RESUMEN
BACKGROUND: In many parts of Asia, the inaccessibility and high cost of diagnostic tests have hampered the study of community-acquired pneumonia (CAP) caused by atypical respiratory pathogens. OBJECTIVE: This surveillance study examined the frequency of infection with Mycoplasma pneumoniae, Chlamydophila pneumoniae, and Legionella pneumophila in 1756 patients presenting with signs and symptoms of CAP at 12 medical centres in Asia, using standardised laboratory techniques and interpretation criteria in all participating centres. METHODS: Diagnosis of current infection was based on significant changes in antibody titer or persisting high antibody titers, together with the presence of bacterial DNA in respiratory secretions, in the case of M. pneumoniae and C. pneumoniae infections, or bacterial antigen in urine, in the case of L. pneumophila serogroup 1 infection. RESULTS: Using these criteria, results from 1374 patients with paired sera showed that, overall, 23.5% of CAP cases were associated with infection with atypical respiratory pathogens, with M. pneumoniae, C. pneumoniae, and L. pneumophila being found in 12.2%, 4.7%, and 6.6% of cases, respectively. Persisting high antibody titers indicative of past exposure to M. pneumoniae, C. pneumoniae, and L. pneumophila were seen in 10.2%, 4.8%, and 18.9% of patients, respectively. CONCLUSION: These data reflect the overall high prevalence of these atypical pathogens among Asian patients with CAP.
Asunto(s)
Chlamydophila pneumoniae/aislamiento & purificación , Infecciones Comunitarias Adquiridas/epidemiología , Infecciones Comunitarias Adquiridas/microbiología , Legionella pneumophila/aislamiento & purificación , Mycoplasma pneumoniae/aislamiento & purificación , Neumonía Bacteriana/epidemiología , Neumonía Bacteriana/microbiología , Adolescente , Adulto , Pruebas de Aglutinación , Niño , Preescolar , Chlamydophila pneumoniae/genética , Infecciones Comunitarias Adquiridas/diagnóstico , ADN Bacteriano/química , ADN Bacteriano/genética , Asia Oriental/epidemiología , Femenino , Técnica del Anticuerpo Fluorescente Indirecta , Humanos , Masculino , Persona de Mediana Edad , Mycoplasma pneumoniae/genética , Neumonía Bacteriana/diagnóstico , Reacción en Cadena de la Polimerasa , PrevalenciaRESUMEN
The minimal inhibitory concentrations of tetracycline, gatifloxacin, moxifloxacin, ciprofloxacin, clindamycin and azithromycin for 28 Singapore clinical Mycoplasma hominis strains were studied using the Etest method. Different incubation conditions did not affect susceptibility categories, except for tetracycline intermediate-susceptibility strains. Tetracycline-susceptibility was only 35.7%. All strains were susceptible to the fluoroquinolones and clindamycin but resistant to azithromycin.