Yıl: 2010 Cilt: 58 Sayı: 2 Sayfa Aralığı: 119 - 127 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Etiological agents of community-acquired pneumonia in adult patients in Turkey; a multicentric, cross-sectional study

Öz:
Bu kesitsel çalışma öncesinde antibiyotik tedavisi almayan erişkin hastalarda toplum kökenli pnömoniler (TKP)in etyolojisinin araştırılması için tasarlandı. Çalışmaya alınan 218 hastanın 137 (%62.8)sinde etyolojik ajan tespit edildi. En sık tespit edilen ajanlar Streptococcus pneumoniae (%14.7), Mycoplasma pneumoniae (%13.8) ve respiratuar sinsityal virüs (%10.1) idi. Olguların %50.9unda tek patojen, %11.9unda çoklu patojen belirlendi. Olguların %35.8inde tipik patojenler,%20.2sinde atipik patojenler, %20.6sında ise viral patojenler belirlendi. Altta yatan hastalık olarak hastaların %42.7sinde kronik obstrüktif akciğer hastalığı vardı. S. pneumoniae TKPli erişkin hastalarda en yaygın patojendi. Atipik patojenler 65 yaşın altında daha yaygındı. M. pneumoniae bu yaş grubunda en sık etkendi. Çalışmamız, Türkiyede TKPli hastalarda başlangıç antibiyotik tedavisinin, S. pneumoniae ve M. pneumoniaeyı kapsaması gerektiğini göstermektedir.
Anahtar Kelime:

Konular: Solunum Sistemi Kulak, Burun, Boğaz

Türkiye de erişkin hastalarda toplum kökenli pnömonilerde etyolojik ajanlar; çok merkezli, kesitsel çalışma

Öz:
Dilara İnan Özcan, Department of Infectious Diseases and Clinical Microbiology, Akdeniz University Medical Faculty, Antalya/Candan Öğüş, Department of Chest Diseases and Tuberculosis, Akdeniz University Medical Faculty, Antalya/Emin Tekeli, Department of Infectious Diseases and Clinical Microbiology, Ankara University Medical Faculty, Ankara/Akın Kaya, Department of Chest Diseases and Tuberculosis, Ankara University Medical Faculty, Ankara/Celal Ayaz, Department of Infectious Diseases and Clinical Microbiology, Dicle University Medical Faculty, Diyarbakir/Canan Eren Dağlı, Department of Chest Diseases and Tuberculosis, Dicle University Medical Faculty, Diyarbakir/Orhan Yıldız, Department of Infectious Diseases and Clinical Microbiology, Erciyes University Medical Faculty, Kayseri/Fatma Sema Oymak, Department of Chest Diseases and Tuberculosis, Erciyes University Medical Faculty, Kayseri/Ahmet Kalkan, Department of Infectious Diseases and Clinical Microbiology, Firat University Medical Faculty, Elazig/Mehmet Hamdi Muz, Department of Chest Diseases and Tuberculosis, Firat University Medical Faculty, Elazig/Hüseyin Turgut, Department of Infectious Diseases and Clinical Microbiology, Pamukkale University Medical Faculty, Denizli/Fatma Fi- şekçi, Department of Chest Diseases and Tuberculosis, Pamukkale University Medical Faculty, Denizli/Yasemin Heper, Department of Infectious Diseases and Clinical Microbiology, Uludag University Medical Faculty, Bursa/Esra Uzaslan, Department of Chest Diseases and Tuberculosis, Uludag University Medical Faculty, Bursa, Turkey. This cross-sectional study was intended to investigate the etiology of community-acquired pneumonia (CAP) in adult patients receiving no prior antibiotic therapy. Etiological agents were identified in 137 (62.8%) of 218 patients, the most frequent being Streptococcus pneumoniae (14.7%), Mycoplasma pneumoniae (13.8%) and respiratory syncytial virus (10.1%). A single pathogen was detected in 50.9% of cases and mixed pathogens in 11.9%. Typical pathogens were determined in 35.8% of cases, atypical pathogens in 20.2% and viral pathogens in 20.6%. Chronic obstructive pulmonary disease was a common (42.7%) comorbidity. S. pneumoniae was the most common pathogen in adult patients with CAP. Atypical pathogens were more common in patients < 65 years old, M. pneumoniae being the most common in this age group. Our results suggest that initial empiric antibiotic treatment in patients with CAP should cover S. pneumoniae and M. pneumoniae in Turkey.
