Etiology and antimicrobial resistance of community-acquired pneumonia in adult patients in China

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TAO Li-li(Department of Respiratory Medicine,Zhongshan Hospital,Fudan University,Shanghai 200032,China)
DENG Wei-wu(Department of Respiratory Medicine,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China)
HU Bi-jie(Department of Respiratory Medicine,Zhongshan Hospital,Fudan University,Shanghai 200032,China)
HE Li-xian(Department of Respiratory Medicine,Zhongshan Hospital,Fudan University,Shanghai 200032,China)
WEI Li(Department of Respiratory Medicine,Taishan Medical University Affiliated Hospital,Taian,Shandong 271000,China)
XIE Hong-mei(Department of Respiratory Medicine,Zhongshan Hospital,Fudan University,Shanghai 200032,China)
WANG Bao-qing(Department of Respiratory Medicine,Zhongshan Hospital,Fudan University,Shanghai 200032,China)
LI Hua-ying(Department of Respiratory Medicine,Zhongshan Hospital,Fudan University,Shanghai 200032,China)
CHEN Xue-hua(Department of Respiratory Medicine,Zhongshan Hospital,Fudan University,Shanghai 200032,China)
ZHOU Chun-mei(Department of Respiratory Medicine,Zhongshan Hospital,Fudan University,Shanghai 200032,China)
Journal Title:
Chinese Medical Journal
Volume 125, Issue 17, 2012
Key Word:
community-acquired infection; pneumonia; etiology; antimicrobial drug resistance; epidemiology

Abstract: Background Appropriate antimicrobial therapy of community-acquired pneumonia (CAP) is mainly based on the distribution of etiology and antimicrobial resistance of major pathogens.We performed a prospective observational study of adult with CAP in 36 hospitals in China.Methods Etiological pathogens were isolated in each of the centers,and all of the isolated pathogens were sent to Zhongshan Hospital for antimicrobial susceptibility tests using agar dilution.Results A total of 593 patients were enrolled in this study,and 242 strains of bacteria were isolated from 225 patients.Streptococcus pneumoniae (79/242,32.6%) was the most frequently isolated pathogen,followed by Haemophilus influenzae (55/242,22.7%) and Klebsiella pneumoniae (25/242,10.3%).Totally 527 patients underwent serological tests for atypical pathogens; Mycoplasma pneumoniae and Chlamydia pneumoniae infections were identified in 205 (38.9%)and 60 (11.4%) patients respectively.Legionella pneumophila infections were identified in 4.0% (13/324) of patients.The non-susceptibility rate of isolated Streptococcus pneumoniae to erythromycin and penicillin was 63.2% and 19.1%respectively.Six patients died from the disease,the 30-day mortality rate was 1.1% (6/533).Conclusions The top three bacteria responsible for CAP in Chinese adults were Streptococcus pneumonia,Haemophitus influenza and Klebsiella pneumonia.There was also a high prevalence of atypical pathogens and mixed pathogens.The resistance rates of the major isolated pathogens were relatively low except for the high prevalence of macrolide resistance in Streptococcus pneumoniae.

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