Aetiological agents of adult community-acquired pneumonia in Japan : systematic review and meta-analysis of published data
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ..
OBJECTIVE: Epidemiological information is essential in providing appropriate empiric antimicrobial therapy for pneumonia. This study aimed to clarify the epidemiology of community-acquired pneumonia (CAP) by conducting a systematic review of published studies in Japan.
DESIGN: Systematic review.
DATA SOURCE: PubMed and Ichushi web database (January 1970 to October 2022).
ELIGIBILITY CRITERIA: Clinical studies describing pathogenic micro-organisms in CAP written in English or Japanese, excluding studies on pneumonia other than adult CAP, investigations limited to specific pathogens and case reports.
DATA EXTRACTION AND SYNTHESIS: Patient setting (inpatient vs outpatient), number of patients, concordance with the CAP guidelines, diagnostic criteria and methods for diagnosing pneumonia pathogens as well as the numbers of each isolate. A meta-analysis of various situations was performed to measure the frequency of each aetiological agent.
RESULTS: Fifty-six studies were included and 17 095 cases of CAP were identified. Pathogens were undetectable in 44.1% (95% CI 39.7% to 48.5%). Streptococcus pneumoniae was the most common cause of CAP requiring hospitalisation or outpatient care (20.0% (95% CI 17.2% to 22.8%)), followed by Haemophilus influenzae (10.8% (95% CI 7.3% to 14.3%)) and Mycoplasma pneumoniae (7.5% (95% CI 4.6% to 10.4%)). However, when limited to CAP requiring hospitalisation, Staphylococcus aureus was the third most common at 4.9% (95% CI 3.9% to 5.8%). Pseudomonas aeruginosa was more frequent in hospitalised cases, while atypical pathogens were less common. Methicillin-resistant S. aureus accounted for 40.7% (95% CI 29.0% to 52.4%) of S. aureus cases. In studies that used PCR testing for pan-respiratory viral pathogens, human enterovirus/human rhinovirus (9.4% (95% CI 0% to 20.5%)) and several other respiratory pathogenic viruses were detected. The epidemiology varied depending on the methodology and situation.
CONCLUSION: The epidemiology of CAP varies depending on the situation, such as in the hospital versus outpatient setting. Viruses are more frequently detected by exhaustive genetic searches, resulting in a significant variation in epidemiology.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:10 |
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| Enthalten in: |
BMJ open respiratory research - 10(2023), 1 vom: 26. Sept. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Fujikura, Yuji [VerfasserIn] |
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| Links: |
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| Themen: |
Bacterial infection |
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| Anmerkungen: |
Date Revised 03.10.2023 published: Print Citation Status Publisher |
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| doi: |
10.1136/bmjresp-2023-001800 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM362483248 |
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| 100 | 1 | |a Fujikura, Yuji |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Aetiological agents of adult community-acquired pneumonia in Japan |b systematic review and meta-analysis of published data |
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| 500 | |a Date Revised 03.10.2023 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. | ||
| 520 | |a OBJECTIVE: Epidemiological information is essential in providing appropriate empiric antimicrobial therapy for pneumonia. This study aimed to clarify the epidemiology of community-acquired pneumonia (CAP) by conducting a systematic review of published studies in Japan | ||
| 520 | |a DESIGN: Systematic review | ||
| 520 | |a DATA SOURCE: PubMed and Ichushi web database (January 1970 to October 2022) | ||
| 520 | |a ELIGIBILITY CRITERIA: Clinical studies describing pathogenic micro-organisms in CAP written in English or Japanese, excluding studies on pneumonia other than adult CAP, investigations limited to specific pathogens and case reports | ||
| 520 | |a DATA EXTRACTION AND SYNTHESIS: Patient setting (inpatient vs outpatient), number of patients, concordance with the CAP guidelines, diagnostic criteria and methods for diagnosing pneumonia pathogens as well as the numbers of each isolate. A meta-analysis of various situations was performed to measure the frequency of each aetiological agent | ||
| 520 | |a RESULTS: Fifty-six studies were included and 17 095 cases of CAP were identified. Pathogens were undetectable in 44.1% (95% CI 39.7% to 48.5%). Streptococcus pneumoniae was the most common cause of CAP requiring hospitalisation or outpatient care (20.0% (95% CI 17.2% to 22.8%)), followed by Haemophilus influenzae (10.8% (95% CI 7.3% to 14.3%)) and Mycoplasma pneumoniae (7.5% (95% CI 4.6% to 10.4%)). However, when limited to CAP requiring hospitalisation, Staphylococcus aureus was the third most common at 4.9% (95% CI 3.9% to 5.8%). Pseudomonas aeruginosa was more frequent in hospitalised cases, while atypical pathogens were less common. Methicillin-resistant S. aureus accounted for 40.7% (95% CI 29.0% to 52.4%) of S. aureus cases. In studies that used PCR testing for pan-respiratory viral pathogens, human enterovirus/human rhinovirus (9.4% (95% CI 0% to 20.5%)) and several other respiratory pathogenic viruses were detected. The epidemiology varied depending on the methodology and situation | ||
| 520 | |a CONCLUSION: The epidemiology of CAP varies depending on the situation, such as in the hospital versus outpatient setting. Viruses are more frequently detected by exhaustive genetic searches, resulting in a significant variation in epidemiology | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a bacterial infection | |
| 650 | 4 | |a pneumonia | |
| 650 | 4 | |a respiratory infection | |
| 650 | 4 | |a viral infection | |
| 700 | 1 | |a Somekawa, Kohei |e verfasserin |4 aut | |
| 700 | 1 | |a Manabe, Toshie |e verfasserin |4 aut | |
| 700 | 1 | |a Horita, Nobuyuki |e verfasserin |4 aut | |
| 700 | 1 | |a Takahashi, Hiroshi |e verfasserin |4 aut | |
| 700 | 1 | |a Higa, Futoshi |e verfasserin |4 aut | |
| 700 | 1 | |a Yatera, Kazuhiro |e verfasserin |4 aut | |
| 700 | 1 | |a Miyashita, Naoyuki |e verfasserin |4 aut | |
| 700 | 1 | |a Imamura, Yoshifumi |e verfasserin |4 aut | |
| 700 | 1 | |a Iwanaga, Naoki |e verfasserin |4 aut | |
| 700 | 1 | |a Mukae, Hiroshi |e verfasserin |4 aut | |
| 700 | 1 | |a Kawana, Akihiko |e verfasserin |4 aut | |
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