Clinical Study Concerning the Relationship between Community-Acquired Pneumonia and Viral Infection in Northern Thailand

Abstract

Objective The etiological agents associated with community-acquired pneumonia (CAP) in Thailand have been studied extensively in bacterial pathogens, but not in viral pathogens. To clarify the association of viral pathogens with CAP, we conducted a comprehensive study of viral and bacterial pathogens in patients with CAP. Methods We enrolled 119 hospitalized patients with CAP in Nakornping Hospital, Chiang Mai, Thailand between 2006 and 2008. The severity of pneumonia was classified and the risk factors for death were estimated. Bacterial and fungal pathogens were determined from specimens taken from blood and sputum, and viral pathogens were identified from nasopharyngeal specimens by RT-PCR using primers specific for 7 respiratory viruses. Results Overall, 29 patients were HIV-infected and 90 patients were non-HIV-infected. The microbial pathogens most commonly isolated among HIV-infected patients were: 4 Klebsiella pneumoniae, 4 Mycobacterium tuberculosis and 3 Haemophilus influenzae. Among non-HIV infected patients, predominant microbial pathogens were: 6 Pseudomonas aeruginosa, 5 Haemophilus influenzae and 4 Klebsiella pneumoniae. As for viral pathogens for CAP, influenza virus was identified from 2 HIV-infected patients and 5 non-HIV infected patients. In addition, human rhinovirus (HRV) and respiratory syncytial virus (RSV) were identified from 2 patients each among non-HIV-infected patients. Conclusion Our study demonstrates that the most common viral agent was influenza virus (5%), followed by HRV (2%) and RSV (2%) among CAP patients in northern Thailand. The underlying chronic obstructive pulmonary disease (COPD) seems to be correlated with the severity of illness.

Viral and bacterial infection among hospitalized-suspected influenza A/H5N1 patients in Indonesia, 2008-2009

“…This finding was similar with previous study where Streptococcus pneumoniae is the prominent pathogen causing community acquired pneumonia in Asian countries while Klebsiella pneumoniae and Haemophillus influenzae were the commonest bacterial pathogens in South East Asia. 9,22,23 Co-infection of viral and bacterial pathogen cases were found within the present study although only minor cases. Co-infections between one of viral pathogen such as; influenza A, Coronavirus 229E/NL 63, Rhinovirus, Bocavirus, Adenovirus, Parainfluenza Virus, respiratory syncytial virus and bacterial, Klebsiella pneumoniae, Streptococcus pneumoniae and Haemophillus influenzae were detected.…”

Etiologies and Resistance Profiles of Bacterial Community-Acquired Pneumonia in Cambodian and Neighboring Countries’ Health Care Settings: A Systematic Review (1995 to 2012)

“…Ultimately, 23 articles were included. From 15 of them, we extracted information on CAP etiologies [32], [33], [34], [35], [36], [37], [38], [39], [40], [41], [42], [43], [44], [45], [46]. Eight presented antibiotic resistance data [18], [46], [47], [48], [49], [50], [51], [52].…”

Viral infection in community-acquired pneumonia: a systematic review and meta-analysis

“…For the outcome short-term mortality, we pooled data from 13 studies [2,3,6,7,24,26,28,29,[31][32][33][34][35]. The odds of death were higher in patients with viral infection, but there was no statistical significance (OR 1.3, 95% CI 0.8-2.16; p=0.283; I 2 =44.1%) (figure 3).…”

“…In patients with dual bacterial and viral infection (10 studies), the odds of death were significantly higher compared with patients without dual infection (OR 2. [3] SAITO [32] HOLM [22] JENNINGS [8] HOHENTHAL [21] CHARLES [17] JOHNSTONE [27] DIEDEREN [20] MERMOND [7] SHIBLI [34] JOHANSSON [26] LIEBERMAN [30] HARA [6] CILLÓNIZ [18] CHOI [2] SANGIL [33] YIN [36] VAN GAGELDONK-LAFEBER [5] LUCHSINGER [9] TAKAHASHI [10] WIEMKEN [11] MUSHER [12] VIASUS [35] HUIJSKENS [24] KIM [29] KARHU [28] HOLTER [23] QU [31] DAS [19] JAIN [25] …”

“…The advent of PCR has greatly improved the identification of viruses in patients with CAP [1]. Over the last decade, several studies have used PCR to establish the importance of viruses in the aetiology of CAP [1][2][3][4][5][6][7][8][9][10][11][12]. An updated and objective literature review that quantitatively summarises and critically appraises the results of these studies is warranted.…”