The Etiology of Community‐Acquired Pneumonia at an Urban Public Hospital: Influence of Human Immunodeficiency Virus Infection and Initial Severity of Illness

In a prospective study, the etiology of community‐acquired pneumonia (CAP) was investigated among consecutive patients admitted to an academic, urban public hospital in Seattle. The study population was uniquely young, was predominantly male, and had high rates of homelessness, cigarette smoking, al...

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Bibliographic Details
Published in:	The Journal of infectious diseases 2001-08, Vol.184 (3), p.268-277
Main Authors:	Park, David R. , Sherbin, Vandy L. , Goodman, Michelle S. , Pacifico, Albert D. , Rubenfeld, Gordon D. , Polissar, Nayak L.
Format:	Article
Language:	eng
Subjects:	Adult Aged Aged, 80 and over Alcoholism Antibacterial agents Antibiotics Antibiotics. Antiinfectious agents. Antiparasitic agents Aspiration pneumonia Bacterial pneumonia Biological and medical sciences Blood Transfusion Cocaine-Related Disorders Community-Acquired Infections - epidemiology Community-Acquired Infections - etiology Community-Acquired Infections - microbiology Comorbidity Etiology Female HIV HIV Infections - complications HIV Infections - epidemiology HIV Infections - microbiology HIV Seronegativity Hospital admissions Hospitals, Public - statistics & numerical data Hospitals, Urban - statistics & numerical data Human viral diseases Humans Infections Infectious diseases Legionella Legionellosis - diagnosis Major Articles Male Marijuana Abuse Medical sciences Middle Aged Mycobacterium Infections - diagnosis Mycobacterium tuberculosis Mycoplasma pneumoniae Pathogens Pharmacology. Drug treatments Pneumocystis carinii Pneumonia Pneumonia, Bacterial - classification Pneumonia, Bacterial - epidemiology Pneumonia, Bacterial - microbiology Pneumonia, Mycoplasma - diagnosis Pneumonia, Pneumococcal - diagnosis Risk Factors Smoking Socioeconomic Factors Streptococcus pneumoniae Substance Abuse, Intravenous Tuberculosis, Pulmonary - diagnosis Viral diseases Viral diseases of the lymphoid tissue and the blood. Aids Washington - epidemiology
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Summary:	In a prospective study, the etiology of community‐acquired pneumonia (CAP) was investigated among consecutive patients admitted to an academic, urban public hospital in Seattle. The study population was uniquely young, was predominantly male, and had high rates of homelessness, cigarette smoking, alcoholism, injection drug use, and human immunodeficiency virus (HIV) infection. Leading causes of CAP among HIV‐negative patients were aspiration, followed by Streptococcus pneumoniae, Legionella species, and Mycoplasma pneumoniae. Among HIV‐positive patients, Pneumocystis carinii, Mycobacterium tuberculosis, S. pneumoniae, and M. pneumoniae were the most common etiologic agents. Severe CAP was associated with typical bacterial infections and aspiration pneumonia but not Legionella infection among HIV‐negative patients and with Pseudomonas aeruginosa infections among HIV‐positive patients. These findings emphasize the need to tailor empirical antibiotic therapy according to local patient populations and individual risk factors and highlight the importance of recognizing underlying HIV infection in patients who are hospitalized with CAP.
ISSN:	0022-1899 1537-6613