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

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

Clinical Microbiology and Antimicrobial Chemotherapy. 2024; 26(2):141-147

​ 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.
10.36488/cmac.2024.2.141-147
community-acquired pneumonia COVID-19 etiology adults
Section
Diseases and Pathogens
Type
Original Article
Publication
Clinical Microbiology and Antimicrobial Chemotherapy. 2024; 26(2):141-147

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.

Svetlana A. Rachina

I.M. Sechenov First Moscow State Medical University, Moscow, Russia

Kupryushina O.A.

I.M. Sechenov First Moscow State Medical University, Moscow, Russia

Daria А. Strelkova

I.M. Sechenov First Moscow State Medical University, Moscow, Russia

Avdeev S.N.

I.M. Sechenov First Moscow State Medical University, Moscow, Russia

Vlasenko A.E.

Samara State Medical University, Samara, Russia

Yasneva A.S.

I.M. Sechenov First Moscow State Medical University, Moscow, Russia

Yudanova T.A.

Smolensk Regional Clinical Hospital, Smolensk, Russia

Trofimenko I.N.

Irkutsk State Medical Academy of Postgraduate Education – branch of the Russian Medical Academy of Continuous Professional Education, Irkutsk, Russia

Antonov V.N.

South-Ural State Medical University, Chelyabinsk, Russia
Regional Clinical Hospital No. 3, Chelyabinsk Regional Pulmonology Center, Chelyabinsk, Russia

Agibalova M.N.

Kotlas Central City Hospital named after Saint Luka (V.F. Voyno-Yasenetski), Kotlas, Russia

Merzhoeva Z.M.

I.M. Sechenov First Moscow State Medical University, Moscow, Russia

Yatsyshina S.B.

Central Research Institute of Epidemiology, Moscow, Russia

Tikhonova M.A.

Central Research Institute of Epidemiology, Moscow, Russia

Elkina M.A.

Central Research Institute of Epidemiology, Moscow, Russia

Ananicheva N.A.

City Clinical Hospital named after S.S. Yudin, Moscow, Russia

Burmistrova E.N.

City Clinical Hospital named after S.S. Yudin, Moscow, Russia

Marina V. Sukhorukova

National Medical Research Center for Neurosurgery named after N.N. Burdenko, Moscow, Russia

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