Semin Respir Crit Care Med 2016; 37(06): 839-854
DOI: 10.1055/s-0036-1592075
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Community-Acquired Pneumonia in the Asia-Pacific Region

Jae-Hoon Song
1   Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
2   Asia-Pacific Foundation for Infectious Diseases, Seoul, Korea
,
Kyungmin Huh
3   Division of Infectious Diseases, Department of Internal Medicine, Armed Forces Capital Hospital, Seongnam, Korea
,
Doo Ryeon Chung
1   Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
2   Asia-Pacific Foundation for Infectious Diseases, Seoul, Korea
› Author Affiliations
Further Information

Publication History

Publication Date:
13 December 2016 (online)

Abstract

Community-acquired pneumonia (CAP) is an important cause of mortality and morbidity worldwide. Aging population, dense urbanization, and poor access to health care make the Asia-Pacific region vulnerable to CAP. The high incidence of CAP poses a significant health and economic burden in this region. Common etiologic agents in other global regions including Streptococcus pneumoniae, Mycoplasma pneumoniae, Haemophilus influenzae, Chlamydophila pneumoniae, Staphylococcus aureus, and respiratory viruses are also the most prevalent pathogens in the Asia-Pacific region. But the higher incidence of Klebsiella pneumoniae and the presence of Burkholderia pseudomallei are unique to the region. The high prevalence of antimicrobial resistance in S. pneumoniae and M. pneumoniae has been raising the need for more prudent use of antibiotics. Emergence and spread of community-acquired methicillin-resistant S. aureus deserve attention, while the risk has not reached significant level yet in cases of CAP. Given a clinical and socioeconomic importance of CAP, further effort to better understand the epidemiology and impact of CAP is warranted in the Asia-Pacific region.

Funding

This study was partly supported by a grant from the Korean Health Technology R&D Project, Ministry of Health & Welfare, Republic of Korea (Grant No. HI12C0756), and partly by the Asia Pacific Foundation for Infectious Diseases.


 
  • References

  • 1 2015 Population Data Sheet. United Nations Economic and Social Commission for Asia and the Pacific (UNESCAP). 2015. Available at http://www.unescapsdd.org/publications/2015-escap-population-data-sheet . Accessed May 1, 2016
  • 2 The global burden of disease: 2004 update. World Health Organization. 2008. Available at http://www.who.int/healthinfo/global_burden_disease/2004_report_update/en/ . Accessed April 1, 2016
  • 3 Jordan HT, Prapasiri P, Areerat P , et al. A comparison of population-based pneumonia surveillance and health-seeking behavior in two provinces in rural Thailand. Int J Infect Dis 2009; 13 (3) 355-361
  • 4 Shimouchi A, Huong ND, Hiep H, Co NV. A household survey on morbidity and treatment of acute respiratory infections in communities in Vietnam. Environ Health Prev Med 2002; 7 (4) 151-155
  • 5 Ngeow YF, Suwanjutha S, Chantarojanasriri T , et al. An Asian study on the prevalence of atypical respiratory pathogens in community-acquired pneumonia. Int J Infect Dis 2005; 9 (3) 144-153
  • 6 Williams P, Gracey M, Smith P. Hospitalization of aboriginal and non-aboriginal patients for respiratory tract diseases in Western Australia, 1988-1993. Int J Epidemiol 1997; 26 (4) 797-805
  • 7 He J, Gu D, Wu X , et al. Major causes of death among men and women in China. N Engl J Med 2005; 353 (11) 1124-1134
