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CORRESPONDENCE
Year : 2014  |  Volume : 32  |  Issue : 2  |  Page : 204-205
 

Prevalence of atypical bacterial pathogens in hospitalised adult patients with community-acquired pneumonia in Central Greece


Departments of Microbiology and Respiratory Medicine, Medical School, University of Thessaly, Biopolis, Larissa, Greece

Date of Submission14-Dec-2013
Date of Acceptance13-Apr-2013
Date of Web Publication2-Apr-2014

Correspondence Address:
E Petinaki
Departments of Microbiology and Respiratory Medicine, Medical School, University of Thessaly, Biopolis, Larissa
Greece
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0255-0857.129852

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How to cite this article:
Neocleous C, Gerogianni I, Gourgoulianis K, Petinaki E. Prevalence of atypical bacterial pathogens in hospitalised adult patients with community-acquired pneumonia in Central Greece. Indian J Med Microbiol 2014;32:204-5

How to cite this URL:
Neocleous C, Gerogianni I, Gourgoulianis K, Petinaki E. Prevalence of atypical bacterial pathogens in hospitalised adult patients with community-acquired pneumonia in Central Greece. Indian J Med Microbiol [serial online] 2014 [cited 2019 Nov 20];32:204-5. Available from: http://www.ijmm.org/text.asp?2014/32/2/204/129852


Dear Editor,

Community-acquired pneumonia (CAP) is a common disease and a frequent cause of morbidity and mortality worldwide. In the present study, the prevalence of atypical pathogens (Mycoplasma pneumoniae, Chlamydia pneumoniae, Legionella pneumophila serogroup 1) in the pathogenesis of CAP was determined among 215 hospitalised patients aged ≥ 17 years with CAP, in Central Greece, between 2007 and 2009.

The patients were hospitalised in the Respiratory Department of University Hospital of Larissa (UHL) that is the only 700-bed tertiary care hospital in Central Greece, covering an urban population of 600,000 inhabitants. Demographic and clinical data from the patients such as age, sex, symptoms, etc., were collected.

From all patients, blood, bronchial secretions and urine were obtained and were sent to the Microbiological Department of UHL. Blood and bronchial specimens were cultured for common pathogens (Streptococcus pneumoniae, Staphylococcus aureus, etc.); bronchial secretions were also examined by molecular methods for the presence of DNA of M. pneumoniae, C. pneumoniae and L. pneumophila.[1] In addition, from all patients two serum specimens were collected, the first on the patient admission and the second one 2 weeks latter; both were examined by indirect fluorescence test for the presence of IgM and IgG antibodies (Inova) against the three atypical pathogens described above. Furthermore, urine samples were tested from the detection of S. pneumoniae and L. pneumophila antigens (Binax).

The aetiology was considered definite, when one of the following criteria was met: 1. blood or sputum culture yields a bacterial pathogen (in the absence of an apparent extrapulmonary focus), 2. single IgM titre for C. pneumoniae (≥1:32), M. pneumoniae (any positive titre) and L. pneumophila serogroup 1 (≥1:128), 3. seroconversion (i.e. a four-fold increase in IgG titre between the first and the second serum specimen), 4. positive urinary antigen test for L. pneumophila serogroup 1 and S. pneumonia. [2]

During the study period, 215 patients with CAP (152 male and 63 female) were hospitalised. The mean age of the patients was 61-years old (18-80 years), while, 101 of them (50%) had received antibiotic therapy before admission. Seventy-eight out of them (36.3%), were found to be positive for any CAP-related bacteria. The bacterial aetiologic cause of CAP in our patients was described in [Table 1]. Typical pathogens were detected in 52 out 78 patients (66.6%), while atypical pathogens were found in the remaining 26 patients (33.4%). As shown in [Table 1], the three most frequent pathogens were S. pneumoniae, C. pneumoniae M. pneumoniae. None of the patients were found with two pathogens.
Table 1: Clinical data, etiology and diagnostic methods of 78 CAP patients

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To our knowledge, this is the first hospital-based study in Greece concerning the causative atypical bacterial agents of CAP among hospitalised adult patients. In our target group the aetiological agent of CAP was defined in 36.3% of the cases despite the application of various methods. [3],[4] Although this finding is in accordance with other studies, it could be explained firstly by the fact that various viruses contribute in the aetiology of CAP and secondarily that 50% of patients have been previously received empirical antimicrobial therapy.

 
 ~ References Top

1.Cho MC, Kim H, An D, Lee M, Noh SA, Kim MN, et al. Comparison of sputum and nasopharyngeal swab specimens for molecular diagnosis of Mycoplasma pneumoniae, Chlamydophila pneumoniae, and legionella pneumophila. Ann Lab Med 2012;32:133-8.  Back to cited text no. 1
    
2.Cillóniz C, Ewig S, Polverino E, Marcos MA, Prina E, Sellares J, et al. Community-acquired pneumonia in outpatients: Aetiology and outcomes. Eur Respir J 2012;40:931-8.  Back to cited text no. 2
    
3.Daxboeck F, Khanakah G, Bauer C, Stadler M, Hofmann H, Stanek G. Detection of mycoplasma pneumoniae in serum specimens from patients with mycoplasma pneumonia by PCR. Int J Med Microbiol 2005;295:279-85.  Back to cited text no. 3
    
4.Wellinghausen N, Straube E, Freidank H, von Baum H, Marre R, Essig A. Low prevalence of chlamydia pneumoniae in adults with community-acquired pneumonia. Int J Med Microbiol 2006;296:485-91.  Back to cited text no. 4
    



 
 
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