Distribution of the atypical pathogens of community-acquired pneumonia to disease severity

Cheng, Gong; Zhang, Tiegang; Luo, Ming‐Cheng; Li, Aihua; Dong, Mei; Li, Maozhong; Wang, Yiting; Huang, Fang

doi:10.21037/jtd.2018.10.50

Cited by 17 publications

(19 citation statements)

References 10 publications

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“…In the GLIMP [19] and EPIC studies [20], viral CAP diagnosis was 37.2% in Asia and 23% in the USA, similar to our results (39.2%). Studies of adult CAP in China from 2001 and 2005 showed that bacterial aetiology (atypical and other bacteria) was much higher than viral causes (30.3-53.1% versus 10.6-19.0%) [21][22][23][24][25], whereas recent CAP aetiology studies from 2009 and 2016 in China revealed an increased detection of viral infections (21.1% versus 34.9%) and a decline of bacterial infections (7.8-24.8%) [14,[26][27][28][29], similar to the trends reported in European countries and the USA [30]. The use of new molecular diagnostic methods rather than paired serum antibody titres might explain the higher rate of viral detection.…”

Section: Discussionmentioning

confidence: 99%

“…The use of new molecular diagnostic methods rather than paired serum antibody titres might explain the higher rate of viral detection. According to the recent epidemic surveillance data, with the exception of IFV, the primary causes of non-influenza viral pneumonia in China were AdV, RSV, CoVs, PIV, HRV and HMPV, with these viruses representing the main focus of this study [14,26,29,[31][32][33][34].…”

Section: Discussionmentioning

confidence: 99%

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Disease severity and clinical outcomes of community-acquired pneumonia caused by non-influenza respiratory viruses in adults: a multicentre prospective registry study from the CAP-China Network

et al. 2019

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Although broad knowledge of influenza viral pneumonia has been established, the significance of non-influenza respiratory viruses in community-acquired pneumonia (CAP) and their impact on clinical outcomes remains unclear, especially in the non-immunocompromised adult population.Hospitalised immunocompetent patients with CAP were prospectively recruited from 34 hospitals in mainland China. Respiratory viruses were detected by molecular methods. Comparisons were conducted between influenza and non-influenza viral infection groups.In total, 915 out of 2336 adult patients with viral infection were enrolled in the analysis, with influenza virus (28.4%) the most frequently detected virus, followed by respiratory syncytial virus (3.6%), adenovirus (3.3%), human coronavirus (3.0%), parainfluenza virus (2.2%), human rhinovirus (1.8%) and human metapneumovirus (1.5%). Non-influenza viral infections accounted for 27.4% of viral pneumonia. Consolidation was more frequently observed in patients with adenovirus infection. The occurrence of complications such as sepsis (40.1% versus 39.6%; p=0.890) and hypoxaemia (40.1% versus 37.2%; p=0.449) during hospitalisation in the influenza viral infection group did not differ from that of the non-influenza viral infection group. Compared with influenza virus infection, the multivariable adjusted odds ratios of CURB-65 (confusion, urea >7 mmol·L−1, respiratory rate ≥30 breaths·min−1, blood pressure <90 mmHg (systolic) or ≤60 mmHg (diastolic), age ≥65 years) ≥3, arterial oxygen tension/inspiratory oxygen fraction <200 mmHg, and occurrence of sepsis and hypoxaemia for non-influenza respiratory virus infection were 0.87 (95% CI 0.26–2.84), 0.72 (95% CI 0.26–1.98), 1.00 (95% CI 0.63–1.58) and 1.05 (95% CI 0.66–1.65), respectively. The hazard ratio of 90-day mortality was 0.51 (95% CI 0.13–1.91).The high incidence of complications in non-influenza viral pneumonia and similar impact of non-influenza respiratory viruses relative to influenza virus on disease severity and outcomes suggest more attention should be given to CAP caused by non-influenza respiratory viruses.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Disease severity and clinical outcomes of community-acquired pneumonia caused by non-influenza respiratory viruses in adults: a multicentre prospective registry study from the CAP-China Network

et al. 2019

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“…CAP patients were included if they had evidence of CAP according to the guidelines for the diagnosis and treatment of adult community-acquired pneumonia in China (2016 edition) and the guidelines for the management of community-acquired pneumonia in children (the revised edition of 2013) [ 28–30 ]. They were further classified as severe CAP (SCAP) and non-severe CAP (NSCAP) based on illness severity according to the criteria described previously [ 31 ]. The inclusion and exclusion criteria of the study subjects were described in detail in appendix supplementary.…”