  • 8 Sutanto A, Gessner BD, Djlantik I , et al. Acute respiratory illness incidence and death among children under two years of age on Lombok Island, Indonesia. Am J Trop Med Hyg 2002; 66 (2) 175-179
  • 9 Morimoto K, Suzuki M, Ishifuji T , et al; Adult Pneumonia Study Group-Japan (APSG-J). The burden and etiology of community-onset pneumonia in the aging Japanese population: a multicenter prospective study. PLoS ONE 2015; 10 (3) e0122247
  • 10 Takaki M, Nakama T, Ishida M , et al. High incidence of community-acquired pneumonia among rapidly aging population in Japan: a prospective hospital-based surveillance. Jpn J Infect Dis 2014; 67 (4) 269-275
  • 11 Scott G, Scott H, Turley M, Baker M. Economic cost of community-acquired pneumonia in New Zealand adults. N Z Med J 2004; 117 (1196) U933
  • 12 Chambers S, Laing R, Murdoch D , et al. Māori have a much higher incidence of community-acquired pneumonia and pneumococcal pneumonia than non-Māori: findings from two New Zealand hospitals. N Z Med J 2006; 119 (1234) U1978
  • 13 Grant CC, Scragg R, Tan D, Pati A, Aickin R, Yee RL. Hospitalization for pneumonia in children in Auckland, New Zealand. J Paediatr Child Health 1998; 34 (4) 355-359
  • 14 Nizami SQ, Bhutta ZA, Hasan R. Incidence of acute respiratory infections in children 2 months to 5 years of age in periurban communities in Karachi, Pakistan. J Pak Med Assoc 2006; 56 (4) 163-167
  • 15 Kosai H, Tamaki R, Saito M , et al. Incidence and risk factors of childhood pneumonia-like episodes in Biliran Island, Philippines—a community-based study. PLoS ONE 2015; 10 (5) e0125009
  • 16 Kim SA, Kilgore PE, Lee SY, Nyambat B, Ki M. Trends in pneumonia and influenza-associated hospitalizations in South Korea, 2002-2005. J Health Popul Nutr 2011; 29 (6) 574-582
  • 17 Lim D, Ha M, Song I. Trends in the leading causes of death in Korea, 1983-2012. J Korean Med Sci 2014; 29 (12) 1597-1603
  • 18 Rudan I, Boschi-Pinto C, Biloglav Z, Mulholland K, Campbell H. Epidemiology and etiology of childhood pneumonia. Bull World Health Organ 2008; 86 (5) 408-416
  • 19 Leung KK, Tang LY, Chie WC, Lue BH, Lee LT. Mortality trends of elderly people in Taiwan from 1974 to 1994. Age Ageing 1999; 28 (2) 199-203
  • 20 Wu PS, Chang IS, Tsai FY , et al. Epidemiology and impacts of children hospitalized with pneumonia from 1997 to 2004 in Taiwan. Pediatr Pulmonol 2009; 44 (2) 162-166
  • 21 Reechaipichitkul W, Thavornpitak Y, Sutra S. Burden of adult pneumonia in Thailand: a nationwide hospital admission data 2010. J Med Assoc Thai 2014; 97 (3) 283-292
  • 22 Prapasiri P, Jareinpituk S, Keawpan A , et al. Epidemiology of radiographically-confirmed and bacteremic pneumonia in rural Thailand. Southeast Asian J Trop Med Public Health 2008; 39 (4) 706-718
  • 23 Aungkulanon S, McCarron M, Lertiendumrong J, Olsen SJ, Bundhamcharoen K. Infectious disease mortality rates, Thailand, 1958-2009. Emerg Infect Dis 2012; 18 (11) 1794-1801
  • 24 Olsen SJ, Laosiritaworn Y, Siasiriwattana S, Chunsuttiwat S, Dowell SF. The incidence of pneumonia in rural Thailand. Int J Infect Dis 2006; 10 (6) 439-445
  • 25 Kanlayanaphotporn J, Brady MA, Chantate P , et al. Pneumonia surveillance in Thailand: current practice and future needs. Southeast Asian J Trop Med Public Health 2004; 35 (3) 711-716
  • 26 Teeratakulpisarn J, Uppala R, Thepsuthammarat K, Sutra S. Burden of acute lower respiratory infection in children in Thailand in 2010: have we achieved the national target in under-five morbidity and mortality?. J Med Assoc Thai 2012; 95 (Suppl. 07) S87-S96
