Cited by 500Pneumonia and Respiratory InfectionsMicrobial infections and disease researchBacterial Identification and Susceptibility Testing

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Etiology of Community‐Acquired Pneumonia: Increased Microbiological Yield with New Diagnostic Methods

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Johansson, Niclas, Kalin, Mats, Tiveljung‐Lindell, Annika, Giske, Christian G., Hedlund, Jonas·2010·Clinical Infectious Diseases

DOI 10.1086/648678PMC PMC7107844

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Abstract

BACKGROUND: The microbial etiology of community-acquired pneumonia (CAP) is still not well characterized. During the past few years, polymerase chain reaction (PCR)-based methods have been developed for many pathogens causing respiratory tract infections. The aim of this study was to determine the etiology of CAP among adults-especially the occurrence of mixed infections among patients with CAP-by implementing a new diagnostic PCR platform combined with conventional methods. METHODS: Adults admitted to Karolinska University Hospital were studied prospectively during a 12-month period. Microbiological testing methods included culture from blood, sputum, and nasopharyngeal secretion samples; sputum samples analyzed by real-time quantitative PCR for Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis; nasopharyngeal specimens analyzed by use of PCR; serological testing for Mycoplasma pneumoniae, Chlamydophila pneumoniae, and viruses common in the respiratory tract; and urine antigen assays for detection of pneumococcal and Legionella pneumophila antigens. RESULTS: A microbial etiology could be identified for 67% of the patients (n = 124). For patients with complete sampling, a microbiological agent was identified for 89% of the cases. The most frequently detected pathogens were S. pneumoniae (70 patients [38%]) and respiratory virus (53 patients [29%]). Two or more pathogens were present in 43 (35%) of 124 cases with a determined etiology. CONCLUSIONS: By supplementing traditional diagnostic methods with new PCR-based methods, a high microbial yield was achieved. This was especially evident for patients with complete sampling. Mixed infections were frequent (most commonly S. pneumoniae together with a respiratory virus).

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Authors: Johansson, N., Kalin, M., Tiveljung‐Lindell, A., Giske, C. G., & Hedlund, J.
Affiliations: Karolinska University Hospital (SE)
ORCID: Johansson, Niclas
Giske, Christian G.
Venue: Clinical Infectious Diseases
Publisher: Oxford University Press (OUP)
Published: 2010-01-15
Volume: 50
Issue: 2
Pages: 202-209
ISSN: 1058-4838 (ISSN-L)
1537-6591
DOI: 10.1086/648678
PMC: PMC7107844
OpenAlex: W2163593399
Cited by: 500
References: 38
Citations by year: 2026: 7 · 2025: 19 · 2024: 19 · 2023: 33 · 2022: 28 · 2021: 29 · 2020: 47 · 2019: 33 · 2018: 24 · 2017: 30 · 2016: 37 · 2015: 30 · 2014: 41 · 2013: 46 · 2012: 37
FWCI: 17.31
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: Clinical Infectious Diseases (publishedVersion)
Europe PMC (PubMed Central) (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: Karolinska Institutet
Topics: Health Sciences › Medicine › Epidemiology › Pneumonia and Respiratory Infections
Life Sciences › Immunology and Microbiology › Microbiology › Microbial infections and disease research
Health Sciences › Medicine › Microbiology (medical) › Bacterial Identification and Susceptibility Testing
Keywords: community-acquired pneumonia, microbial etiology, co-infection, Streptococcus pneumoniae, respiratory viruses, Haemophilus influenzae, Moraxella catarrhalis, Mycoplasma pneumoniae, Chlamydia pneumoniae, Legionella pneumophila, pneumococcal antigen detection, PCR diagnosis, sputum culture, serological testing
MeSH terms: Adolescent, Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Pneumonia, Prospective Studies, Virus Diseases, Community-Acquired Infections, Young Adult

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Etiology of Community‐Acquired Pneumonia: Increased Microbiological Yield with New Diagnostic Methods

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