An Asian study on the prevalence of atypical respiratory pathogens in community-acquired pneumonia

Ngeow, Yun Fong; Suwanjutha, S; Chantarojanasriri, Teerachai; Wang, Fu; Saniel, M. C.; Alejandria, Marissa; Hsueh, Po-Ren; Lee, Ping-Ing; Park, Seung Chul; Sohn, Jang Wook; Aziah, Ahmad M.; Liu, You-ning; Seto, W. H.; Ngan, C. C. L.; Mangunnegoro, Hadiarto; Hood, Alsagaff; Cheong, Y M

doi:10.1016/j.ijid.2004.06.006

Cited by 71 publications

(63 citation statements)

References 21 publications

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“…Almost similar observations regarding the clinical presentations were also found by Andrews et al 16 , Fang et al 8 , Sohn et al 22 and Ngeow et al 4 . Ashraf et al 24 showed fever and cough were 89.0% and 99.0% respectively in their study children.…”

Section: Discussionsupporting

confidence: 81%

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Clinical Presentation and Bacterial Etiology of Adult Community Acquired Pneumonia

Salam¹,

Amin

Islam³

2017

J. Bangladesh Coll. Phys.

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Introduction: Pneumonia is a worldwide, serious threat to health and an enormous socio-economic burden for health care system. According to recent WHO data, each year 3-4 million patients die from pneumonia. The clinical presentations and bacterial agents responsible for community acquired pneumonia (CAP) varies according to geography and culture.Methods: A cross sectional observational study conducted among the 53 consecutive patients with a clinical diagnosis of CAP in admitted patient in the department of Medicine, DMCH, during January 2010 to December 2010. Hematological measurements (TC of WBC, Hb%, ESR, platelet count), blood culture, chest X-ray P/A view, sputum for Gram staining and culture sensitivity, sputum for AFB, blood urea and random blood sugar were done in all cases. ELISA for IgM antibody of Mycoplasma pneumoniae and Chlamydia pneumoniae were done in sputum culture negative cases.Results: The mean (±SD) age was 38.9±17.3 years and Male female ratio was 3:1. Fever, chest pain and productive cough were the most common clinical features. The mean (±SD) respiratory rate was 23.0±2.8 /minute . COPD and DM were found in 17.0% and 5.7% of patients respectively . Blood culture was found positive in only 1.9% of the study patients. Gram positive Cocci 62.26%, Gram negative Bacilli 9.43%, mixed Gram positive cocci and Gram negative bacilli 11.32% and Gram negative Cocco Bacilli 1.9% were observed and in 15.03 % cases, no bacteria could be seen. Sputum culture revealed 53.8% streptococcus pneumoniae, 26.9% Klebsiella pneumonia as predominant organism. Mycoplasma pneumoniae and Chlamydia pneumoniae were found in 7.4% and 3.7% respectively by serological test. For Streptococcus pneumoniae, sensitive antibiotics were Amoxyclav and Levofloxacin. For Gram negative bacilli and coccobacilli, more sensitive antibiotics were Meropenem, Ceftriaxone, and Clarithromycin. The best sensitive drug were found meropenem. The mean (±SD) duration of hospital stay was 5.0±1.7 days with ranging from 3 to 10 days.Conclusion: Region based bacteroiological diagnosis of Cap is important for selecting the best and sensitive drugs for complete cure.J Bangladesh Coll Phys Surg 2016; 34(3): 128-134

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Section: Discussionsupporting

confidence: 81%

“…Sullivan et al 13 , Macfarlane et al 14 and Ngeow et al 4 observed Mycoplasma pneumoniae 9.3%, 2.4% and 9.2% respectively in their study. Falguera 17 observed Chlamydia pneumoniae 11.0%, Mycoplasma pneumoniae 9.0%.…”

Section: Discussionmentioning

confidence: 71%

Clinical Presentation and Bacterial Etiology of Adult Community Acquired Pneumonia

Salam¹,

Amin

Islam³

2017

J. Bangladesh Coll. Phys.

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“…The majority (5.5% out of a total of 7%) of serology testing in the European Union is performed with a single, high convalescent-phase titer (120), which can be problematic, since prior exposure cannot be ruled out, even at titers of Ͼ1:256 (238,314). A growing list of studies suggests that elevated Ig titers for Legionella can be detected in Ͻ1% to almost 30% of healthy individuals, depending on age, location, work environment, and, occasionally, gender (154,155,158,288,293,297,315). Of potential importance, the use of different in-house-developed and commercially developed IFA and EIA antigen preparations may complicate the interpretation of antibody titers for Legionella, especially across time and from different studies.…”

Section: Serological and Antibody-based Assaysmentioning

confidence: 99%

Current and Emerging Legionella Diagnostics for Laboratory and Outbreak Investigations