  • 27 Song JH, Oh WS, Kang CI , et al; Asian Network for Surveillance of Resistant Pathogens Study Group. Epidemiology and clinical outcomes of community-acquired pneumonia in adult patients in Asian countries: a prospective study by the Asian network for surveillance of resistant pathogens. Int J Antimicrob Agents 2008; 31 (2) 107-114
  • 28 Mandell LA, Wunderink RG, Anzueto A , et al; Infectious Diseases Society of America; American Thoracic Society. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis 2007; 44 (Suppl. 02) S27-S72
  • 29 File TM. Community-acquired pneumonia. Lancet 2003; 362 (9400) 1991-2001
  • 30 Jain S, Self WH, Wunderink RG , et al; CDC EPIC Study Team. Community-acquired pneumonia requiring hospitalization among U.S. adults. N Engl J Med 2015; 373 (5) 415-427
  • 31 Gadsby NJ, Russell CD, McHugh MP , et al. Comprehensive molecular testing for respiratory pathogens in community-acquired pneumonia. Clin Infect Dis 2016; 62 (7) 817-823
  • 32 Cillóniz C, Ewig S, Polverino E , et al. Microbial aetiology of community-acquired pneumonia and its relation to severity. Thorax 2011; 66 (4) 340-346
  • 33 Johansson N, Kalin M, Tiveljung-Lindell A, Giske CG, Hedlund J. Etiology of community-acquired pneumonia: increased microbiological yield with new diagnostic methods. Clin Infect Dis 2010; 50 (2) 202-209
  • 34 Ishida T, Hashimoto T, Arita M, Ito I, Osawa M. Etiology of community-acquired pneumonia in hospitalized patients: a 3-year prospective study in Japan. Chest 1998; 114 (6) 1588-1593
  • 35 Miyashita N, Fukano H, Mouri K , et al. Community-acquired pneumonia in Japan: a prospective ambulatory and hospitalized patient study. J Med Microbiol 2005; 54 (Pt 4): 395-400
  • 36 Miyashita N, Fukano H, Niki Y, Matsushima T, Okimoto N. Etiology of community-acquired pneumonia requiring hospitalization in Japan. Chest 2001; 119 (4) 1295-1296
  • 37 Motomura K, Masaki H, Terada M , et al. Usefulness of the Japanese Respiratory Society guidelines for community pneumonia: a retrospective analysis of community-acquired pneumonia between 2000 and 2002 in a general hospital. Respirology 2005; 10 (2) 208-214
  • 38 Ishida T, Hashimoto T, Arita M, Tojo Y, Tachibana H, Jinnai M. A 3-year prospective study of a urinary antigen-detection test for Streptococcus pneumoniae in community-acquired pneumonia: utility and clinical impact on the reported etiology. J Infect Chemother 2004; 10 (6) 359-363
  • 39 Sohn JW, Park SC, Choi YH , et al. Atypical pathogens as etiologic agents in hospitalized patients with community-acquired pneumonia in Korea: a prospective multi-center study. J Korean Med Sci 2006; 21 (4) 602-607
  • 40 Jeon EJ, Cho SG, Shin JW , et al. The difference in clinical presentations between healthcare-associated and community-acquired pneumonia in university-affiliated hospital in Korea. Yonsei Med J 2011; 52 (2) 282-287
  • 41 Lauderdale TL, Chang FY, Ben RJ , et al. Etiology of community acquired pneumonia among adult patients requiring hospitalization in Taiwan. Respir Med 2005; 99 (9) 1079-1086
  • 42 Yen MY, Hu BS, Chen YS , et al. A prospective etiologic study of community-acquired pneumonia in Taiwan. J Formos Med Assoc 2005; 104 (10) 724-730
  • 43 Charles PG, Whitby M, Fuller AJ , et al; Australian CAP Study Collaboration. The etiology of community-acquired pneumonia in Australia: why penicillin plus doxycycline or a macrolide is the most appropriate therapy. Clin Infect Dis 2008; 46 (10) 1513-1521
