Document Detail


Epidemiology of severe pneumonia caused by Legionella longbeachae, Mycoplasma pneumoniae, and Chlamydia pneumoniae: 1-year, population-based surveillance for severe pneumonia in Thailand.
MedLine Citation:
PMID:  18190309     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Legionella species, Mycoplasma pneumoniae, and Chlamydia pneumoniae are recognized as important causes of pneumonia in high-income countries, but their significance in middle-income countries, such as Thailand, is unknown. METHODS: Population-based surveillance identified inpatient 3489 cases of clinically-defined pneumonia in a rural Thai province for 1 year. Patients who had a chest radiograph performed (for 2059 cases of pneumonia) were enrolled in an etiology study (which included 755 cases of pneumonia among 738 patients). Paired serum, nasopharyngeal swab, and urine specimens were obtained for diagnostic immunologic and molecular tests. Patients aged <18 years were not systematically tested for Legionella species. We report a lower limit of incidence (observed incidence) and an upper limit extrapolated to persons not tested or not enrolled in the study. RESULTS: The incidence of pneumonia due to Legionella longbeachae requiring hospitalization was 5-29 cases per 100,000 population. No case of Legionella pneumophila pneumonia was observed. The definite C. pneumoniae pneumonia incidence was 3-23 cases per 100,000 population; rates were highest among patients aged <1 year (18-166 cases per 100,000 population) and those aged >or=70 years (23-201 cases per 100,000 population). M. pneumoniae pneumonia had a similar age distribution, with an overall incidence of 6-44 cases per 100,000 population. These pathogens were associated with 15% of all cases of pneumonia. A nonsignificantly higher proportion of patients with pneumonia associated with L. longbeachae, compared with patients with pneumonia associated with M. pneumoniae or C. pneumoniae, required supplemental oxygen or mechanical ventilation (45% vs. 18%; P<.1). Among patients with atypical pneumonia, only 15% received antibiotics with activity against the associated pathogen. CONCLUSION: M. pneumoniae, C. pneumoniae, and L. longbeachae, but not L. pneumophila, are frequently associated with severe pneumonia in rural Thailand. Few patients receive antibiotics that cover atypical pathogens.
Authors:
Christina R Phares; Piyada Wangroongsarb; Somrak Chantra; Wantana Paveenkitiporn; Maria-Lucia Tondella; Robert F Benson; W Lanier Thacker; Barry S Fields; Matthew R Moore; Julie Fischer; Scott F Dowell; Sonja J Olsen
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Clinical infectious diseases : an official publication of the Infectious Diseases Society of America     Volume:  45     ISSN:  1537-6591     ISO Abbreviation:  Clin. Infect. Dis.     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2008-01-14     Completed Date:  2008-03-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9203213     Medline TA:  Clin Infect Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e147-55     Citation Subset:  IM    
Affiliation:
Epidemic Intelligence Service Program, Office of Workforce and Career Development, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. CPhares@cdc.gov
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Aged
Child, Preschool
Chlamydophila Infections / epidemiology,  microbiology
Chlamydophila pneumoniae*
Female
Humans
Incidence
Infant
Infant, Newborn
Legionella longbeachae*
Legionellosis / epidemiology,  microbiology
Male
Middle Aged
Mycoplasma pneumoniae*
Pneumonia, Bacterial / complications,  epidemiology*,  microbiology
Pneumonia, Mycoplasma / epidemiology,  microbiology
Population Surveillance*
Sex Factors
Thailand / epidemiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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