Community-acquired pneumonia is adding strain to U.S. hospitals, with respiratory viruses contributing to a significant number of cases, according to a study in the New England Journal of Medicine.
The study, released July 14, was conducted by CDC researchers between January 2010 and June 2012. The study focused on patients in five hospitals in Chicago and Nashville, including John H. Stroger, Jr. Hospital of Cook County, Rush University Medical Center and University of Tennessee Health Science Center-Saint Thomas Health. Researchers looked at 2,488 adults age 18 and older, with the median age of patients being 57, according to the study.
Among patients whose pneumonia was able to be tested both virally and for bacteria, a pathogen was found in 38% of patients, the study stated. One or more viruses were found in 23% of patients, with bacteria found in 11% of patients, bacterial and viral pathogens in 3% and a fungal or mycobacteria pathogen in 1%. Human rhinovirus was the most common pathogen at 9%, followed by influenza at 6% and streptococcus pneumoniae at 5%.
A little more than 20% of patients required intensive care, the study said, and 2% died. The annual incidence of pneumonia was nearly 25% and the highest rates were among adults 65 and older, the study stated.
Pneumonia is one of the leading causes of hospitalization and death for U.S. adults, researchers noted, and in 2011, the illness created medical costs exceeding $10 billion. Still, the study also mentioned the benefits of routine pneumococcal conjugate vaccinations in children, which has resulted in an overall reduction in the rate of invasive disease and pneumonia among adults, according to the study.
But with influenza being one of the main pathogens discovered in pneumonia patients 80 and older, improvements are needed in influenza-vaccine uptake, study authors wrote.
“The burden of community-acquired pneumonia requiring hospitalization among adults is substantial and is markedly higher among the oldest adults,” the researchers concluded. “Although pathogens were not detected in the majority of patients, respiratory virus were more frequently detected than bacteria, which probably reflects the indirect benefit of bacterial vaccines and relatively insensitive diagnostic tests. These data suggest that improving the coverage and effectiveness of recommended influenza and pneumococcal vaccines and developing effective vaccines and treatments for HMPV, RSV and parainfluenza virus infection could reduce the burden of pneumonia among adults. Further development of new rapid diagnostic tests that can accurately identify and distinguish among potential pneumonia pathogens is needed.”
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