An Asian study on the prevalence of atypical respiratory pathogens in community-acquired pneumonia
Yun-Fong Ngeow1, Subharee Suwanjutha, Teerachai Chantarojanasriri
1University Malaya Medical Centre, Petaling Jaya, Malaysia. ngeowyf@ummc.edu.my
Background:
In many parts of Asia, the inaccessibility and high cost of diagnostic tests have hampered the study of community-acquired pneumonia (CAP) caused by atypical respiratory pathogens.
Objective:
This surveillance study examined the frequency of infection with Mycoplasma pneumoniae, Chlamydophila pneumoniae, and Legionella pneumophila in 1756 patients presenting with signs and symptoms of CAP at 12 medical centres in Asia, using standardised laboratory techniques and interpretation criteria in all participating centres.
Methods:
Diagnosis of current infection was based on significant changes in antibody titer or persisting high antibody titers, together with the presence of bacterial DNA in respiratory secretions, in the case of M. pneumoniae and C. pneumoniae infections, or bacterial antigen in urine, in the case of L. pneumophila serogroup 1 infection.
Results:
Using these criteria, results from 1374 patients with paired sera showed that, overall, 23.5% of CAP cases were associated with infection with atypical respiratory pathogens, with M. pneumoniae, C. pneumoniae, and L. pneumophila being found in 12.2%, 4.7%, and 6.6% of cases, respectively. Persisting high antibody titers indicative of past exposure to M. pneumoniae, C. pneumoniae, and L. pneumophila were seen in 10.2%, 4.8%, and 18.9% of patients, respectively.
Conclusion:
These data reflect the overall high prevalence of these atypical pathogens among Asian patients with CAP.
Insights
A study found that 23.5% of community-acquired pneumonia (CAP) cases in Asia were linked to atypical pathogens like Mycoplasma pneumoniae and Legionella pneumophila, highlighting their significant prevalence.
Area of Science:
- Infectious Diseases
- Microbiology
- Public Health
Background:
- Atypical respiratory pathogens pose a challenge in diagnosing community-acquired pneumonia (CAP) in Asia due to limited access and high costs of diagnostic tests.
- Understanding the prevalence of specific atypical pathogens is crucial for effective CAP management.
Purpose of the Study:
- To determine the frequency of Mycoplasma pneumoniae, Chlamydophila pneumoniae, and Legionella pneumophila infections in patients with CAP across 12 Asian medical centers.
- To establish standardized laboratory techniques and interpretation criteria for accurate diagnosis.
Main Methods:
- A surveillance study involving 1756 patients presenting with CAP symptoms.
- Diagnosis confirmed by significant antibody titer changes or high persistent titers, alongside bacterial DNA in secretions (M. pneumoniae, C. pneumoniae) or antigen in urine (L. pneumophila).
Main Results:
- Overall, 23.5% of CAP cases were attributed to atypical pathogens.
- Mycoplasma pneumoniae accounted for 12.2%, Chlamydophila pneumoniae for 4.7%, and Legionella pneumophila for 6.6% of infections.
- Past exposure indicated by high antibody titers was observed in 10.2% (M. pneumoniae), 4.8% (C. pneumoniae), and 18.9% (L. pneumoniae).
Conclusions:
- Atypical respiratory pathogens are highly prevalent in Asian patients diagnosed with CAP.
- These findings underscore the importance of considering these pathogens in CAP diagnostics and treatment strategies in the region.
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