Role of ‘atypical pathogens’ among adult hospitalized patients with community‐acquired pneumonia

Lui, Grace; Ip, Margaret; Lee, Nelson; Rainer, Timothy Hudson; Man, S. Y.; Cockram, Clive S.; Antonio, Gregory E.; Ng, Margaret H.L.; Chan, Michael; Chau, Shirley S.L.; Mak, Pauline; Chan, Paul K.S.; Ahuja, Anil T.; Sung, Joseph J.Y.; Hui, David S.

doi:10.1111/j.1440-1843.2009.01637.x

Cited by 51 publications

(68 citation statements)

References 42 publications

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“…Several genera of important possible pathogens were detected by the 454 platform but were absent from the list obtained by the clinical method. According to our knowledge and published articles, Mycoplasma, Haemophilus, and Moraxella are referred to as atypical pathogens of pneumonia [5,[26][27][28]. Compared with clinical reports, these potential pathogens were only found sporadically by our method in sputum samples.…”

Section: This Indicates That Althoughmentioning

confidence: 88%

Analysis of the microbiota of sputum samples from patients with lower respiratory tract infections

Zhou¹,

Lin²,

Li³

et al. 2010

ABBS

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Sputum is the most common sample collected from patients suffering from lower respiratory tract infections and it is crucial for the bacterial identification of these infections. In this study, we enrolled 101 sputum samples from 101 patients with lower respiratory tract infections. Initially, pyrosequencing of the 16S rDNA V3 hypervariable regions of the bacteria contained in the sputum was utilized as a culture-independent approach for microbiota analysis. For comparison, clinical laboratory tests using a culture-dependent automated bacterial identification system for the same cohort of sputum samples were also done. By pyrosequencing, >70,000 DNA fragments were found and classified into 129 bacterial genera after being analyzed by the Ribosomal Database Project (RDP) process. Most sequences belonged to several predominant genera, such as Streptococcus and Staphylococcus, indicating that these genera play an important role in lower respiratory tract infections. In addition, some sequences belonging to potential causative agents, such as Mycoplasma, Haemophilus, and Moraxella, were also found, but these sequences were not found by clinical laboratory tests. For the nine genera detected by both methods, the methods' sensitivities were compared and the results showed that pyrosequencing was more sensitive, except for Klebsiella and Mycobacterium. Significantly, this method revealed much more complicated bacterial communities and it showed a promising ability for the detection of bacteria.

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Section: This Indicates That Althoughmentioning

confidence: 88%

Analysis of the microbiota of sputum samples from patients with lower respiratory tract infections

Zhou¹,

Lin²,

Li³

et al. 2010

ABBS

View full text Add to dashboard Cite

show abstract

“…In China, viral pathogens were identified as adenovirus, influenza virus B, respiratory syncytial virus and influenza virus A in 16, 12, 3 and 5 CAP patients, respectively [44]. In Hong Kong, viral pathogens were identified in 126 (10.6%) of 1193 CAP patients, including influenza virus in 8.5% [60].…”

Section: Endemic Community-acquired Pneumonia Pathogensmentioning

confidence: 99%

“…In Hong Kong, a single-centre prospective observational study was conducted in adults admitted to hospital over an 18-month period in 2004-2005 [60]. Of the patients with aetiological diagnoses, 28.6% had infections with atypical pathogens.…”

Section: Pathogenmentioning

confidence: 99%

Clinical and economic burden of community-acquired pneumonia amongst adults in the Asia-Pacific region

Song

Thamlikitkul

Hsueh

2011

International Journal of Antimicrobial Agents

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“…The study by Arnold et al [16] showed that the incidence of CAP due C. pneumoniae from 4337 patients was 8 % in North America, 7 % in Europe, 6 % in Latin America, and 5 % in Asia. Lui et al [37], in a prospective observational study of hospitalized patients with CAP, reported that 29 % of cases with defined etiology were caused by intracellular pathogens; of these, 35 % were classified as PSI IV-V, 5 % of these cases needed ICU admission, and the mortality rate was 2.2 % in the atypical group. A study from Thailand on severe CAP reported that the incidence of C. pneumoniae pneumonias was 3-23 cases per 100,000 population; the highest rates were among patients aged under 1 year (18-166 cases per 100,000) and those aged 70 years or over (23-201 cases per 100,000) [38].…”

Section: Chlamydophila Pneumoniae and Chlamydophila Psittacimentioning

confidence: 99%

Community-acquired pneumonia related to intracellular pathogens

Cillóniz¹,

Niederman

Eerden

et al. 2016

Intensive Care Med

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Community-acquired pneumonia (CAP) is associated with high rates of morbidity and mortality worldwide; the annual incidence of CAP among adults in Europe has ranged from 1.5 to 1.7 per 1000 population. Intracellular bacteria are common causes of CAP. However, there is considerable variation in the reported incidence between countries and change over time. The intracellular pathogens that are well established as causes of pneumonia are Legionella pneumophila, Mycoplasma pneumoniae, Chlamydophila pneumoniae, Chlamydophila psittaci, and Coxiella burnetii. Since it is known that antibiotic treatment for severe CAP is empiric and includes coverage of typical and atypical pathogens, microbiological diagnosis bears an important relationship to prognosis of pneumonia. Factors such as adequacy of initial antibiotic or early de-escalation of therapy are important variables associated with outcomes, especially in severe cases. Intracellular pathogens sometimes appear to cause more severe disease with respiratory failure and multisystem dysfunction associated with fatal outcomes. The clinical relevance of intracellular pathogens in severe CAP has not been specifically investigated. We review the prevalence, general characteristics, and outcomes of severe CAP cases caused by intracellular pathogens.

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Role of ‘atypical pathogens’ among adult hospitalized patients with community‐acquired pneumonia

Abstract: ABSTRACT; non-invasive ventilation 3.7% vs 3.3%; admission to the intensive care unit 4.5% vs 2.7%; length of hospitalization 6 day vs 7 day; 30-day mortality: 2.2% vs 6.0%; overall P > 0.05). Age <65 years, female gender, fever Ն38.0°C, respiratory

Cited by 51 publications

References 42 publications

Analysis of the microbiota of sputum samples from patients with lower respiratory tract infections

Analysis of the microbiota of sputum samples from patients with lower respiratory tract infections

Clinical and economic burden of community-acquired pneumonia amongst adults in the Asia-Pacific region

Community-acquired pneumonia related to intracellular pathogens

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