Section: Methodsmentioning

confidence: 99%

Mycoplasma pneumoniae triggers pneumonia epidemic in autumn and winter in Beijing: a multicentre, population-based epidemiological study between 2015 and 2020

Wang

Luo

et al. 2022

Emerging Microbes & Infections

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The objective of this paper is to explore the characteristics of Mycoplasma pneumoniae (MP) epidemics in Beijing, China. Patients with acute respiratory tract infection (ARTI) were enrolled from 35 sentinel hospitals in Beijing, 2015–2020. Their medical records were reviewed and respiratory specimens were collected for assay for nucleic acids of 24 respiratory pathogens, including MP. The genotypes of MP were analysed using a real-time PCR method. The domain V of 23s rRNA gene was sequenced to identify macrolide-resistant mutations. A total of 41,677 specimens of ARTI patients were included, with an MP positive rate of 6.16%. MP prevalence mainly occurred between August and January, and peaked in October. The increase in the MP detection rate was coincident with the elevation of the reported number of patients with pneumonia in the 35 sentinel hospitals. One or more respiratory pathogens were co-detected in 27.1% of the MP-positive patients. Type 1 MP remained predominant, and the macrolide-resistant rate of MP had exceeded over 90%. A2063G mutation accounted for 99.0% of macrolide-resistant MP infections. MP epidemic in Beijing mainly occurred between August and January with a remarkable high macrolide-resistant rate. MP is one of the important contributors to the pneumonia epidemic in autumn and winter in Beijing.

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“…Several case‐control studies have reported a higher risk of developing severe or very severe CAP (SCAP) among patients infected with RSV 4,5 . However, similar results have not been observed among Chinese children in Beijing, 3 suggesting that sustained effort is needed to understand whether viral infections lead to more serious disease.…”

Section: Introductionmentioning

confidence: 98%

Prevalence and clinical significance of common respiratory pathogens in the upper respiratory tract of children with community‐acquired pneumonia in Zunyi, China

Zhang

Yao

et al. 2020

Pediatric Pulmonology

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Purpose To estimate the prevalence of common respiratory pathogens among children with community‐acquired pneumonia (CAP) in Zunyi City, Guizhou, China, and to assess whether the presence of common respiratory pathogens in patients is associated with disease severity. Patients and Methods This retrospective study assessed the prevalence of common respiratory viruses and bacteria in the upper respiratory tract of among infants and children aged 1 month to 5 years hospitalized with radiologically confirmed CAP between April 2017 and March 2018. Direct immunofluorescence assay and bacterial culture were used to identify viruses and bacteria in the upper airway specimens, respectively. The association between severe CAP and the presence of pathogens was determined using multivariate logistic regression models. Results Of the 685 patients enrolled, 583 cases had viral and/or bacterial pathogens detected, which included the presence of only viral pathogens, only bacterial pathogens, and mixed viral and bacterial pathogens in 34.3%, 29.7%, and 36.0% of cases, respectively. Respiratory syncytial virus (RSV) was the most common viral pathogen, with a prevalence rate of 39.9% (273/685). Haemophilus influenzae was the most commonly detected bacterial pathogen, with a prevalence rate of 15.3% (105/685). The presence of RSV (adjusted odds ratio [aOR], 1.9; 95% confidence interval [CI], 1.3‐2.8) and Staphylococcus aureus (aOR, 13.7; 95% CI, 5.5‐33.9) in children with CAP was associated with severe pneumonia. Conclusions In a cohort of Zunyi infants and children hospitalized with CAP, RSV was the most common pathogen.

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Distribution of the atypical pathogens of community-acquired pneumonia to disease severity

Cited by 17 publications

References 10 publications

Disease severity and clinical outcomes of community-acquired pneumonia caused by non-influenza respiratory viruses in adults: a multicentre prospective registry study from the CAP-China Network

Disease severity and clinical outcomes of community-acquired pneumonia caused by non-influenza respiratory viruses in adults: a multicentre prospective registry study from the CAP-China Network

Mycoplasma pneumoniae triggers pneumonia epidemic in autumn and winter in Beijing: a multicentre, population-based epidemiological study between 2015 and 2020

Prevalence and clinical significance of common respiratory pathogens in the upper respiratory tract of children with community‐acquired pneumonia in Zunyi, China

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