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doi:10.1016/j.ijantimicag.2007.09.014 
Copyright © 2007 Elsevier B.V. and the International Society of Chemotherapy All rights reserved.
Epidemiology and clinical outcomes of community-acquired pneumonia in adult patients in Asian countries: a prospective study by the Asian network for surveillance of resistant pathogens
Jae-Hoon Songa, b, 
, 
, , Won Sup Oha, Cheol-In Kanga, Doo Ryeon Chunga, Kyong Ran Pecka, Kwan Soo Kob, Joon Sup Yeomc, Choon Kwan Kimd, Shin Woo Kime, Hyun-Ha Change, Yeon-Sook Kimf, Sook-In Jungg, Zhaohui Tongh, Qingtao Wangh, Shao-Guang Huangi, Jien-Wei Liuj, M.K. Lalithak, Ban-Hock Tanl, Pham Hung Vanm, Celia C. Carlosn, Thomas Soo and on behalf of the Asian Network for Surveillance of Resistant Pathogens Study Group
Received 10 July 2007;
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Abstract
Appropriate antimicrobial treatment of community-acquired pneumonia (CAP) should be based on the distribution of aetiological pathogens, antimicrobial resistance of major pathogens, clinical characteristics and outcomes. We performed a prospective observational study of 955 cases of adult CAP in 14 hospitals in eight Asian countries. Microbiological evaluation to determine etiological pathogens as well as clinical evaluation was performed. Bronchopulmonary disease (29.9%) was the most frequent underlying disease, followed by cardiovascular diseases (19.9%), malignancy (11.7%) and neurological disorder (8.2%). Streptococcus pneumoniae (29.2%) was the most common isolate, followed by Klebsiella pneumoniae (15.4%) and Haemophilus influenzae (15.1%). Serological tests were positive for Mycoplasma pneumoniae (11.0%) and Chlamydia pneumoniae (13.4%). Only 1.1% was positive for Legionella pneumophila by urinary antigen test. Of the pneumococcal isolates, 56.1% were resistant to erythromycin and 52.6% were not susceptible to penicillin. Seventeen percent of CAP had mixed infection, especially S. pneumoniae with C. pneumoniae. The overall mortality rate was 7.3%, and nursing home residence, mechanical ventilation, malignancy, cardiovascular diseases, respiratory rate > 30/min and hyponatraemia were significant independent risk factors for mortality by multivariate analysis (P < 0.05). The current data provide relevant information about pathogen distribution and antimicrobial resistance of major pathogens of CAP as well as clinical outcomes of illness in Asian countries.
Keywords: Community-acquired pneumonia; Aetiology; Epidemiology; Clinical outcome
Article Outline
- 1. Introduction
- 2. Materials and methods
- 2.1. Participating centres
- 2.2. Study population and design
- 2.3. Microbiological evaluation
- 2.4. Antimicrobial susceptibility tests
- 2.5. Statistical analysis
- 3. Results
- 3.1. Patient characteristics
- 3.2. Clinical manifestations
- 3.3. Aetiology of CAP
- 3.4. Antimicrobial susceptibility testing
- 3.5. Antimicrobial therapy
- 3.6. Clinical outcomes of CAP
- 4. Discussion
- References
