Volume 12, issue 3, 1 september 1998, pages 723740. Epidemiology and etiology of communityacquired pneumonia. In patients who are clinically improving after initiation of broadspectrum empiric therapy, knowing the etiology may allow streamlining the regimen with therapy directed to the. Etiology of communityacquired pneumonia request pdf. The microbial etiology of communityacquired pneumonia cap is still not well characterized. The etiology of communityacquired pneumonia among children under 5 years of age in mainland china, 20012015. Empirical selection of antibiotic treatment is the cornerstone of management of patients with pneumonia.
Communityacquired pneumonia etiology bmj best practice. Etiology of community acquired pneumonia among children in. Ruiz m, ewig s, marcos ma, martinez ja, arancibia f, mensa j, torres a. In addition to methicillinsensitive staphylococcus aureus mssa, both hospitalacquired and communityacquired strains of mrsa are causing an increasing number of hap cases. Etiology of communityacquired pneumonia evaluation by transtracheal aspiration, blood culture, or serology lars jstergaard, m. Furthermore, the majority of pneumonia etiologic studies are based on hospitalized patients, whereas there have been no recent populationbased studies encompassing. Clinical features, etiology, and outcomes of communityacquired pneumonia in patients with diabetes mellitus. University of tampere a serologic study on etiology, with special focus. Although diameter of most bacteria is 1 m or more, mycoplasma, chlamydophila, and coxiella are 5 to 100 times smaller. The proposed study aims to provide current information, etiology and outcome of communityacquired pneumonia cap, risk factors for for cap in isolates of streptococcus pneumoniae and haemophilus influencae, mycoplasma pneumoniae, chlamydia pneumoniae and legionella. Cdc etiology of pneumonia in the community epic study was a prospective, multicenter, pop. Infectious diseases society of americaamerican thoracic society consensus guidelines on the management of communityacquired pneumonia in adults lionel a.
Diagnosing cap based on clinical presentation and chest xray findings can help guide empiric treatment with. Order a chest xray in all patients with suspected communityacquired pneumonia cap who are admitte. Etiology of communityacquired pneumonia in a populationbased study link between etiology and patients characteristics, processofcare, clinical evolution and outcomes. Cap etiology is changing owing to the recognized importance of viruses, pneumococcal and in. Microbial etiology of community acquired pneumonia cap 2. The etiology of communityacquired pneumonia and the role of normal respiratory flora. Defining the etiology of pneumonia may have significant implications for patient management. Viral pneumonia in adults could present as communityacquired pneumonia cap, ranging from mild disease to severe disease requiring hospital admission and mechanical ventilation. This fact brings up the link between etiology of cap and its clinical evolution and outcome. This article covers community acquired pneumonia cap. Most community acquired pneumonia cap are bacterial in origin and often follow brief viral upper respiratory tract infection. S46, with additional informa tion from references 9 through 11. The microbial patterns reported have differed considerably, depending on the epidemiologic area studied, the patient population included, and the extent and nature of the microbiologic techniques used.
Pdf etiology of communityacquired pneumonia mauricio. To determine the etiology of communityacquired pneumonia in ambulatory children and to compare responses to treatment with azithromycin, amoxicillinclavulanate or erythromycin estolate. Communityacquired pneumonia requiring hospitalization. The aim of this study was to determine the etiology of communityacquired pneumonia cap and the impact of age, comorbidity, and severity on microbial etiologies of such pneumonia. However, there is paucity of data from a large cohort, examining multiple biological specimens for diverse pathogens bacteria and viruses. Communityacquired pneumonia is the most common type of pneumonia. The initial choice of antibiotic is made empirically. Cap may be caused by bacteria, viruses, and fungi yeasts. Ambulatory patients with pneumonia were identified at the childrens medical center of. Pathogens implicated in cap in adults admitted to hospital in the uk using modern and traditional microbiological. Backgroundsince the last british study of the microbial aetiology of community acquired pneumonia cap about 20 years ago, new organisms have been identified for example, chlamydia pneumoniae, new antibiotics introduced, and fresh advances made in microbiological techniques. Before antibiotics, pneumonia was the thirdleading cause of death in the country, as this cover of a 1937 u. The most commonly identified pathogens are streptococcus pneumoniae, haemophilus influenzae, atypical bacteria ie, chlamydia pneumoniae, mycoplasma pneumoniae, legionella species, and viruses. Etiology and treatment of communityacquired pneumonia in.
Pediatric communityacquired pneumonia academic dissertation to be presented, with the permission of the faculty of medicine of the university of tampere, for public discussion in the auditorium of finnmedi 1, biokatu 6, tampere, on august 21st, 2009, at 12 oclock. Communityacquired pneumonia cap is a lung infection that you get from being around other people in the community. Google scholar see all references however, prospective studies on the etiology of cap among the japanese population have been very limited, and only the etiology of cap has been investigated by ishida et al december 1998. Etiology of communityacquired pneumonia springerlink. Typically characterized by a new lung infiltrate on chest xray, together with one or more of the following. Specifically, contemporary estimates of the incidence and etiology of communityacquired pneumonia hospitalizations based on prospectively collected data are needed. Study of community acquired pneumonia aetiology scapa in. The germs are easily spread from an infected person to others by coughing, sneezing, or close contact. Daniel musher md distinguished service professor of medicine molecular virology and microbiology baylor college of medicine disclosures. Regular microbial investigation included examination of sputum. Etiology of communityacquired pneumonia in hospitalized patients.
