > 10 pack-years (odds ratio [OR], 2.6; 95% confidence interval [CI], 1.2 to 5.4; p = 0.01). Respiratory viruses were isolated more often in fall or winter (28%; p = 0.011), and as an exclusive etiology tended to be isolated in patients >/= 65 years of age (20%; p = 0.07). Viral CAP was associated with antimicrobial therapy prior to hospital admission (OR, 4.5; 95% CI, 1.4 to 14.6). CONCLUSIONS: S pneumoniae remains the most frequent pathogen in adults with CAP and should be covered with empirical antimicrobial treatment. Viruses were the second most common etiologic agent and should be tested for, especially in fall or winter, both in young and elderly patients who are hospitalized with CAP. SN - 0012-3692 UR - https://www.unboundmedicine.com/medline/citation/17356093/Etiology_of_community_acquired_pneumonia_in_hospitalized_patients_in_chile:_the_increasing_prevalence_of_respiratory_viruses_among_classic_pathogens_ DB - PRIME DP - Unbound Medicine ER -