Chest ACCP Education Calendar
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Guest Access | Sign In via User Name/Password
doi:10.1378/chest.06-1800
(Chest. 2007; 131:779-787)
© 2007 American College of Chest Physicians
This Article
Right arrow Full Text Free
Right arrow Full Text (PDF) Free
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Article Archive
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via ISI Web of Science (9)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Díaz, A.
Right arrow Articles by Saldias, F.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Díaz, A.
Right arrow Articles by Saldias, F.

Etiology of Community-Acquired Pneumonia in Hospitalized Patients in Chile*

The Increasing Prevalence of Respiratory Viruses Among Classic Pathogens

Alejandro Díaz, MD; Paulina Barria, MD; Michael Niederman, MD, FCCP; Marcos I. Restrepo, MD, MSc; Jorge Dreyse; Gino Fuentes; Bernardita Couble and Fernando Saldias, MD

* From the Departamento de Enfermedades Respiratorias (Drs. Díaz, Barria, and Saldias, Mr. Dreyse, Mr. Fuentes, and Ms. Couble), Pontificia Universidad Católica de Chile, Santiago, Chile; the Department of Medicine (Dr. Niederman), Winthrop University Hospital, Mineola, NY; and the Department of Medicine (Dr. Restrepo), Division of Pulmonary/Critical Care Medicine, and Infectious Diseases, South Texas Veterans Health Care System, San Antonio, TX.

Correspondence to: Alejandro Díaz, MD, 20 Bonner Ave, Somerville, MA 02143; e-mail: alediazf{at}hotmail.com

Abstract

Background and study objectives: The range and relative impact of microbial pathogens, particularly viral pathogens, as a cause of community-acquired pneumonia (CAP) in hospitalized adults has not received much attention. The aim of this study was to determine the microbial etiology of CAP in adults and to identify the risk factors for various specific pathogens.

Methods: We prospectively studied 176 patients (mean [± SD] age, 65.8 ± 18.5 years) who had hospitalized for CAP to identify the microbial etiology. For each patient, sputum and blood cultures were obtained as well as serology testing for Mycoplasma pneumoniae and Chlamydophila pneumoniae, urinary antigen testing for Legionella pneumophila and Streptococcus pneumoniae, and a nasopharyngeal swab for seven respiratory viruses.

Results: Microbial etiology was determined in 98 patients (55%). S pneumoniae (49 of 98 patients; 50%) and respiratory viruses (32%) were the most frequently isolated pathogen groups. Pneumococcal pneumonia was associated with tobacco smoking of > 10 pack-years (odds ratio [OR], 2.6; 95% confidence interval [CI], 1.2 to 5.4; p = 0.01). Respiratory viruses were isolated more often in fall or winter (28%; p = 0.011), and as an exclusive etiology tended to be isolated in patients ≥ 65 years of age (20%; p = 0.07). Viral CAP was associated with antimicrobial therapy prior to hospital admission (OR, 4.5; 95% CI, 1.4 to 14.6).

Conclusions: S pneumoniae remains the most frequent pathogen in adults with CAP and should be covered with empirical antimicrobial treatment. Viruses were the second most common etiologic agent and should be tested for, especially in fall or winter, both in young and elderly patients who are hospitalized with CAP.

Key Words: bacterial pneumonia • community • etiology • viruses






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2007 by the American College of Chest Physicians.