Cdc etiology of pneumonia in the community epic study was a prospective, multicenter, pop. Communityacquired pneumonia is the most common type of pneumonia. The etiology of pneumonia in the community epic study conducted by cdc and three u. Typically characterized by a new lung infiltrate on chest xray, together with one or more of the following. In patients who are clinically improving after initiation of broadspectrum empiric therapy, knowing the etiology may allow streamlining the regimen with therapy directed to the. Communityacquired pneumonia causes great mortality and morbidity and high costs worldwide. This article covers communityacquired pneumonia cap. Etiology of community acquired pneumonia full text view.
Most community acquired pneumonia cap are bacterial in origin and often follow brief viral upper respiratory tract infection. Etiology of communityacquired pneumonia in a population. In upright position lower lobes are best ventilated therefore deposition of inhaled micro organisms is higher in these lobes. Microbial etiology of community acquired pneumonia cap 2. Pediatric communityacquired pneumonia academic dissertation to be presented, with the permission of the faculty of medicine of the university of tampere, for public discussion in the auditorium of finnmedi 1, biokatu 6, tampere, on august 21st, 2009, at 12 oclock. Backgroundsince the last british study of the microbial aetiology of community acquired pneumonia cap about 20 years ago, new organisms have been identified for example, chlamydia pneumoniae, new antibiotics introduced, and fresh advances made in microbiological techniques. The most commonly identified pathogens are streptococcus pneumoniae, haemophilus influenzae, atypical bacteria ie, chlamydia pneumoniae, mycoplasma pneumoniae, legionella species, and viruses. Regular microbial investigation included examination of sputum. This article covers community acquired pneumonia cap. Google scholar see all references however, prospective studies on the etiology of cap among the japanese population have been very limited, and only the etiology of cap has been investigated by ishida et al december 1998. It is estimated that 4 million cases of communityacquired pneumonia occur annually in the united states, of which. Communityacquired pneumonia etiology bmj best practice.
Overall, 395 consecutive patients with cap were studied prospectively during a 15mo period. The etiology of communityacquired pneumonia and the role of normal respiratory flora. Pneumonia is a breathing respiratory condition in which there is an infection of the lung. Overview and objectives of the etiology of pneumonia in the community epic study. Pdf etiology of communityacquired pneumonia mauricio. Communityacquired pneumonia cap has a major impact on public health and results in more than 10 million visits to physicians and 600,000 hospitalizations each year in the usa 1, where it is. Transtracheal aspiration tta could be performed on 119 patients, blood cultures. The microbial etiology of communityacquired pneumonia cap is still not well characterized. Pathogens implicated in cap in adults admitted to hospital in the uk using modern and traditional microbiological. The importance of defining the etiology of communityacquired pneumonia. Childhood community acquired pneumonia cap is a significant problem in developing countries, and confirmation of microbial etiology is important for individual, as well as public health. Community acquired pneumonia infectious disease and.
Etiology of childhood community acquired pneumonia and its. Furthermore, the majority of pneumonia etiologic studies are based on hospitalized patients, whereas there have been no recent populationbased studies encompassing. Nascimentocarvalho department of pediatrics, faculty of medicine, federal university of bahia, salvador, bahia, brazil pneumonia is an important cause of morbidity and mortality among children throughout the world. The epic study was a prospective, multicenter, populationbased, active surveillance study. Communityacquired pneumonia is defined as pneumonia that is acquired outside the hospital. Communityacquired pneumonia pulmonary disorders msd. This fact brings up the link between etiology of cap and its clinical evolution and outcome. Etiology of communityacquired pneumonia evaluation by transtracheal aspiration, blood culture, or serology lars jstergaard, m. Etiology and treatment of communityacquired pneumonia in. Cap may be caused by bacteria, viruses, and fungi yeasts. Etiology of childhood community acquired pneumonia and its implications for vaccination cristiana m. Communityacquired pneumonia cap is defined as an acute infection of the pulmonary parenchyma in a patient who has acquired the infection in the community, as distinguished from hospitalacquired nosocomial pneumonia. Communityacquired pneumonia cap is caused by bacterial, viral, fungal, or zoonotic organisms that produce mild to severe illness in people of all ages. University of tampere a serologic study on etiology, with special focus.
Although diameter of most bacteria is 1 m or more, mycoplasma, chlamydophila, and coxiella are 5 to 100 times smaller. The etiology of communityacquired pneumonia among children under 5 years of age in mainland china, 20012015. Communityacquired pneumonia in infants and children. Etiology of communityacquired pneumonia in hospitalized patients. Diagnosing cap based on clinical presentation and chest xray findings can help guide empiric treatment with.