2015

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SUMMARY Legionnaires' disease (LD) is an often severe and potentially fatal form of bacterial pneumonia caused by an extensive list of Legionella species. These ubiquitous freshwater and soil inhabitants cause human respiratory disease when amplified in man-made water or cooling systems and their aerosols expose a susceptible population. Treatment of sporadic cases and rapid control of LD outbreaks benefit from swift diagnosis in concert with discriminatory bacterial typing for immediate epidemiological responses. Traditional culture and serology were instrumental in describing disease incidence early in its history; currently, diagnosis of LD relies almost solely on the urinary antigen test, which captures only the dominant species and serogroup, Legionella pneumophila serogroup 1 (Lp1). This has created a diagnostic “blind spot” for LD caused by non-Lp1 strains. This review focuses on historic, current, and emerging technologies that hold promise for increasing LD diagnostic efficiency and detection rates as part of a coherent testing regimen. The importance of cooperation between epidemiologists and laboratorians for a rapid outbreak response is also illustrated in field investigations conducted by the CDC with state and local authorities. Finally, challenges facing health care professionals, building managers, and the public health community in combating LD are highlighted, and potential solutions are discussed.

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“…Mycoplasma pneumoniae is increasingly recognized as common and important pathogen in community-acquired respiratory tract infections (RTIs) and pneumonia, particularly in school-age children and young adults (9,13). M. pneumoniae isolates are usually susceptible to macrolides; thus, macrolides are the most important drugs for treatment of RTI infections, especially in children (13).…”

mentioning

confidence: 99%

Antimicrobial Susceptibility of Mycoplasma pneumoniae Isolates and Molecular Analysis of Macrolide-Resistant Strains from Shanghai, China

Liu

Zhang

et al. 2009

Antimicrob Agents Chemother

120

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Fifty-three Mycoplasma pneumoniae strains were isolated from pediatric patients in Shanghai, China, from October 2005 to February 2008. Of 53 clinical isolates, 44 (83%) were resistant to erythromycin (MICs of >128 g/ml for all 44 strains), azithromycin, and clarithromycin. All macrolide-resistant M. pneumoniae strains harbored an A-to-G transition mutation at position 2063 in 23S rRNA genes. Forty-five (85%) clinical isolates were classified into the P1 gene restriction fragment length polymorphism type I, and six (11%) were type II.Mycoplasma pneumoniae is increasingly recognized as common and important pathogen in community-acquired respiratory tract infections (RTIs) and pneumonia, particularly in school-age children and young adults (9, 13). M. pneumoniae isolates are usually susceptible to macrolides; thus, macrolides are the most important drugs for treatment of RTI infections, especially in children (13). Fluoroquinolones and tetracyclines, which may be used as alternatives to macrolides, are not recommended for children. Macrolide-resistant M. pneumoniae strains have been reported in Japan, China, France, and the United States (6-8, 12, 16, 17).In this study, 53 strains of M. pneumoniae were collected from pediatric patients with RTIs in Shanghai, China. The in vitro activities of macrolides, tetracyclines, and fluoroquinolones against M. pneumoniae isolates were determined, and the mechanisms of resistance for macrolide-resistant stains were investigated. In addition, the type of M. pneumoniae clinical isolates was determined by PCR-restriction fragment length polymorphism (RFLP) typing of the P1 gene. pneumoniae was performed as described previously by Waites (14). All of the strains were identified by colony morphology and PCR assay. PCR amplification of 16S rRNA genes was done to identify M. pneumoniae using primers with sequences 5Ј-GCCACCCTCGGGGGCAGTCAG-3Ј and 5Ј-GAGTCGG GATTCCCCGCGGAGG-3Ј as previously described (4).Antimicrobial susceptibility of M. pneumoniae. To determine the MICs, the broth microdilution method with SP4 broth (Remel, Lenexa, KS) was performed as described previously by Waites (14). Every susceptibility testing was repeated three times. M. pneumoniae reference strain MPFH (ATCC 15531) was also included. Comparative in vitro activities of 10 antimicrobials are listed in Table 1. All of the M. pneumoniae isolates were susceptible to the tetracyclines and fluoroquinolones tested in this study. Moxifloxacin was more active than ciprofloxacin and levofloxacin. The MIC 50 and MIC 90 of moxifloxacin were 0.03 g/ml and 0.06 g/ml, respectively-much lower than those of ciprofloxacin and levofloxacin.Among 53 strains, 44 (83%) were resistant to erythromycin with a MIC 90 of Ͼ128 g/ml to either erythromycin or clarithromycin. These strains also showed high MICs to azithromycin and josamycin, with MIC 90 s of 64 g/ml and 4 g/ml, respectively (Table 1). All 44 macrolide-resistant strains had erythromycin MICs of Ͼ128 g/ml. The 16-member macrolide josamycin possessed lower MICs than the 14-a...

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An Asian study on the prevalence of atypical respiratory pathogens in community-acquired pneumonia

Abstract: These data reflect the overall high prevalence of these atypical pathogens among Asian patients with CAP.

Cited by 71 publications

References 21 publications

Clinical Presentation and Bacterial Etiology of Adult Community Acquired Pneumonia

Clinical Presentation and Bacterial Etiology of Adult Community Acquired Pneumonia

Current and Emerging Legionella Diagnostics for Laboratory and Outbreak Investigations

Antimicrobial Susceptibility of Mycoplasma pneumoniae Isolates and Molecular Analysis of Macrolide-Resistant Strains from Shanghai, China

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