Infection and co-infection patterns of community-acquired pneumonia in patients of different ages in China from 2009 to 2020: a national surveillance study

作者：Yanning Liu, Yun-Fa Zhang, Qiang Xu, Yan Qiu, Qing‐Bin Lu, Tao Wang, Xiao‐Ai Zhang, Sheng-Hong Lin, Chen‐Long Lv, Bao‐Gui Jiang, Hao Li, Zhongjie Li, George F. Gao, Wei-Zhong Yang, Simon I Hay, Liping Wang, Li‐Qun Fang, Wei Liu · 发表于：The Lancet Microbe · 年份：2023 · DOI：10.1016/s2666-5247(23)00031-9 · 被引用次数：282 · 研究领域：Pneumonia and Respiratory Infections、Respiratory viral infections research、Antibiotic Use and Resistance

BACKGROUND: Severe community-acquired pneumonia (SCAP) is associated with a substantial number of hospitalisations and deaths worldwide. Infection or co-infection patterns, along with their age dependence and clinical effects are poorly understood. We aimed to explore the causal and epidemiological characteristics by age, to better describe patterns of community-acquired pneumonia (CAP) and their association with severe disease. METHODS: National surveillance of CAP was conducted through a network of hospitals in 30 provinces in China from 2009-20 inclusive. Patients with CAP were included if they had evidence of acute respiratory tract, had evidence of pneumonia by chest radiography, diagnosis of pneumonia within 24 h of hospital admission, and resided in the study catchment area. For the enrolled patients with CAP, nasopharyngeal and oral swabs were taken and tested for eight viral pathogens; and blood, urine, or expectorated sputum was tested for six bacterial pathogens. Clinical outcomes, including SCAP, were investigated with respect to age and patterns of infections or co-infections by performing binary logistic regression and multivariate analysis. FINDINGS: Between January, 2009, and December, 2020, 18 807 patients with CAP (3771 [20·05%] with SCAP) were enrolled. For both children (aged ≤5 years) and older adults (aged >60 years), a higher overall rate of viral and bacterial infections, as well as viral-bacterial co-infections were seen in patients with SCAP than in ...