Etiology of community-acquired pneumonia in adults in Russian hospitals after the COVID-19 pandemic: results of a multicenter prospective study

Autor: Rachina S.A., Kupryushina O.A., Strelkova D.A., Avdeev S.N., Vlasenko A.E., Yasneva A.S., Yudanova T.A., Trofimenko I.N., Antonov V.N., Agibalova M.N., Merzhoeva Z.M., Yatsyshina S.B., Tikhonova M.A., Elkina M.A., Ananicheva N.A., Burmistrova E.N., Sukhorukova M.V.
Jazyk: ruština
Rok vydání: 2024
Předmět:
Zdroj: Клиническая микробиология и антимикробная химиотерапия, Vol 26, Iss 2, Pp 141-147 (2024)
Druh dokumentu: article
ISSN: 1684-4386
2686-9586
DOI: 10.36488/cmac.2024.2.141-147
Popis: Objective. To study the etiology of community-acquired pneumonia (CAP) in adult hospitalized patients after the COVID-19 pandemic. Materials and Methods. The prospective multicenter study included patients 18 years and older with confirmed diagnosis of CAP admitted to 6 hospitals in different regions of Russia from July to November 2023. Etiology was confirmed by respiratory samples (sputum, tracheal aspirate) culture, blood culture (severe cases), and urinary antigen tests (Legionella pneumophila serogroup 1, Streptococcus pneumoniae). Mycoplasma pneumoniae, Chlamydia pneumoniae, and common respiratory viruses were identified using the real-time polymerase chain reaction (PCR) in respiratory samples. Qualitative PCR for S. pneumoniae and Haemophilus influenzae DNA tests were also applied. Results. Altogether 152 patients were enrolled, and significant CAP pathogens were identified in 96 (63%) cases; the median age of patients with verified etiology of CAP was 45 [34.8; 66] years, comorbidity index was 0.5 (0; 3.0) points. The most frequently detected pathogens were M. pneumoniae – 42 (44%), rhinovirus – 23 (24%), S. pneumoniae – 17 (18%) and SARS-CoV-2 – 13 (14%). Coinfection was registered in 22% of cases, the most common associations were M. pneumoniae + rhinovirus – 5 (3.3%), S. pneumoniae + rhinovirus – 3 (2%). Pneumococcal bacteremia was detected in 1 patient. In most patients CAP was non-severe; 17 (18%) patients required admission to the ICU. Hospital mortality was 7%. Conclusions. M. pneumoniae, respiratory viruses (mainly rhinovirus and SARS-CoV-2), and S. pneumoniae were the predominant CAP pathogens in hospitalized adults with CAP in the first months after the COVID-19 pandemiс. The use of an integrated approach to etiological diagnosis can significantly increase the proportion of patients with an established etiology of CAP.
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