Etiology of community-acquired pneumonia in hospitalized patients in Chile

The increasing prevalence of respiratory viruses among classic pathogens

Alejandro Díaz, Paulina Barria, Michael Niederman, Marcos Restrepo, Jorge Dreyse, Gino Fuentes, Bernardita Couble, Fernando Saldias

Research output: Contribution to journalArticle

88 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)779-787
Number of pages9
JournalChest
Volume131
Issue number3
DOIs
StatePublished - Mar 2007
Externally publishedYes

Fingerprint

Chile
Pneumonia
Viruses
Odds Ratio
Confidence Intervals
Pneumococcal Pneumonia
Legionella pneumophila
Chlamydophila pneumoniae
Mycoplasma pneumoniae
Serology
Streptococcus pneumoniae
Sputum
Smoking
Antigens
Therapeutics

Keywords

  • Bacterial pneumonia
  • Community
  • Etiology
  • Viruses

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Etiology of community-acquired pneumonia in hospitalized patients in Chile : The increasing prevalence of respiratory viruses among classic pathogens. / Díaz, Alejandro; Barria, Paulina; Niederman, Michael; Restrepo, Marcos; Dreyse, Jorge; Fuentes, Gino; Couble, Bernardita; Saldias, Fernando.

In: Chest, Vol. 131, No. 3, 03.2007, p. 779-787.

Research output: Contribution to journalArticle

Díaz, Alejandro ; Barria, Paulina ; Niederman, Michael ; Restrepo, Marcos ; Dreyse, Jorge ; Fuentes, Gino ; Couble, Bernardita ; Saldias, Fernando. / Etiology of community-acquired pneumonia in hospitalized patients in Chile : The increasing prevalence of respiratory viruses among classic pathogens. In: Chest. 2007 ; Vol. 131, No. 3. pp. 779-787.
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AU - Restrepo, Marcos

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