Anahtar Kelime:

Konular: Solunum Sistemi Kulak, Burun, Boğaz
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Mandell LA. Epidemiology and etiology of communityacquired pneumonia. Infect Dis Clin North Am 2004; 18: 761-76.
  • 2. Lode HM. Managing community-acquired pneumonia: a European perspective. Respir Med 2007; 101: 1864-73.
  • 3. Mandell LA, Wunderink RG, Anzueto A, et al; American Thoracic Society. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis 2007; 44(Suppl 2): S27-S72.
  • 4. Lagerström F, Bader M, Foldevi M, et al. Microbiological etiology in clinically diagnosed community-acquired pneumonia in primary care in Orebro, Sweden. Clin Microbiol Infect 2003; 9: 645-52.
  • 5. Ozlu T, Bulbul Y, Ozsu S. Community-acquired pneumonia based on the Turkish national data. Tuberk Toraks 2007; 55: 191-212.
  • 6. Sener B, Tunçkanat F, Ulusoy S, et al. A survey of antibiotic resistance in Streptococcus pneumoniae and Haemophilus influenzae in Turkey, 2004-2005. J Antimicrob Chemother 2007; 60: 587-93.
  • 7. Honeybourne D. Community-acquired pneumonia in ambulatory patients: relative importance of atypical pathogens. Int J Antimicrob Agents 2001; 18: 57-61
  • 8. Ozyilmaz E, Akan OA, Gulhan M, et al. Major bacteria of community-acquired respiratory tract infections in Turkey. Jpn J Infect Dis 2005; 58: 50-2.
  • 9. Kaygusuz S, Koksal I, Aydin K, Caylan R. Investigation of atypical bacteria and virus antigens in respiratory tract infections by use of an immunofluorescence method. Jpn J Infect Dis 2004; 57: 33-6.
  • 10. Ozlu T, Bulbul Y, Kaygusuz S, et al. Prevalence of M. pneumoniae, C. pneumoniae and L. pneumophilia in our cases with community-acquired pneumonia. Solunum Hastalıkları 2000; 11: 135-9.
  • 11. Mandell LA, Wunderink RG, Anzueto A, et al. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis 2007; (Suppl 2): 27-72.
  • 12. Lim WS, van der Eerden MM, Laing R, et al. Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study. Thorax 2003; 58: 377-82.
  • 13. Charles PG, Whitby M, Fuller AJ, et al. Australian CAP Study Collaboration. The etiology of community-acquired pneumonia in Australia: why penicillin plus doxycycline or a macrolide is the most appropriate therapy. Clin Infect Dis 2008; 46: 1522-4.
  • 14. Endeman H, Schelfhout V, Voorn GP, et al. Clinical features predicting failure of pathogen identification in patients with community acquired pneumonia. Scand J Infect Dis 2008; 8: 1-6.
  • 15. Song JH, Oh WS, Kang CI, et al. Asian Network for Surveillance of Resistant Pathogens Study Group. Epidemiology and clinical outcomes of community-acquired pneumonia in adult patients in Asian countries: a prospective study by the Asian network for surveillance of resistant pathogens. Int J Antimicrob Agents 2008; 31: 107-14.
  • 16. Creer DD, Dilworth JP, Gillespie SH, et al. Aetiological role of viral and bacterial infections in acute adult lower respiratory tract infection (LRTI) in primary care. Thorax 2006; 61: 75-9.
  • 17. Lim WS, Macfarlane JT, Boswell TC, et al. Study of community acquired pneumonia aetiology (SCAPA) in adults admitted to hospital: implications for management guidelines. Thorax 2001; 56: 296-301.
  • 18. Almirall J, Boixeda R, Bolíbar I, et al; GEMPAC Study Group. Differences in the etiology of community-acquired pneumonia according to site of care: a populationbased study. Respir Med 2007; 101: 2168-75.
  • 19. Angeles Marcos M, Camps M, Pumarola T, et al. The role of viruses in the aetiology of community-acquired pneumonia in adults. Antivir Ther 2006; 11: 351-9.
