Objective. To assess the etiology of community-acquired pneumonia (CAP) in the army recruits using a polymerase chain reaction (PCR) assay. Materials and Methods. Sputum, blood, bronchoalveolar lavage samples and oropharyngeal swabs collected from 255 hospitalized army recruits with radiographically confirmed diagnosis of CAP were tested by PCR assay. The comparator group included 270 otherwise healthy recruits. Detection of Streptococcus pneumoniae, Haemophilus influenzaе, Mycoplasma pneumoniae, Chlamydophila pneumoniae, Chlamydophila psittaci, Legionella pneumophila, adenoviruses, Herpes simplex virus I/II, cytomegalovirus was performed by PCR using commercial AmpliSens kits and GenPak DNA PCR test. Results. The specific causative agent of CAP was determined in 94.1% of the enrolled military personnel. S. pneumoniae was a predominant pathogen of CAP. The high S. pneumoniae carriage rate (86.3%) among the military personnel was found. The incidence rates of M. pneumoniae and C. pneumoniae were 14.5±2.2% and 13.7±2.2%, respectively. The highest rates of C. pneumoniae and M. pneumoniae were observed in patients with non-severe CAP (16.2±2.6% and 16.7±2.7%, respectively) compared to significantly lower rates in patients with severe CAP (5.3±3.0% and 7.0±3.4%, respectively; p<0.05). The significance of L. pneumophila and C. psittaci as a cause of CAP in the military personnel was negligible. The adenoviruses were detected in 14.1±2.2% of patients, particularly those with severe CAP (36.8±6.4%). There was found the high incidence of associations between bacterial and bacterial or viral pathogens. Conclusions. PCR is a highly effective method for determining CAP etiology in military personnel, especially during the periods of increased morbidity. The high S. pneumoniae carriage rate among military personnel and its predominant role in the CAP etiology indicate a need for pneumococcal immunization of recruits. The significant proportion of M. pneumoniae and C. pneumoniae among pathogens causing CAP confirms a need to include these pathogens in the algorithm for examination of patients with CAP.

The actual guidelines on treatment of pneumonia emphasize necessity of establishment of etiologic diagnosis for therapy rationale. The necessity occurs to group agents according significance of their effect at evaluating etiologic role of a number of agents, for instance under implementation of epidemiological investigations, studying of etiologic structure of infections, planning of medicinal support. In that case, the Fishburn method fits perfectly. The purpose of study is to implement Fishburn method in establishing role of traditional and atypical agents in etiologic structure of community-acquired pneumonia.Materials and methods. The sampling included 172 examined patients aged from 18 to 30 years being under hospital treatment with confirmed diagnosis of community-acquired pneumonia. The analysis was applied to such biologic substrates as phlegm, blood, lavage (bronchoalveolar fluid). The technique of polymerase chain reaction was used. To determine weight coefficients of every analyzed etiologic agents with their subsequent distribution according percentage in etiologic structure. The Fishburn method was applied. The results. The main agents were established Streptococcus pneumoniae (separated in 86,3% of patients) and Haemophilus influenzae (41,2%). The mixed infection occurred in 65.8% of examined patients. The most propagated are such associations as Streptococcus pneumoniae and Haemophilus influenzae, Streptococcus pneumoniae and M. pneumoniae. Conclusion. S. pneumoniae, H. influenzae, M. pneumoniae are independent infection agents related to high and average levels. In the most cases, the detected agents were found in associations. A significant rate of detection of Herpes simplex I/II (16,2%) in blood and saliva of patients with community-acquired pneumonia testifies weakening of immune system. Herpes simplex I/II worsens course of diseases but is not considered as independent infection agent. The data obtained has epidemiological significance and can impact on development of medication support.