Chest
Clinical InvestigationsA Prospective Study of Community-Acquired Pneumonia in Hong Kong
Section snippets
Patients
Between January 1, 1988 and December 31, 1988, all cases of community-acquired pneumonia in adults requiring admission to the Prince of Wales Hospital were considered for inclusion in the study. All patients had clinical features of acute lower respiratory tract infection and radiologic evidence of consolidation or shadowing suggestive of infection. The following were criteria for exclusion: (1) pneumonia distal to a bronchial obstruction due to a foreign body or carcinoma; (2) patients with
RESULTS
Forty-five definite or probable infective agents were detected in 37 patients (41 percent) (Table 1).
The bacterial pathogen most commonly identified was Streptococcus pneumoniae (11 patients). The diagnosis of pneumococcal infection was definite in four patients: one had a positive blood culture (the only positive blood culture in the whole study), and pneumococcal antigen was detected in the urine of three others. The diagnosis of pneumococcal infection was probable in seven patients: the
DISCUSSION
In this study, we were able to identify the pathogenic organism in 37 patients only (41 percent). This is lower than that reported in other countries with results ranging from 49 percent to 97 percent.3, 4 The percentage of pneumococcal pneumonia in our group of patients was 12.2 percent. This was much lower than studies from other countries that revealed S pneumoniae as the pathogen in 15 to 76 percent of cases.1, 2, 4, 5, 6, 7 The only exception was a report from the United Kingdom that
ACKNOWLEDGMENTS
We would like to thank the Microbiology Department of the Prince of Wales Hospital for technical support for this study.
REFERENCES (17)
- et al.
Hospital study of adult community-acquired pneumonia
Lancet
(1982) - et al.
Community-acquired pneumonia: importance of initial noninvasive bacteriologic and radiographic investigations
Chest
(1988) - et al.
Deaths occurring in newly notified patients with pulmonary tuberculosis in England and Wales
Br J Dis Chest
(1984) - et al.
A survey of deaths in Hong Kong attributed to tuberculosis
Tubercle
(1981) Chlamydia pneumoniae, strain TWAR
Chest
(1989)- et al.
Epidemiology of Mycoplasma pneumoniae infection in the British Isles 1974-9
J Infect
(1980) - British Thoracic Society Research Committee. Community-acquired pneumonia in adults at British hospitals in 1982-1983:...
- et al.
Adult pneumonia in a general hospital
Arch Intern Med
(1972)
Cited by (62)
Diagnostic value of the neutrophil lymphocyte ratio in discrimination between tuberculosis and bacterial community acquired pneumonia: A meta-analysis
2023, Journal of Clinical Tuberculosis and Other Mycobacterial DiseasesEtiology and epidemiology of community-acquired pneumonia in adults requiring hospital admission: A prospective study in rural Central Philippines
2019, International Journal of Infectious DiseasesCitation Excerpt :In this study, younger adults aged 14–49 years had a higher proportion of M. tuberculosis infection than elderly patients aged ≥65 years (16% vs. 2%, p < 0.001). Compared to CAP patients in the USA and Europe, a distinguishing feature of adult pneumonia in low and middle-income countries in Asia is the higher proportion of cases with PTB presenting as CAP requiring hospital admission (Chan et al., 1992; Liam et al., 2006; Garg et al., 2015). M. tuberculosis should be considered an important risk factor for CAP in areas where TB is endemic (Luna et al., 2000; Miller et al., 2000).
First epidemiologic data on pneumonia in Cambodia
2014, Revue de Pneumologie CliniqueClinical and economic burden of community-acquired pneumonia amongst adults in the Asia-Pacific region
2011, International Journal of Antimicrobial AgentsCitation Excerpt :The burden of CAP amongst adults in the Asia-Pacific region may be underestimated owing to self-treatment with antibiotics where they are available over the counter [10,11], poor accessibility to and high costs of diagnostic testing [12], lack of surveillance programmes (especially in rural areas), and the practice of treating empirically versus obtaining a definitive diagnosis [13–15]. Practical difficulties (lack of a productive cough and administering antibiotics before obtaining cultures) may leave the aetiological pathogen unidentified [11,16,17]. Limitations on the sensitivity of diagnostic tests may also contribute to this problem.
A one-year prospective study of infectious etiology in patients hospitalized with acute exacerbations of COPD and concomitant pneumonia
2008, Respiratory MedicineCitation Excerpt :Comparison of the infectious etiology of pneumonia in subjects with and without COPD was not available as we had not collected the clinical data and respiratory specimens from subjects with pneumonia but without COPD in this current study. An early study of CAP in 90 subjects (13% with chronic bronchitis) in Hong Kong in 1988 found that 41% had identifiable etiologies but there was no comparison between subjects with and without COPD.29 Their etiologies appeared different from ours, with S. pneumoniae and Mycobacterium tuberculosis (each 12.2%) as the commonest organisms.
Definition of low respiratory tract infections
2006, Medecine et Maladies Infectieuses