  • 44 Laing R, Slater W, Coles C , et al. Community-acquired pneumonia in Christchurch and Waikato 1999-2000: microbiology and epidemiology. N Z Med J 2001; 114 (1143) 488-492
  • 45 Lee YT, Chen SC, Chan KC, Wu TC, Tsao SM, Chan CH. Impact of infectious etiology on the outcome of Taiwanese patients hospitalized with community acquired pneumonia. J Infect Dev Ctries 2013; 7 (2) 116-124
  • 46 Saito A, Kohno S, Matsushima T , et al; Study Group. Prospective multicenter study of the causative organisms of community-acquired pneumonia in adults in Japan. J Infect Chemother 2006; 12 (2) 63-69
  • 47 Huang HH, Zhang YY, Xiu QY , et al. Community-acquired pneumonia in Shanghai, China: microbial etiology and implications for empirical therapy in a prospective study of 389 patients. Eur J Clin Microbiol Infect Dis 2006; 25 (6) 369-374
  • 48 Liu Y, Chen M, Zhao T , et al. Causative agent distribution and antibiotic therapy assessment among adult patients with community acquired pneumonia in Chinese urban population. BMC Infect Dis 2009; 9: 31
  • 49 Zhang X, Wang R, Di X, Liu B, Liu Y. Different microbiological and clinical aspects of lower respiratory tract infections between China and European/American countries. J Thorac Dis 2014; 6 (2) 134-142
  • 50 Wattanathum A, Chaoprasong C, Nunthapisud P , et al. Community-acquired pneumonia in Southeast Asia: the microbial differences between ambulatory and hospitalized patients. Chest 2003; 123 (5) 1512-1519
  • 51 Wu CL, Ku SC, Yang KY , et al. Antimicrobial drug-resistant microbes associated with hospitalized community-acquired and healthcare-associated pneumonia: a multi-center study in Taiwan. J Formos Med Assoc 2013; 112 (1) 31-40
  • 52 Mustafa MI, Al-Marzooq F, How SH, Kuan YC, Ng TH. The use of multiplex real-time PCR improves the detection of the bacterial etiology of community acquired pneumonia. Trop Biomed 2011; 28 (3) 531-544
  • 53 Liam CK, Pang YK, Poosparajah S. Pulmonary tuberculosis presenting as community-acquired pneumonia. Respirology 2006; 11 (6) 786-792
  • 54 Reechaipichitkul W, Lulitanond V, Tantiwong P, Saelee R, Pisprasert V. Etiologies and treatment outcomes in patients hospitalized with community-acquired pneumonia (CAP) at Srinagarind Hospital, Khon Kaen, Thailand. Southeast Asian J Trop Med Public Health 2005; 36 (1) 156-161
  • 55 Acharya VK, Padyana M, B. U, R. A, Acharya PR, Juneja DJ. Microbiological profile and drug sensitivity pattern among community acquired pneumonia patients in tertiary care centre in Mangalore, Coastal Karnataka, India. J Clin Diagn Res 2014; 8 (6) MC04-MC06
  • 56 Reechaipichitkul W, Tantiwong P. Clinical features of community-acquired pneumonia treated at Srinagarind Hospital, Khon Kaen, Thailand. Southeast Asian J Trop Med Public Health 2002; 33 (2) 355-361
  • 57 Tan YK, Khoo KL, Chin SP, Ong YY. Aetiology and outcome of severe community-acquired pneumonia in Singapore. Eur Respir J 1998; 12 (1) 113-115
  • 58 Farida H, Gasem MH, Suryanto A , et al. Viruses and Gram-negative bacilli dominate the etiology of community-acquired pneumonia in Indonesia, a cohort study. Int J Infect Dis 2015; 38: 101-107
  • 59 Takahashi K, Suzuki M, Minh N , et al. The incidence and aetiology of hospitalised community-acquired pneumonia among Vietnamese adults: a prospective surveillance in Central Vietnam. BMC Infect Dis 2013; 13: 296
