Aetiological agents of adult community-acquired pneumonia in Japan: systematic review and meta-analysis of published data
Objective Epidemiological information is essential in providing appropriate empiric antimicrobial therapy for pneumonia. This study aimed to clarify the epidemiology of community-acquired pneumonia (CAP) by conducting a systematic review of published studies in Japan.Design Systematic review.Data so...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-12-01
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| Series: | BMJ Open Respiratory Research |
| Online Access: | https://bmjopenrespres.bmj.com/content/10/1/e001800.full |
| _version_ | 1797370837431484416 |
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| author | Hiroshi Takahashi Hiroshi Mukae Kazuhiro Yatera Nobuyuki Horita Yuji Fujikura Kohei Somekawa Toshie Manabe Futoshi Higa Naoyuki Miyashita Yoshifumi Imamura Naoki Iwanaga Akihiko Kawana |
| author_facet | Hiroshi Takahashi Hiroshi Mukae Kazuhiro Yatera Nobuyuki Horita Yuji Fujikura Kohei Somekawa Toshie Manabe Futoshi Higa Naoyuki Miyashita Yoshifumi Imamura Naoki Iwanaga Akihiko Kawana |
| author_sort | Hiroshi Takahashi |
| collection | DOAJ |
| description | Objective Epidemiological information is essential in providing appropriate empiric antimicrobial therapy for pneumonia. This study aimed to clarify the epidemiology of community-acquired pneumonia (CAP) by conducting a systematic review of published studies in Japan.Design Systematic review.Data source PubMed and Ichushi web database (January 1970 to October 2022).Eligibility criteria Clinical studies describing pathogenic micro-organisms in CAP written in English or Japanese, excluding studies on pneumonia other than adult CAP, investigations limited to specific pathogens and case reports.Data extraction and synthesis Patient setting (inpatient vs outpatient), number of patients, concordance with the CAP guidelines, diagnostic criteria and methods for diagnosing pneumonia pathogens as well as the numbers of each isolate. A meta-analysis of various situations was performed to measure the frequency of each aetiological agent.Results Fifty-six studies were included and 17 095 cases of CAP were identified. Pathogens were undetectable in 44.1% (95% CI 39.7% to 48.5%). Streptococcus pneumoniae was the most common cause of CAP requiring hospitalisation or outpatient care (20.0% (95% CI 17.2% to 22.8%)), followed by Haemophilus influenzae (10.8% (95% CI 7.3% to 14.3%)) and Mycoplasma pneumoniae (7.5% (95% CI 4.6% to 10.4%)). However, when limited to CAP requiring hospitalisation, Staphylococcus aureus was the third most common at 4.9% (95% CI 3.9% to 5.8%). Pseudomonas aeruginosa was more frequent in hospitalised cases, while atypical pathogens were less common. Methicillin-resistant S. aureus accounted for 40.7% (95% CI 29.0% to 52.4%) of S. aureus cases. In studies that used PCR testing for pan-respiratory viral pathogens, human enterovirus/human rhinovirus (9.4% (95% CI 0% to 20.5%)) and several other respiratory pathogenic viruses were detected. The epidemiology varied depending on the methodology and situation.Conclusion The epidemiology of CAP varies depending on the situation, such as in the hospital versus outpatient setting. Viruses are more frequently detected by exhaustive genetic searches, resulting in a significant variation in epidemiology. |
| first_indexed | 2024-03-08T18:11:09Z |
| format | Article |
| id | doaj.art-0b536f16f8a7485fae3fc2bc47a11805 |
| institution | Directory Open Access Journal |
| issn | 2052-4439 |
| language | English |
| last_indexed | 2024-03-08T18:11:09Z |
| publishDate | 2023-12-01 |
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| series | BMJ Open Respiratory Research |
| spelling | doaj.art-0b536f16f8a7485fae3fc2bc47a118052024-01-01T06:10:09ZengBMJ Publishing GroupBMJ Open Respiratory Research2052-44392023-12-0110110.1136/bmjresp-2023-001800Aetiological agents of adult community-acquired pneumonia in Japan: systematic review and meta-analysis of published dataHiroshi Takahashi0Hiroshi Mukae1Kazuhiro Yatera2Nobuyuki Horita3Yuji Fujikura4Kohei Somekawa5Toshie Manabe6Futoshi Higa7Naoyuki Miyashita8Yoshifumi Imamura9Naoki Iwanaga10Akihiko Kawana11Department of Respiratory Medicine, Saka General Hospital, Shiogama, Miyagi, JapanDepartment of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Nagasaki, JapanDepartment of Respiratory Medicine, University of Occupational and Environmental Health Japan, Kitakyushu, JapanChemotherapy