J Korean Med Sci.  2006 Aug;21(4):602-607. 10.3346/jkms.2006.21.4.602.

Atypical Pathogens as Etiologic Agents in Hospitalized Patients with Community-Acquired Pneumonia in Korea: A Prospective Multi-Center Study

• Sohn JW
• Park SC
• Choi YH
• Woo HJ
• Cho YK
• Lee JS
• Sim HS
• Kim MJ

• KMID: 2157808
• DOI: http://doi.org/10.3346/jkms.2006.21.4.602

Abstract

Local epidemiologic data on the etiologies of patients hospitalized with community-acquired pneumonia (CAP) is needed to develop guidelines for clinical practice. This study was conducted prospectively to determine the proportion of atypical bacterial pathogens in adults patients hospitalized with CAP in Korea between October 2001 and December 2002. Microbiological diagnosis was determined by serology for antibodies to Mycoplasma pneumoniae, Chlamydia pneumoniae, and Legionella pneu-mophila. Nucleic acid of M. pneumoniae and C. pneumoniae in respiratory samples and Legionella antigen in urine samples were detected. The study population consisted of 126 patients (71 males, 55 females), averaging 54.6 yr (SD+/-17.8), whose paired sera were available. An etiologic diagnosis for atypical pathogens was made in 18 patients (14.3%): C. pneumoniae 9 (7.1%), M. pneumoniae 8 (6.3%), and L. pneumophila 3 patients (2.4%). Streptococcus preumoniae and other typical pathogens were isolated from 36 patients (28.6%). Of 126 patients, 16 (12.7%) were admitted to intensive care unit and atypical pathogens were identified in 5 patients (31.3%). Initial clinical features of patients with pneumonia due to atypical, typical or undetermined pathogens were indistinguishable. We conclude that atypical pathogens should be seriously considered in hospitalized patients with CAP, when initiating empiric treatment in Korea.

Keyword

Chlamydophila pneumoniae; Mycoplasma pneumoniae; Legionella pneumophila; Community-Acquired Infections; Pneumonia

MeSH Terms

RNA, Ribosomal, 16S/genetics
Prospective Studies
Polymerase Chain Reaction
Pneumonia, Bacterial/blood/*microbiology/urine
Mycoplasma pneumoniae/genetics/immunology/*isolation & purification
Middle Aged
Male
Legionella pneumophila/genetics/immunology/*isolation & purification
Korea
Humans
Hospitalization/statistics & numerical data
Female
Community-Acquired Infections/microbiology
Chlamydophila pneumoniae/genetics/immunology/*isolation & purification
Antigens, Bacterial/urine
Antibodies, Bacterial/blood
Aged
Adult

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