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Viral aetiology of hospitalised patients with community-acquired pneumonia in Hong Kong

Abstract number: O34

Ip M., Lee N., Rainer T., Antonio G., Lui G., Chau S., Ng F., Leung E., Hui D., Chan P.

Objectives: Community-acquired pneumonia (CAP) is a leading infectious cause of death throughout the world. Pandemic avian influenza is an impending concern and prevention remains one of highest priority in Hong Kong where previous H5N1 influenza cases occurred. Diagnostic exclusion remains one of importance in the exclusion of new pathogen. A multiplex PCR that examined 17 viruses, and including influenza H typing was applied to nasopharyngeal aspirates from 857 adults hospitalised with community acquired pneumonia during 2004–5.

Methods: A prospective observational study of consecutive inpatients with CAP was performed in a university hospital in the New Territories of Hong Kong. Adult patients with CAP were recruited prospectively from Jan, 2004 to June, 2005. Nasopharyngeal aspirates (NPA) were collected and assessed by polymerase chain reaction (PCR) and viral isolation. Five groups of nested multiplex PCR assays targeting 17 respiratory viruses, namely influenza virus type A subtypes H1N1, H3N2, H5N1, influenza virus type B, Parainfluenza viruses group 1 to 4, human respiratory syncytial viruses A and B, Coronaviruses incl. SARS, OC43 and 229E, human adenovirus, Metapneumonvirus, human rhinovirus, human enterovirus, were included.

Results: 857 episodes of CAP cases were recruited. The F:M ratio of this cohort was 1:1.4. The mean age was 70.1 yrs (median 75 yrs, IR25% 62 yrs, IR75% 83 yrs, range 17–103 yrs old). Elderly subjects of geqslant R: gt-or-equal, slanted65 yrs of age constituted 73% of all cases. One hundred seventy six episodes (41.5%) yielded positive viral aetiology by PCR/and or by virus isolation. The viruses identified were influenza virus types A/B (25.9%), Metapneumovirus (4.5%), RSV A/B (3.1%), rhinovirus (3.1%), parainfluenza viruses group 1–4 (2.6%), Coronaviruses OC43/229 (2.1%) and Adenovirus (0.2%). Avian influenza H5N1, SARS coronavirus and human enteroviruses were not detected. The overall mortality rate was 5.0% in this cohort and there was no statistical difference to those who were PCR positive to a viral pathogen to those who were negative.

Conclusion: Influenza virus types A/B, Metapneumovirus, and RSV viruses were the common viral aetiological agents in patients hospitalised with CAP in Hong Kong.

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Barcelona, Spain
Presentation type:
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