  • 60 Self WH, Williams DJ, Zhu Y , et al. Respiratory viral detection in children and adults: comparing asymptomatic controls and patients with community-acquired pneumonia. J Infect Dis 2016; 213 (4) 584-591
  • 61 Song JH, Thamlikitkul V, Hsueh PR. Clinical and economic burden of community-acquired pneumonia amongst adults in the Asia-Pacific region. Int J Antimicrob Agents 2011; 38 (2) 108-117
  • 62 Song JH, Jung SI, Ko KS , et al. High prevalence of antimicrobial resistance among clinical Streptococcus pneumoniae isolates in Asia (an ANSORP study). Antimicrob Agents Chemother 2004; 48 (6) 2101-2107
  • 63 Felmingham D, Cantón R, Jenkins SG. Regional trends in beta-lactam, macrolide, fluoroquinolone and telithromycin resistance among Streptococcus pneumoniae isolates 2001-2004. J Infect 2007; 55 (2) 111-118
  • 64 Batuwanthudawe R, Karunarathne K, Dassanayake M , et al. Surveillance of invasive pneumococcal disease in Colombo, Sri Lanka. Clin Infect Dis 2009; 48 (Suppl. 02) S136-S140
  • 65 Song J-H, Jung K-S. Treatment guidelines for community-acquired pneumonia in Korea: an evidence-based approach to appropriate antimicrobial therapy. J Korean Med Assoc 2010; 53: 20-42
  • 66 Miyashita N, Matsushima T, Oka M ; Japanese Respiratory Society. The JRS guidelines for the management of community-acquired pneumonia in adults: an update and new recommendations. Intern Med 2006; 45 (7) 419-428
  • 67 Kim SN, Kim SW, Choi IH, Pyo SN, Rhee DK. High incidence of multidrug-resistant Streptococcus pneumoniae in South Korea. Microb Drug Resist 1996; 2 (4) 401-406
  • 68 Song JH, Jung SI, Ki HK , et al; Asian Network for Surveillance of Resistant Pathogens Study Group. Clinical outcomes of pneumococcal pneumonia caused by antibiotic-resistant strains in Asian countries: a study by the Asian Network for Surveillance of Resistant Pathogens. Clin Infect Dis 2004; 38 (11) 1570-1578
  • 69 Yanagihara K, Otsu Y, Ohno H , et al. Clinical characteristics of pneumonia caused by penicillin resistant and sensitive Streptococcus pneumoniae in Japan. Intern Med 2004; 43 (11) 1029-1033
  • 70 Reechaipichitkul W, Assawasanti K, Chaimanee P. Risk factors and clinical outcomes of penicillin resistant S. pneumoniae community-acquired pneumonia in Khon Kaen, Thailand. Southeast Asian J Trop Med Public Health 2006; 37 (2) 320-326
  • 71 Centers for Disease Control and Prevention (CDC). Effects of new penicillin susceptibility breakpoints for Streptococcus pneumoniae—United States, 2006-2007. MMWR Morb Mortal Wkly Rep 2008; 57 (50) 1353-1355
  • 72 Kim SH, Song JH, Chung DR , et al; ANSORP Study Group. Changing trends in antimicrobial resistance and serotypes of Streptococcus pneumoniae isolates in Asian countries: an Asian Network for Surveillance of Resistant Pathogens (ANSORP) study. Antimicrob Agents Chemother 2012; 56 (3) 1418-1426
  • 73 Inoue M, Farrell DJ, Kaneko K , et al. Antimicrobial susceptibility of respiratory tract pathogens in Japan during PROTEKT years 1-5 (1999-2004). Microb Drug Resist 2008; 14 (2) 109-117
  • 74 Qin L, Watanabe H, Yoshimine H , et al. Antimicrobial susceptibility and serotype distribution of Streptococcus pneumoniae isolated from patients with community-acquired pneumonia and molecular analysis of multidrug-resistant serotype 19F and 23F strains in Japan. Epidemiol Infect 2006; 134 (6) 1188-1194
  • 75 Ishida T, Maniwa K, Kagioka H , et al. Antimicrobial susceptibilities of Streptococcus pneumoniae isolated from adult patients with community-acquired pneumonia in Japan. Respirology 2008; 13 (2) 240-246