Communityacquired pneumonia cap is a major health concern, because it is a very frequent and deadly condition. The aim of this study was to determine the etiology of cap among adultsespecially. Communityacquired pneumonia cap is a serious lower respiratory tract infection associated with significant morbidity and mortality that is characterized by disputes over diagnostic evaluations. Communityacquired pneumonia cap is caused by bacterial, viral, fungal, or zoonotic organisms that produce mild to severe illness in people of all ages. This type of pneumonia is found in people who have not recently been in the hospital or another health care facility such as a nursing home or rehab facility. Introduction communityacquired pneumonia cap is a leading cause of morbidity and mortality worldwide. Communityacquired pneumonia cap is defined as an acute infection of the pulmonary parenchyma in a patient who has acquired the infection in the community, as distinguished from hospitalacquired nosocomial pneumonia. Moreover, the role of viruses in hospitalacquired pneumonia and ventilatorassociated pneumonia as causative agents or as copathogens and the effect of virus detection. Support for this program is provided by abbott the information presented is consistent with applicable fdaguidelines. Etiology of community acquired pneumonia full text view. Overall, 395 consecutive patients with cap were studied prospectively during a 15mo period. In a 5year period, 254 patients with communityacquired pneumonia were attended to.
The importance of defining the etiology of communityacquired pneumonia. Communityacquired pneumonia is one of the most common serious infections in children, with an annual incidence of 34 to 40 cases per 1,000 children in europe and north america. Hospitalacquired pneumonia etiology bmj best practice. Infectious diseases society of americaamerican thoracic. The epic study was a prospective, multicenter, populationbased, active surveillance study. The etiology of adult communityacquired pneumonia cap has been under constant study in different local settings during the past decade.
Etiology of communityacquired pneumonia in a population. It is estimated that 4 million cases of community acquired pneumonia occur annually in the united states, of which. Nascimentocarvalho department of pediatrics, faculty of medicine, federal university of bahia, salvador, bahia, brazil pneumonia is an important cause of morbidity and mortality among children throughout the world. Over the last three decades, successful pneumococcal and haemophilus influenzae type b vaccination has markedly reduced the burden of disease associated with these pathogens, including that associated with pneumonia. Communityacquired pneumonia causes great mortality and morbidity and high costs worldwide. Bacteria cause most cases of hap and ventilatorassociated pneumonia vap, especially aerobic gramnegative bacilli such as pseudomonas aeruginosa, escherichia coli, klebsiella pneumoniae, and acinetobacter species. A fiveyear study of severe communityacquired pneumonia with emphasis on prognosis in patients admitted to an intensive care unit. Pneumonia is a breathing respiratory condition in which there is an infection of the lung. The etiologic profile of communityacquired pneumonia cap for each age group could be similar among inpatients and outpatients. During the past few years, polymerase chain reaction pcrbased methods have been developed for many pathogens causing respiratory tract infections. Communityacquired pneumonia pulmonary disorders msd. To reduce the misuse of antibiotics, antibiotic resistance, and sideeffects, an empirical, effective, and individualised antibiotic treatment is needed. Infection of the pulmonary parenchyma or lower respiratory tract in a communitydwelling patient not at risk for healthcareassociated pneumonia hcap. Pathogens implicated in cap in adults admitted to hospital in the uk using modern and traditional microbiological investigations are described.
Etiology of childhood community acquired pneumonia and its implications for vaccination cristiana m. Pneumonia is classified according to the types of germs that cause it and where you got the infection. The etiology of pneumonia in the community epic study conducted by cdc and three u. Community acquired pneumonia infectious disease and. Communityacquired pneumonia cap has a major impact on public health and results in more than 10 million visits to physicians and 600,000 hospitalizations each year in the usa 1, where it is. Communityacquired pneumonia in infants and children.
In upright position lower lobes are best ventilated therefore deposition of inhaled micro organisms is higher in these lobes. Epidemiology in 20, the global burden of disease study based on data from 188 countries around the world, reported that lower respiratory tract infection was the second most common cause of death 4. It is estimated that 4 million cases of communityacquired pneumonia occur annually in the united states, of which. Overview and objectives of the etiology of pneumonia in the community epic study. This article covers communityacquired pneumonia cap. Communityacquired pneumonia is defined as pneumonia that is acquired outside the hospital. This article on the epidemiology and etiology of communityacquired pneumonia should be read in the context of other articles in this issue. Symptoms and signs are fever, cough, sputum production, pleuritic chest pain, dyspnea, tachypnea. It occurs outside of hospitals or other health care facilities. Etiology of childhood community acquired pneumonia and its. Transtracheal aspiration tta could be performed on 119 patients, blood cultures. The clinical presentation of cap varies, ranging from mild pneumonia characterized by fever and productive cough to severe pneumonia characterized by respiratory distress and sepsis. Childhood community acquired pneumonia cap is a significant problem in developing countries, and confirmation of microbial etiology is important for individual, as well as public health.
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