  • 20. Miyashita N, Fukano H, Mouri K, et al. Community-acquired pneumonia in Japan: a prospective ambulatory and hospitalized patient study. J Med Microbiol 2005; 54: 395-400.
  • 21. Díaz A, Barria P, Niederman M, et al. Etiology of community-acquired pneumonia in hospitalized patients in Chile: the increasing prevalence of respiratory viruses among classic pathogens. Chest 2007; 131: 779-87.
  • 22. Beovic B, Bonac B, Kese D, et al. Aetiology and clinical presentation of mild community-acquired bacterial pneumonia. Eur J Clin Microbiol Infect Dis 2003; 22: 584-91.
  • 23. Wattanathum A, Chaoprasong C, Nunthapisud P, et al. Community-acquired pneumonia in southeast Asia the microbial differences between ambulatory and hospitalized patients. Chest 2003; 123: 1512-19.
  • 24. Bochud PY, Moser F, Erard P, et al. Community-acquired pneumonia. A prospective outpatient study. Medicine (Baltimore). 2001; 80: 75-87.
  • 25. Logroscino CD, Penza O, Locicero S, et al. Community-acquired pneumonia in adults: a multicentric observational AIPO study. Monaldi Arch Chest Dis 1999; 54: 11-7.
  • 26. Moine P, Vercken JB, Chevret S, et al. Severe communityacquired pneumonia. Etiology, epidemiology, and prognosis factors. French study group for community-acquired pneumonia in the intensive care unit. Chest 1994; 105: 1487-95.
  • 27. Lauderdale TL, Chang FY, Ben RJ, et al. Etiology of community acquired pneumonia among adult patients requiring hospitalization in Taiwan. Respir Med 2005; 99: 1079-86.
  • 28. Sohn JW, Park SC, Choi YH, et al. Atypical pathogens as etiologic agents in hospitalized patients with community-acquired pneumonia in Korea: a prospective multicenter study. J Korean Med Sci 2006; 21: 602-7.
  • 29. Gutiérrez F, Masiá M, Rodríguez JC, et al. Community-acquired pneumonia of mixed etiology: prevalence, clinical characteristics, and outcome. Eur J Clin Microbiol Infect Dis 2005; 24: 377-83.
  • 30. Gutiérrez F, Masiá M, Rodríguez JC, et al. Epidemiology of community-acquired pneumonia in adult patients at the dawn of the 21st century: a prospective study on the Mediterranean coast of Spain. Clin Microbiol Infect 2005; 11: 788-800.
  • 31. Howard LS, Sillis M, Pasteur MC, et al. Microbiological profile of community-acquired pneumonia in adults over the last 20 years. J Infect 2005; 50: 107-13
  • 32. Arnold FW, Summersgill JT, Lajoie AS, et al. Community-acquired pneumonia organization (CAPO) investigators. A worldwide perspective of atypical pathogens in community-acquired pneumonia. Am J Respir Crit Care Med 2007; 175: 1086-93
  • 33. Gutiérrez F, Masiá M, Mirete C, et al. The influence of age and gender on the population-based incidence of community-acquired pneumonia caused by different microbial pathogens. J Infect 2006; 53: 166-74.
  • 34. Özlü T, Bülbül Y, Alataş F, Arseven O ve ark. Türk Toraks Derneği erişkinlerde toplumda gelişen pnömoni tanı ve tedavi uzlaşı raporu. Turkish Thoracic Journal 2009; Ek 9.
APA Koksal I, ÖZLÜ T, BAYRAKTAR Ö, YILMAZ G, BÜLBÜL Y, Öztuna F, ÇAYLAN R, AYDIN K, SUCU N (2010). Etiological agents of community-acquired pneumonia in adult patients in Turkey; a multicentric, cross-sectional study. , 119 - 127.
Chicago Koksal Iftihar,ÖZLÜ Tevfik,BAYRAKTAR Özlem,YILMAZ Gürdal,BÜLBÜL Yılmaz,Öztuna Funda,ÇAYLAN Rahmet,AYDIN Kemalettin,SUCU Nurgün Etiological agents of community-acquired pneumonia in adult patients in Turkey; a multicentric, cross-sectional study. (2010): 119 - 127.
