A Prospective Study of Community-Acquired Pneumonia in Hong Kong

Increasing COPD awareness

“…Mycobacterium tuberculosis was also found in 1.1% of sputum specimens. The latter finding mirrors an earlier study in Hong Kong, which found that 12% of hospitalisations for community-acquired pneumonia were due to M. tuberculosis [102]. The empiric use of fluoroquinolones in the treatment of AECOPD should therefore be cautioned, as this group of antibiotics, with their weak anti-tuberculosis effect, may result in a delay in the diagnosis and treatment of pulmonary tuberculosis in areas such as Hong Kong and China, where the disease is still prevalent [103].…”

Hospitalized Patients with Community-Acquired Pneumonia in Hong Kong: A Randomized Study Comparing Imipenem/Cilastatin and Ceftazidime

“…This figure is compa rable to the result of a previous study of CAP in Hong Kong in 1992 [2]. Pneumococcal pneumonia was diag nosed in 8.3% of our patients.…”

“…This is lower than in other countries, which identified S. pneumoniae in 40-80% of the cases of CAP [4][5][6][7], On the other hand, gram-negative organisms were common aetiological agents in our study and were recovered in 15 (25%) sputum samples. This percentage is higher than that published in other series and may be due to the injudicious use of antibiotics by practitioners in Hong Kong which leads to a marked shift of the respiratory flora from gram-positive to gram-nega tive organisms and the emergence of resistance, as noted previously [2,8,9]. A substantial proportion of our hospi talized patients with moderate to severe CAP had un derlying bronchiectasis and chronic obstructive airway disease which could also contribute to the skewed spec trum of respiratory pathogens.…”

“…Atypical pneumonia caused by L. pneumophila is not an uncommon cause of severe pneumonia in other coun tries [5,10], but it is rare in Hong Kong and was not reported as a cause of CAP in our previous study [2], C. pneumoniae (strain TWAR) was reported as the fourth most common cause of CAP in a study of 359 cases in the United States [4], but only 2 of our patients had rising blood values suggestive of chlamydia infection. An epi demic of Mycoplasma pneumonia occurred in Hong Kong between 1986 and 1988, when 179 cases were iden tified among children under the age of 10 years [11], As atypical organisms are uncommon aetiologic agents for CAP in adults in our locality, we feel that it is not neces sary to include a macrolide antibiotic in the initial man agement of hospitalized patients, but it should be added when there is an inadequate response to other antibiot ics.…”

“…Chlamydia pneumoniae and aerobic gram-negative bacilli [ 1 ]. In Hong Kong, the com mon pathogens in CAP are similar to those reported for western populations, except that pulmonary tuberculosis (TB) is common and Legionella pneumonia is extremely rare [2], To assess the efficacy of the proposed guidelines in the management of CAP in Hong Kong, we have evalu ated the outcomes in hospitalized patients with moderate to severe CAP treated initially with ceftazidime or imipcnem/cilastatin and have determined the causes for treatment failures.…”