Support for this program is provided by abbott the information presented is consistent with applicable fdaguidelines. Volume 12, issue 3, 1 september 1998, pages 723740. Hospitalacquired pneumonia etiology bmj best practice. The microbial patterns reported have differed considerably, depending on the epidemiologic area studied, the patient population included, and the extent and nature of the microbiologic techniques used. This article on the epidemiology and etiology of communityacquired pneumonia should be read in the context of other articles in this issue. Daniel musher md distinguished service professor of medicine molecular virology and microbiology baylor college of medicine disclosures. Epidemiology in 20, the global burden of disease study based on data from 188 countries around the world, reported that lower respiratory tract infection was the second most common cause of death 4. This type of pneumonia is found in people who have not recently been in the hospital or another health care facility such as a nursing home or rehab facility. The proposed study aims to provide current information, etiology and outcome of communityacquired pneumonia cap, risk factors for for cap in isolates of streptococcus pneumoniae and haemophilus influencae, mycoplasma pneumoniae, chlamydia pneumoniae and legionella.
It occurs outside of hospitals or other health care facilities. Ruiz m, ewig s, marcos ma, martinez ja, arancibia f, mensa j, torres a. Moreover, the role of viruses in hospitalacquired pneumonia and ventilatorassociated pneumonia as causative agents or as copathogens and the effect of virus detection. Infection of the pulmonary parenchyma or lower respiratory tract in a communitydwelling patient not at risk for healthcareassociated pneumonia hcap. Specifically, contemporary estimates of the incidence and etiology of communityacquired pneumonia hospitalizations based on prospectively collected data are needed.
The clinical presentation of cap varies, ranging from mild pneumonia characterized by fever and productive cough to severe pneumonia characterized by respiratory distress and sepsis. Study of community acquired pneumonia aetiology scapa in. Symptoms and signs are fever, cough, sputum production, pleuritic chest pain, dyspnea, tachypnea. Ambulatory patients with pneumonia were identified at the childrens medical center of. A fiveyear study of severe communityacquired pneumonia with emphasis on prognosis in patients admitted to an intensive care unit.
To reduce the misuse of antibiotics, antibiotic resistance, and sideeffects, an empirical, effective, and individualised antibiotic treatment is needed. Infectious diseases society of americaamerican thoracic. Bacteria cause most cases of hap and ventilatorassociated pneumonia vap, especially aerobic gramnegative bacilli such as pseudomonas aeruginosa, escherichia coli, klebsiella pneumoniae, and acinetobacter species. The etiologic profile of communityacquired pneumonia cap for each age group could be similar among inpatients and outpatients.
It is estimated that 4 million cases of community acquired pneumonia occur annually in the united states, of which. Etiology of communityacquired pneumonia springerlink. Communityacquired pneumonia cap is a serious lower respiratory tract infection associated with significant morbidity and mortality that is characterized by disputes over diagnostic evaluations. During the past few years, polymerase chain reaction pcrbased methods have been developed for many pathogens causing respiratory tract infections. The initial choice of antibiotic is made empirically.
Communityacquired pneumonia is one of the most common serious infections in children, with an annual incidence of 34 to 40 cases per 1,000 children in europe and north america. Defining the etiology of pneumonia may have significant implications for patient management. The germs are easily spread from an infected person to others by coughing, sneezing, or close contact. Pneumonia is classified according to the types of germs that cause it and where you got the infection. Etiology of communityacquired pneumonia in a populationbased study link between etiology and patients characteristics, processofcare, clinical evolution and outcomes. Before antibiotics, pneumonia was the thirdleading cause of death in the country, as this cover of a 1937 u. S46, with additional informa tion from references 9 through 11. Pathogens implicated in cap in adults admitted to hospital in the uk using modern and traditional microbiological investigations are described. Over the last three decades, successful pneumococcal and haemophilus influenzae type b vaccination has markedly reduced the burden of disease associated with these pathogens, including that associated with pneumonia. Communityacquired pneumonia requiring hospitalization. Community acquired pneumonia ambulatory care what you. The aim of this study was to determine the etiology of communityacquired pneumonia cap and the impact of age, comorbidity, and severity on microbial etiologies of such pneumonia.
To determine the etiology of communityacquired pneumonia in ambulatory children and to compare responses to treatment with azithromycin, amoxicillinclavulanate or erythromycin estolate. Empirical selection of antibiotic treatment is the cornerstone of management of patients with pneumonia. The etiology of adult communityacquired pneumonia cap has been under constant study in different local settings during the past decade. The aim of this study was to determine the etiology of cap among adultsespecially. Clinical features, etiology, and outcomes of communityacquired pneumonia in patients with diabetes mellitus. Infectious diseases society of americaamerican thoracic society consensus guidelines on the management of communityacquired pneumonia in adults lionel a. Order a chest xray in all patients with suspected communityacquired pneumonia cap who are admitte. However, there is paucity of data from a large cohort, examining multiple biological specimens for diverse pathogens bacteria and viruses. In addition to methicillinsensitive staphylococcus aureus mssa, both hospitalacquired and communityacquired strains of mrsa are causing an increasing number of hap cases. Viral pneumonia in adults could present as communityacquired pneumonia cap, ranging from mild disease to severe disease requiring hospital admission and mechanical ventilation. Introduction communityacquired pneumonia cap is a leading cause of morbidity and mortality worldwide. Cap etiology is changing owing to the recognized importance of viruses, pneumococcal and in. In a 5year period, 254 patients with communityacquired pneumonia were attended to.
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