The Article in Brief
Prevalence of Atypical Pathogens in Patients With Cough and Community-Acquired Pneumonia: A Meta-Analysis
Mark H. Ebell , and colleagues
Background In most primary care patients with cough, the cough is caused by a virus. In about 5% of cases, patients with cough have community-acquired pneumonia. In addition, some coughs are caused by an atypical bacterial infection, which has the potential to cause serious complications. This study analyzes existing research to describe the prevalence of atypical pathogens among two groups: 1) patients with cough, acute bronchitis, or lower respiratory tract infection in the ambulatory setting and 2) patients with community-acquired pneumonia.
What This Study Found The study found high rates of atypical bacterial pathogens in patients with acute lower respiratory tract diseases, including cough, bronchitis and community-acquired pneumonia (CAP). Among adults with CAP, 14 percent had an atypical pathogen: 7 percent had mycoplasma pneumoniae, 4 percent had Chlamydophila pneumoniae, and 3 percent had Legionella pneumophila. Among children with CAP, 18 percent had Mycoplasma pneumoniae, only 1 percent had Chlamydophila pneumoniae, and Legionella pneumophila was extremely rare (only one case in 1,765 patients). Among patients with prolonged cough, 9 percent of adults and 18 percent of children had Bordetella pertussis.
Implications
- The findings suggest these conditions are underreported, underdiagnosed and undertreated in current clinical practice.
- The authors call for future research to help clinicians more accurately diagnose these pathogens and determine if and when antibiotic treatment is helpful.