Changes in the pathogen spectrum of hospitalized adults with community-acquired pneumonia in Fujian Province: a multicenter, prospective study from 2012 to 2018

Abstract

Changes in the pathogen spectrum of hospitalized adults with community-acquired pneumonia in Fujian Province: a multicenter, prospective study from 2012 to 2018 <b>Objective:</b> To study the changes in the pathogen spectrum of hospitalized adults with community-acquired pneumonia (CAP) in Fujian and analyze the effects of age and season on the distribution of pathogens. <b>Methods:</b> From March 2012 to December 2018, 791 patients with CAP from four different regions of Fujian Province, including 4 central hospitals, were enrolled, and respiratory or blood samples were collected for pathogenic testing, including pathogen cultivation and nucleic acid detection. <b>Results:</b> The pathogen detection rate of 791 CAP patients was 62.3%, while mixed infection accounted for 23.0%. Influenza A virus (Flu-A) was the most common pathogen, with a detection rate of 20.5%, followed by Streptococcus pneumoniae 12.8%, Klebsiella pneumoniae 8.6%, Staphylococcus aureus 6.4%, and Chlamydia pneumoniae 5.2%. Patients with severe CAP (SCAP) accounted for 7.7%, and the top four pathogens detected were K. pneumoniae, Flu-A, S. pneumoniae, and S. aureus. Most viruses were detected in winter. The detection rate of K. pneumoniae and C. pneumoniae was increasing year by year. K. pneumoniae had a higher detection rate in elderly CAP. <b>Conclusion:</b> In recent years, Flu-A and S. pneumoniae are still common pathogens of adult CAP in Fujian. K. pneumoniae has become the most common pathogen of SCAP especially for elderly patients. The incidence of C. pneumoniae is increasing year by year. <b>Funding:</b> the National Science and Technology Major Special Project (2017ZX10103004).