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Importance of atypical pathogens of community-acquired pneumonia

J F Plouffe1

  • 1Department of Internal Medicine, Ohio State University College of Medicine, Columbus, OH, USA. plouffe.1@osu.edu.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|September 13, 2000
PubMed

Insights

Community-acquired pneumonia (CAP) treatment should include atypical pathogens like Mycoplasma pneumoniae, Chlamydia pneumoniae, and Legionella. Early macrolide or fluoroquinolone therapy can reduce hospital mortality for these infections.

Area of Science:

  • Infectious Diseases
  • Pulmonology
  • Microbiology

Background:

  • Community-acquired pneumonia (CAP) can be caused by atypical pathogens, including Mycoplasma pneumoniae and Chlamydia pneumoniae, recognized over the past 50 years.
  • Legionella species, while presenting more acutely, share antimicrobial susceptibility patterns with M. pneumoniae and C. pneumoniae.
  • Atypical pathogens are susceptible to macrolides, tetracyclines, and fluoroquinolones.

Purpose of the Study:

  • To review the role of atypical pathogens in CAP.
  • To emphasize the importance of including atypical pathogen coverage in initial CAP therapy.
  • To highlight the need for improved diagnostic methods for atypical pathogens in future research.

Main Methods:

  • Literature review of studies on atypical pathogens causing CAP.
  • Analysis of antimicrobial susceptibility patterns.
  • Evaluation of treatment strategies and their impact on morbidity and mortality.

Main Results:

  • Recent data indicate that initial therapy for hospitalized pneumonia patients, particularly in the Medicare population, can decrease morbidity and mortality when it includes coverage for atypical pathogens.
  • Macrolides and fluoroquinolones are effective against this group of organisms.
  • Current diagnostic studies often lack culture methodology for detecting atypical pathogens.

Conclusions:

  • Initial antibiotic therapy for CAP should consider coverage for atypical pathogens, such as Mycoplasma pneumoniae, Chlamydia pneumoniae, and Legionella.
  • Future research investigating the efficacy of macrolide or fluoroquinolone therapy for CAP must incorporate comprehensive diagnostic studies for these atypical pathogens.

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