MLA Koksal Iftihar,ÖZLÜ Tevfik,BAYRAKTAR Özlem,YILMAZ Gürdal,BÜLBÜL Yılmaz,Öztuna Funda,ÇAYLAN Rahmet,AYDIN Kemalettin,SUCU Nurgün Etiological agents of community-acquired pneumonia in adult patients in Turkey; a multicentric, cross-sectional study. , 2010, ss.119 - 127.
AMA Koksal I,ÖZLÜ T,BAYRAKTAR Ö,YILMAZ G,BÜLBÜL Y,Öztuna F,ÇAYLAN R,AYDIN K,SUCU N Etiological agents of community-acquired pneumonia in adult patients in Turkey; a multicentric, cross-sectional study. . 2010; 119 - 127.
Vancouver Koksal I,ÖZLÜ T,BAYRAKTAR Ö,YILMAZ G,BÜLBÜL Y,Öztuna F,ÇAYLAN R,AYDIN K,SUCU N Etiological agents of community-acquired pneumonia in adult patients in Turkey; a multicentric, cross-sectional study. . 2010; 119 - 127.
IEEE Koksal I,ÖZLÜ T,BAYRAKTAR Ö,YILMAZ G,BÜLBÜL Y,Öztuna F,ÇAYLAN R,AYDIN K,SUCU N "Etiological agents of community-acquired pneumonia in adult patients in Turkey; a multicentric, cross-sectional study." , ss.119 - 127, 2010.
ISNAD Koksal, Iftihar vd. "Etiological agents of community-acquired pneumonia in adult patients in Turkey; a multicentric, cross-sectional study". (2010), 119-127.
APA Koksal I, ÖZLÜ T, BAYRAKTAR Ö, YILMAZ G, BÜLBÜL Y, Öztuna F, ÇAYLAN R, AYDIN K, SUCU N (2010). Etiological agents of community-acquired pneumonia in adult patients in Turkey; a multicentric, cross-sectional study. Tüberküloz ve Toraks, 58(2), 119 - 127.
Chicago Koksal Iftihar,ÖZLÜ Tevfik,BAYRAKTAR Özlem,YILMAZ Gürdal,BÜLBÜL Yılmaz,Öztuna Funda,ÇAYLAN Rahmet,AYDIN Kemalettin,SUCU Nurgün Etiological agents of community-acquired pneumonia in adult patients in Turkey; a multicentric, cross-sectional study. Tüberküloz ve Toraks 58, no.2 (2010): 119 - 127.
MLA Koksal Iftihar,ÖZLÜ Tevfik,BAYRAKTAR Özlem,YILMAZ Gürdal,BÜLBÜL Yılmaz,Öztuna Funda,ÇAYLAN Rahmet,AYDIN Kemalettin,SUCU Nurgün Etiological agents of community-acquired pneumonia in adult patients in Turkey; a multicentric, cross-sectional study. Tüberküloz ve Toraks, vol.58, no.2, 2010, ss.119 - 127.
AMA Koksal I,ÖZLÜ T,BAYRAKTAR Ö,YILMAZ G,BÜLBÜL Y,Öztuna F,ÇAYLAN R,AYDIN K,SUCU N Etiological agents of community-acquired pneumonia in adult patients in Turkey; a multicentric, cross-sectional study. Tüberküloz ve Toraks. 2010; 58(2): 119 - 127.
Vancouver Koksal I,ÖZLÜ T,BAYRAKTAR Ö,YILMAZ G,BÜLBÜL Y,Öztuna F,ÇAYLAN R,AYDIN K,SUCU N Etiological agents of community-acquired pneumonia in adult patients in Turkey; a multicentric, cross-sectional study. Tüberküloz ve Toraks. 2010; 58(2): 119 - 127.
IEEE Koksal I,ÖZLÜ T,BAYRAKTAR Ö,YILMAZ G,BÜLBÜL Y,Öztuna F,ÇAYLAN R,AYDIN K,SUCU N "Etiological agents of community-acquired pneumonia in adult patients in Turkey; a multicentric, cross-sectional study." Tüberküloz ve Toraks, 58, ss.119 - 127, 2010.
ISNAD Koksal, Iftihar vd. "Etiological agents of community-acquired pneumonia in adult patients in Turkey; a multicentric, cross-sectional study". Tüberküloz ve Toraks 58/2 (2010), 119-127.