Role of atypical bacteria and respiratory viruses in the development of community-acquired pneumonia in adult population of the Republic of Karelia

Abstract

We have examined 184 patients who had negative results in bacteriological analysis of sputum for typical bacteria. Nasopharyngeal swabs of 74 patients were tested with real-time PCR for genomes of influenza A and В viruses, parainfluenza virus, adenovirus, and respiratory-syncytial-virus. For 60 patients ELISA was carried out to detect the presence of IgM and IgG antibodies to mycoplasma and chlamidia pneumonia in pair sera, for 20 of them PCR analysis of sputum was also performed to detect genomes of mycoplasma pneumonia. In 50 patients with severe and moderate course of pneumonia, urine was tested by immunochromatography for legionella pneumophila antigen. Atypical bacterial flora was detected in 21,7% of patients, of those 11,7% had mycoplasma pneumonia, and 10,0% had chlamidia pneumonia. The clinical course of pneumonia was mild in all the patients, convalescence from pneumonia occurred within the usual period of time, and no complications were observed. The clinical picture was characterized by moderate intoxication and pulmonary consolidation syndrome, which was detected more frequently by radiological methods than by objective examination. Legionella pneumophila was not detected in the examined patients. Respiratory viruses were found in 12,2% of patients: 8,1% had adenovirus and 4,1% had influenza A virus (H3N2).The clinical picture was mild in all the patients. So, the contribution of atypical bacteria and respiratory viruses to the etiological structure of community-acquired pneumonia in adult population of the Republic of Karelia was insignificant, amounting to 21,7% and 12,2% accordingly. Pneumonia of these etiologies was characterized by a mild course.