Infection and co-infection patterns of community-acquired pneumonia in patients of different ages in China from 2009 to 2020: a national surveillance study

Liu, Yan‐Ning; Zhang, Yun-Fa; Xu, Qian; Qian, Yan; Lu, Qing‐Bin; Wang, Tao; Zhang, Xiao-Ai; Lin, Sheng-Hong; Lv, Chen-Long; Jiang, Bao-Gui; Li, Hao; Li, Zhongjie; Gao, George F.; Yang, Wei-Zhong; Hay, Simon I; Wang, Liping; Fang, Li‐Qun; Liu, Wei

doi:10.1016/s2666-5247(23)00031-9

Cited by 27 publications

(17 citation statements)

References 23 publications

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“…4,9,10 In a national surveillance study in China over an 11-year period, the most commonly identified viruses in adults with SCAP were influenza (10%), respiratory syncytial virus (RSV, 9%), rhinovirus (7%), parainfluenza virus (5%), adenovirus (3.6%) and human metapneumovirus (1.8%). 11 This pattern is overall consistent with other etiologic studies of SCAP prior to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia pandemic. 12 More detailed discussion of viral SCAP and SCAP in the immunocompromised host are presented in separate chapters of this volume.…”

Section: Microbiology Of Severe Community-acquired Pneumoniasupporting

confidence: 88%

Microbiology of Severe Community-Acquired Pneumonia and the Role of Rapid Molecular Techniques

Pickens,

Gao,

Morales-Nebreda

et al. 2024

Semin Respir Crit Care Med

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The microbiology of severe community acquired pneumonia (SCAP) has implications on management, clinical outcomes and public health policy. Therefore, knowledge of the etiologies of SCAP and methods to identify these microorganisms is key. Bacteria including Streptococcus pneumoniae, Staphylococcus aureus and Enterobacteriaceae continue to be important causes of SCAP. Viruses remain the most commonly identified etiology of SCAP. Atypical organisms are also important etiologies of SCAP and are critical to identify for public health. With the increased number of immunocompromised individuals, less common pathogens may also be found as the causative agent of SCAP. Traditional diagnostic tests, including semi-quantitative respiratory cultures, blood cultures and urinary antigens continue to hold an important role in the evaluation of patients with SCAP. Many of the limitations of the aforementioned tests are addressed by rapid, molecular diagnostic tests. Molecular diagnostics utilize culture-independent technology to identify species-specific genetic sequences. These tests are often semi-automated and provide results within hours, which provides an opportunity for expedient antibiotic stewardship. The existing literature suggests molecular diagnostic techniques may improve antibiotic stewardship in CAP, and future research should investigate optimal methods for implementation of these assays into clinical practice.

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Section: Microbiology Of Severe Community-acquired Pneumoniasupporting

confidence: 88%

Microbiology of Severe Community-Acquired Pneumonia and the Role of Rapid Molecular Techniques

Pickens,

Gao,

Morales-Nebreda

et al. 2024

Semin Respir Crit Care Med

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“…Different age groups have varying susceptibility to different pathogens. For example, the positive rate of respiratory syncytial virus (RSV) in children and adolescents was generally higher than that in older adults aged >60 years with community‐acquired pneumonia in China 29 . In addition, some samples did not yield a definite pathogen.…”

Section: Discussionmentioning

confidence: 99%

“…For example, the positive rate of respiratory syncytial virus (RSV) in children and adolescents was generally higher than that in older adults aged >60 years with community-acquired pneumonia in China. 29 In addition, some samples did not yield a definite pathogen. This finding may have been influenced by numerous factors: (1) Timing of sampling, for example, whether patients had been sampled during the peak season of respiratory disease or had received antibiotics before sampling.…”

Section: Phylogenetic Analysis Of the Ha Gene Of Iavmentioning

confidence: 99%

Simultaneous identification of DNA and RNA pathogens using metagenomic sequencing in cases of severe acute respiratory infection

Xie,

Lin,

et al. 2024

Journal of Medical Virology

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Metagenomic next‐generation sequencing (mNGS) is a valuable technique for identifying pathogens. However, conventional mNGS requires the separate processing of DNA and RNA genomes, which can be resource‐ and time‐intensive. To mitigate these impediments, we propose a novel method called DNA/RNA cosequencing that aims to enhance the efficiency of pathogen detection. DNA/RNA cosequencing uses reverse transcription of total nucleic acids extracted from samples by using random primers, without removing DNA, and then employs mNGS. We applied this method to 85 cases of severe acute respiratory infections (SARI). Influenza virus was identified in 13 cases (H1N1: seven cases, H3N2: three cases, unclassified influenza type: three cases) and was not detected in the remaining 72 samples. Bacteria were present in all samples. Pseudomonas aeruginosa, Klebsiella pneumoniae, and Acinetobacter baumannii were detected in four influenza‐positive samples, suggesting coinfections. The sensitivity and specificity for detecting influenza A virus were 73.33% and 95.92%, respectively. A κ value of 0.726 indicated a high level of concordance between the results of DNA/RNA cosequencing and SARI influenza virus monitoring. DNA/RNA cosequencing enhanced the efficiency of pathogen detection, providing a novel capability to strengthen surveillance and thereby prevent and control infectious disease outbreaks.

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“…Studies investigating the cause of community-acquired pneumonia (CAP) can yield varying results due to differences in patient selection and research methods. In China, Respiratory syncytial virus is the main viral cause of CAP in children, Streptococcus pneumoniae is the main bacterial pathogen in children, Mycoplasma pneumoniae in adolescents, and Haemophilus in uenzae in adults [4]. Anaerobes are believed to play a signi cant role in the development of aspiration pneumonia, which primarily occurs in the elderly [5,6].…”

Section: Discussionmentioning

confidence: 99%

Community-acquired pneumonia associated with influenza co-infection caused by fusobacterium necrophorum: a case report and literature review

Cao,

Huang,

Zhang

2024

Preprint

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Background Fusobacterium necrophorum is a rare pathogen often associated with community-acquired pneumonia (CAP), especially when compromising healthy adults. This case report presents the first documented case of CAP caused by F. necrophorum in a young individual, providing valuable insights for the diagnosis and treatment of similar cases. Case presentation The patient, initially diagnosed with influenza, developed CAP caused by F. necrophorum. Despite one week of outpatient treatment with moxifloxacin, symptoms persisted, leading to hospitalization. Treatment with piperacillin tazobactam/imipenem and doxycycline, targeting atypical pathogens, did not result in improvement after admission. Conventional diagnostic methods failed to identify the causative pathogen, but metagenomics next-generation sequencing of bronchoalveolar lavage fluid confirmed it to be F. necrophorum. The patient showed significant improvement after ten days of targeted treatment with ornidazole and imipenem/piperacillin tazobactam and was discharged. Conclusion Uncommon pathogens, such as F. necrophorum, should be considered as potential culprits in young individuals with CAP when conventional cultures yield negative results but there is a strong suspicion of infection, especially if initial antibiotic therapy is ineffective.

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Infection and co-infection patterns of community-acquired pneumonia in patients of different ages in China from 2009 to 2020: a national surveillance study

Cited by 27 publications

References 23 publications

Microbiology of Severe Community-Acquired Pneumonia and the Role of Rapid Molecular Techniques

Microbiology of Severe Community-Acquired Pneumonia and the Role of Rapid Molecular Techniques

Simultaneous identification of DNA and RNA pathogens using metagenomic sequencing in cases of severe acute respiratory infection

Community-acquired pneumonia associated with influenza co-infection caused by fusobacterium necrophorum: a case report and literature review

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