A prospective etiologic study of community-acquired pneumonia in Taiwan

Muh Yong Yen, Bor Shen Hu, Yao Shen Chen, Susan Shin Jung Lee, Yu Sen E Lin, Shue Ren Wann, Hung Chin Tsai, Hsi Hsun Lin, Chun Kai Huang, Yung Ching Liu

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Background and Purpose: The treatment of community-acquired pneumonia (CAP) is complicated by the growing threat of antimicrobial resistance and the tendency to rely on empirical therapy. This study investigated the etiologic agents of adult CAP in Taiwan and the susceptibility of Streptococcus pneumoniae isolates from diese patients. Methods: A collaborative group was established in the emergency department to conduct a prospective study of the etiology of adult CAP. The etiologic agent was determined by a combination of microscopic, culture, serologic and antigen detection methods. Pneumococcal susceptibility testing was performed to determine the extent of penicillin resistance. Results: A total of 100 consecutive cases of mild to moderate adult CAP prior to the severe acute respiratory syndrome epidemic were enrolled. The etiologic agent was determined in 72% of cases. The 5 most common causative pathogens were S. pneumoniae (26%), Mycoplasma pneumoniae(20%), Chlamydiapneumoniae (13%), Haemophilus influenzae(9%), and Klebsiella pneumoniae (5%). Atypical pathogens accounted for 40% of CAP. Bacteremic pneumonia was diagnosed in 6.2% of cases. Co-infections with 2 or more pathogens were found in 16% of the cases. Among the 20 isolates of S. pneumoniae, 85% (17/20) were susceptible to penicillin, 3 (15%) were intermediate, and none were resistant to penicillin. Conclusion: S. pneumoniae, M. pneumoniae and C. pneumoniae were the 3 leading causes of mild to moderate CAP in Taiwan. This study indicates that penicillin-resistant S. pneumoniae play a very limited role in this condition in adults.

Original languageEnglish
Pages (from-to)724-730
Number of pages7
JournalJournal of the Formosan Medical Association = Taiwan yi zhi
Volume104
Issue number10
Publication statusPublished - 2005
Externally publishedYes

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Taiwan
Pneumonia
Prospective Studies
Streptococcus pneumoniae
Penicillins
Mycoplasma pneumoniae
Penicillin Resistance
Severe Acute Respiratory Syndrome
Haemophilus influenzae
Klebsiella pneumoniae
Coinfection
Hospital Emergency Service
Antigens
Therapeutics

Keywords

  • Community-acquired infections
  • Pneumonia, bacterial
  • Streptococcus pneumoniae, Taiwan

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Yen, M. Y., Hu, B. S., Chen, Y. S., Lee, S. S. J., Lin, Y. S. E., Wann, S. R., ... Liu, Y. C. (2005). A prospective etiologic study of community-acquired pneumonia in Taiwan. Journal of the Formosan Medical Association = Taiwan yi zhi, 104(10), 724-730.

A prospective etiologic study of community-acquired pneumonia in Taiwan. / Yen, Muh Yong; Hu, Bor Shen; Chen, Yao Shen; Lee, Susan Shin Jung; Lin, Yu Sen E; Wann, Shue Ren; Tsai, Hung Chin; Lin, Hsi Hsun; Huang, Chun Kai; Liu, Yung Ching.

In: Journal of the Formosan Medical Association = Taiwan yi zhi, Vol. 104, No. 10, 2005, p. 724-730.

Research output: Contribution to journalArticle

Yen, MY, Hu, BS, Chen, YS, Lee, SSJ, Lin, YSE, Wann, SR, Tsai, HC, Lin, HH, Huang, CK & Liu, YC 2005, 'A prospective etiologic study of community-acquired pneumonia in Taiwan', Journal of the Formosan Medical Association = Taiwan yi zhi, vol. 104, no. 10, pp. 724-730.
Yen, Muh Yong ; Hu, Bor Shen ; Chen, Yao Shen ; Lee, Susan Shin Jung ; Lin, Yu Sen E ; Wann, Shue Ren ; Tsai, Hung Chin ; Lin, Hsi Hsun ; Huang, Chun Kai ; Liu, Yung Ching. / A prospective etiologic study of community-acquired pneumonia in Taiwan. In: Journal of the Formosan Medical Association = Taiwan yi zhi. 2005 ; Vol. 104, No. 10. pp. 724-730.
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abstract = "Background and Purpose: The treatment of community-acquired pneumonia (CAP) is complicated by the growing threat of antimicrobial resistance and the tendency to rely on empirical therapy. This study investigated the etiologic agents of adult CAP in Taiwan and the susceptibility of Streptococcus pneumoniae isolates from diese patients. Methods: A collaborative group was established in the emergency department to conduct a prospective study of the etiology of adult CAP. The etiologic agent was determined by a combination of microscopic, culture, serologic and antigen detection methods. Pneumococcal susceptibility testing was performed to determine the extent of penicillin resistance. Results: A total of 100 consecutive cases of mild to moderate adult CAP prior to the severe acute respiratory syndrome epidemic were enrolled. The etiologic agent was determined in 72{\%} of cases. The 5 most common causative pathogens were S. pneumoniae (26{\%}), Mycoplasma pneumoniae(20{\%}), Chlamydiapneumoniae (13{\%}), Haemophilus influenzae(9{\%}), and Klebsiella pneumoniae (5{\%}). Atypical pathogens accounted for 40{\%} of CAP. Bacteremic pneumonia was diagnosed in 6.2{\%} of cases. Co-infections with 2 or more pathogens were found in 16{\%} of the cases. Among the 20 isolates of S. pneumoniae, 85{\%} (17/20) were susceptible to penicillin, 3 (15{\%}) were intermediate, and none were resistant to penicillin. Conclusion: S. pneumoniae, M. pneumoniae and C. pneumoniae were the 3 leading causes of mild to moderate CAP in Taiwan. This study indicates that penicillin-resistant S. pneumoniae play a very limited role in this condition in adults.",
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AU - Wann, Shue Ren

AU - Tsai, Hung Chin

AU - Lin, Hsi Hsun

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AU - Liu, Yung Ching

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AB - Background and Purpose: The treatment of community-acquired pneumonia (CAP) is complicated by the growing threat of antimicrobial resistance and the tendency to rely on empirical therapy. This study investigated the etiologic agents of adult CAP in Taiwan and the susceptibility of Streptococcus pneumoniae isolates from diese patients. Methods: A collaborative group was established in the emergency department to conduct a prospective study of the etiology of adult CAP. The etiologic agent was determined by a combination of microscopic, culture, serologic and antigen detection methods. Pneumococcal susceptibility testing was performed to determine the extent of penicillin resistance. Results: A total of 100 consecutive cases of mild to moderate adult CAP prior to the severe acute respiratory syndrome epidemic were enrolled. The etiologic agent was determined in 72% of cases. The 5 most common causative pathogens were S. pneumoniae (26%), Mycoplasma pneumoniae(20%), Chlamydiapneumoniae (13%), Haemophilus influenzae(9%), and Klebsiella pneumoniae (5%). Atypical pathogens accounted for 40% of CAP. Bacteremic pneumonia was diagnosed in 6.2% of cases. Co-infections with 2 or more pathogens were found in 16% of the cases. Among the 20 isolates of S. pneumoniae, 85% (17/20) were susceptible to penicillin, 3 (15%) were intermediate, and none were resistant to penicillin. Conclusion: S. pneumoniae, M. pneumoniae and C. pneumoniae were the 3 leading causes of mild to moderate CAP in Taiwan. This study indicates that penicillin-resistant S. pneumoniae play a very limited role in this condition in adults.

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