Community-acquired pneumonia in Japan: a prospective ambulatory and hospitalized patient study.

In this study the aetiology of community-acquired pneumonia (CAP) in Japan was investigated and the incidence of causative pathogens in ambulatory and hospitalized patients was compared. In addition, the roles of Chlamydophila felis and Chlamydophila pecorum as causes of CAP were investigated. Five hundred and six patients with CAP who visited an outpatient clinic or were admitted to one of three different hospitals were enrolled in this study; 106 of them were outpatients and 400 were hospitalized patients. Among the 506 CAP cases, Mycoplasma pneumoniae was the most common pathogen found in the outpatients and Streptococcus pneumoniae was the most common in the hospitalized patients. No cases of Chlamydophila pecorum pneumonia were observed and only one patient had an antibody titre suggestive of recent infection with the feline strain of Chlamydophila. The incidence of infection with M. pneumoniae and Chlamydophila pneumoniae was higher among the outpatients than among hospitalized patients, whereas the incidence of infection with S. pneumoniae and Haemophilus influenzae was higher among the hospitalized patients. Recognition of these results will allow prompt and appropriate antimicrobial therapy to be provided using Japanese CAP guidelines.

[1]  B. Trollfors,et al.  Etiology of community-acquired pneumonia in out-patients , 1986, European Journal of Clinical Microbiology.

[2]  N. Miyashita,et al.  Is it possible to distinguish between atypical pneumonia and bacterial pneumonia?: evaluation of the guidelines for community-acquired pneumonia in Japan. , 2004, Respiratory medicine.

[3]  Arl Medford,et al.  British Thoracic Society , 2004 .

[4]  John G. Bartlett,et al.  Update of Practice Guidelines for the Management of Community-Acquired Pneumonia in Immunocompetent Adults , 2003, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[5]  A. Jatakanon,et al.  Community-acquired pneumonia in southeast Asia: the microbial differences between ambulatory and hospitalized patients. , 2003, Chest.

[6]  R. Peeling,et al.  Chlamydia species as a cause of community-acquired pneumonia in Canada , 2003, European Respiratory Journal.

[7]  N. Miyashita,et al.  Chlamydia pneumoniae infection in adult patients with persistent cough. , 2003, Journal of medical microbiology.

[8]  K. Yamaguchi,et al.  Community-acquired Chlamydia pneumoniae pneumonia in Japan: a prospective multicenter community-acquired pneumonia study. , 2002, Internal medicine.

[9]  Y. Hirakata,et al.  Increasing prevalence of antimicrobial resistance among isolates of Streptococcus pneumoniae from the PROTEKT surveillance study, and compatative in vitro activity of the ketolide, telithromycin. , 2002, The Journal of antimicrobial chemotherapy.

[10]  N. Miyashita,et al.  Clinical presentation of community-acquired Chlamydia pneumoniae pneumonia in adults. , 2002, Chest.

[11]  T. File,et al.  Etiology and management of community-acquired pneumonia in Asia , 2002, Current opinion in infectious diseases.

[12]  P. Francioli,et al.  Community-Acquired Pneumonia: A Prospective Outpatient Study , 2001, Medicine.

[13]  J. Friend.  Do smoking parents seek the best advice for their asthmatic children? , 2001, Thorax.

[14]  M. Fine,et al.  Guidelines for the management of adults with community-acquired pneumonia. Diagnosis, assessment of severity, antimicrobial therapy, and prevention. , 2001, American journal of respiratory and critical care medicine.

[15]  Michael J Fine,et al.  Practice Guidelines for the Management of Community-Acquired Pneumonia in Adults , 2000, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[16]  H. Kitagawa,et al.  Seroepidemiological Investigation of Feline Chlamydiosis in Cats and Humans in Japan , 2000, Microbiology and immunology.

[17]  M. Partridge,et al.  Infection with feline Chlamydia psittaci. , 1998, Thorax.

[18]  R. Peeling,et al.  Ambulatory patients with community-acquired pneumonia: the frequency of atypical agents and clinical course. , 1996, The American journal of medicine.

[19]  C. Pugliese,et al.  Community-acquired pneumonia: is there difference in etiology between hospitalized and out-patients? , 1995, Minerva medica.

[20]  Y. Shemer-Avni,et al.  Chlamydia pneumoniae-induced ciliostasis in ciliated bronchial epithelial cells. , 1995, The Journal of infectious diseases.

[21]  J. Macfarlane,et al.  Prospective study of aetiology and outcome of adult lower-respiratory-tract infections in the community , 1993, The Lancet.

[22]  P. Coll,et al.  Incidence of community-acquired pneumonia and Chlamydia pneumoniae infection: a prospective multicentre study. , 1993, The European respiratory journal.

[23]  N. Miyashita,et al.  Establishment of a particle-counting method for purified elementary bodies of chlamydiae and evaluation of sensitivities of the IDEIA Chlamydia kit and DNA probe by using the purified elementary bodies , 1992, Journal of clinical microbiology.

[24]  J. Blanquer,et al.  Aetiology of community acquired pneumonia in Valencia, Spain: a multicentre prospective study. , 1991, Thorax.

[25]  H. Fukushi,et al.  Immunochemical diversity of the major outer membrane protein of avian and mammalian Chlamydia psittaci , 1988, Journal of clinical microbiology.

[26]  J. Treharne,et al.  Infective endocarditis with glomerulonephritis associated with cat chlamydia (C. psittaci) infection. , 1979, British heart journal.

[27]  P. Griffiths,et al.  Unusual chlamydial infection in a human renal allograft recipient. , 1978, British medical journal.