Center, Yokohama City University Hospital, Yokohama, Kanagawa, JapanDivision of Infectious Diseases and Respiratory Medicine, Department of Internal Medicine, National Defense Medical College, Tokorozawa, Saitama, JapanDepartment of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, JapanGraduate School of Medical Science, Nagoya City University, Nagoya, Aichi, JapanDivision of Respiratory Medicine, National Hospital Organization Okinawa National Hospital, Ginowan, Okinawa, JapanFirst Department of Internal Medicine, Division of Respiratory Medicine, Infectious Disease and Allergology, Kansai Medical University, Hirakata, Osaka, JapanMedical Education Development Center, Nagasaki University Hospital, Nagasaki, Nagasaki, JapanDepartment of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Nagasaki, JapanDivision of Infectious Diseases and Respiratory Medicine, Department of Internal Medicine, National Defense Medical College, Tokorozawa, Saitama, JapanObjective Epidemiological information is essential in providing appropriate empiric antimicrobial therapy for pneumonia. This study aimed to clarify the epidemiology of community-acquired pneumonia (CAP) by conducting a systematic review of published studies in Japan.Design Systematic review.Data source PubMed and Ichushi web database (January 1970 to October 2022).Eligibility criteria Clinical studies describing pathogenic micro-organisms in CAP written in English or Japanese, excluding studies on pneumonia other than adult CAP, investigations limited to specific pathogens and case reports.Data extraction and synthesis Patient setting (inpatient vs outpatient), number of patients, concordance with the CAP guidelines, diagnostic criteria and methods for diagnosing pneumonia pathogens as well as the numbers of each isolate. A meta-analysis of various situations was performed to measure the frequency of each aetiological agent.Results Fifty-six studies were included and 17 095 cases of CAP were identified. Pathogens were undetectable in 44.1% (95% CI 39.7% to 48.5%). Streptococcus pneumoniae was the most common cause of CAP requiring hospitalisation or outpatient care (20.0% (95% CI 17.2% to 22.8%)), followed by Haemophilus influenzae (10.8% (95% CI 7.3% to 14.3%)) and Mycoplasma pneumoniae (7.5% (95% CI 4.6% to 10.4%)). However, when limited to CAP requiring hospitalisation, Staphylococcus aureus was the third most common at 4.9% (95% CI 3.9% to 5.8%). Pseudomonas aeruginosa was more frequent in hospitalised cases, while atypical pathogens were less common. Methicillin-resistant S. aureus accounted for 40.7% (95% CI 29.0% to 52.4%) of S. aureus cases. In studies that used PCR testing for pan-respiratory viral pathogens, human enterovirus/human rhinovirus (9.4% (95% CI 0% to 20.5%)) and several other respiratory pathogenic viruses were detected. The epidemiology varied depending on the methodology and situation.Conclusion The epidemiology of CAP varies depending on the situation, such as in the hospital versus outpatient setting. Viruses are more frequently detected by exhaustive genetic searches, resulting in a significant variation in epidemiology.https://bmjopenrespres.bmj.com/content/10/1/e001800.full |
| spellingShingle | Hiroshi Takahashi Hiroshi Mukae Kazuhiro Yatera Nobuyuki Horita Yuji Fujikura Kohei Somekawa Toshie Manabe Futoshi Higa Naoyuki Miyashita Yoshifumi Imamura Naoki Iwanaga Akihiko Kawana Aetiological agents of adult community-acquired pneumonia in Japan: systematic review and meta-analysis of published data BMJ Open Respiratory Research |
| title | Aetiological agents of adult community-acquired pneumonia in Japan: systematic review and meta-analysis of published data |
| title_full | Aetiological agents of adult community-acquired pneumonia in Japan: systematic review and meta-analysis of published data |
| title_fullStr | Aetiological agents of adult community-acquired pneumonia in Japan: systematic review and meta-analysis of published data |
| title_full_unstemmed | Aetiological agents of adult community-acquired pneumonia in Japan: systematic review and meta-analysis of published data |
| title_short | Aetiological agents of adult community-acquired pneumonia in Japan: systematic review and meta-analysis of published data |
| title_sort | aetiological agents of adult community acquired pneumonia in japan systematic review and meta analysis of published data |
| url | https://bmjopenrespres.bmj.com/content/10/1/e001800.full |
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