  • 76 Hsieh YC, Chang LY, Huang YC, Lin HC, Huang LM, Hsueh PR. Circulation of international clones of levofloxacin non-susceptible Streptococcus pneumoniae in Taiwan. Clin Microbiol Infect 2010; 16 (7) 973-978
  • 77 Lee MR, Chen CM, Chuang TY, Huang YT, Hsueh PR. Capsular serotypes and antimicrobial susceptibilities of Streptococcus pneumoniae causing invasive pneumococcal disease from 2009-2012 with an emphasis on serotype 19A in bacteraemic pneumonia and empyema and β-lactam resistance. Int J Antimicrob Agents 2013; 42 (5) 395-402
  • 78 Canton R, Morosini M, Enright MC, Morrissey I. Worldwide incidence, molecular epidemiology and mutations implicated in fluoroquinolone-resistant Streptococcus pneumoniae: data from the global PROTEKT surveillance programme. J Antimicrob Chemother 2003; 52 (6) 944-952
  • 79 Ho PL, Yung RW, Tsang DN , et al. Increasing resistance of Streptococcus pneumoniae to fluoroquinolones: results of a Hong Kong multicentre study in 2000. J Antimicrob Chemother 2001; 48 (5) 659-665
  • 80 Kyaw MH, Lynfield R, Schaffner W , et al; Active Bacterial Core Surveillance of the Emerging Infections Program Network. Effect of introduction of the pneumococcal conjugate vaccine on drug-resistant Streptococcus pneumoniae . N Engl J Med 2006; 354 (14) 1455-1463
  • 81 Jacobs MR, Good CE, Bajaksouzian S, Windau AR. Emergence of Streptococcus pneumoniae serotypes 19A, 6C, and 22F and serogroup 15 in Cleveland, Ohio, in relation to introduction of the protein-conjugated pneumococcal vaccine. Clin Infect Dis 2008; 47 (11) 1388-1395
  • 82 Pelton SI, Huot H, Finkelstein JA , et al. Emergence of 19A as virulent and multidrug resistant pneumococcus in Massachusetts following universal immunization of infants with pneumococcal conjugate vaccine. Pediatr Infect Dis J 2007; 26 (6) 468-472
  • 83 Gertz Jr RE, Li Z, Pimenta FC , et al; Active Bacterial Core Surveillance Team. Increased penicillin nonsusceptibility of nonvaccine-serotype invasive pneumococci other than serotypes 19A and 6A in post-7-valent conjugate vaccine era. J Infect Dis 2010; 201 (5) 770-775
  • 84 Ubukata K, Chiba N, Hanada S , et al; Invasive Pneumococcal Diseases Surveillance Study Group. Serotype changes and drug resistance in invasive pneumococcal diseases in adults after vaccinations in children, Japan, 2010-2013. Emerg Infect Dis 2015; 21 (11) 1956-1965
  • 85 Akata K, Chang B, Yatera K , et al. Distribution and annual changes in Streptococcus pneumoniae serotypes in adult Japanese patients with pneumonia. J Infect Chemother 2015; 21 (10) 723-728
  • 86 Shin J, Baek JY, Kim SH, Song JH, Ko KS. Predominance of ST320 among Streptococcus pneumoniae serotype 19A isolates from 10 Asian countries. J Antimicrob Chemother 2011; 66 (5) 1001-1004
  • 87 Kawai S, Ochi M, Nakagawa T, Goto H. Antimicrobial therapy in community-acquired pneumonia among emergency patients in a university hospital in Japan. J Infect Chemother 2004; 10 (6) 352-358
  • 88 Lui G, Ip M, Lee N , et al. Role of ‘atypical pathogens’ among adult hospitalized patients with community-acquired pneumonia. Respirology 2009; 14 (8) 1098-1105
  • 89 Prapphal N, Suwanjutha S, Durongkaveroj P , et al. Prevalence and clinical presentations of atypical pathogens infection in community acquired pneumonia in Thailand. J Med Assoc Thai 2006; 89 (9) 1412-1419
  • 90 Thurman KA, Walter ND, Schwartz SB , et al. Comparison of laboratory diagnostic procedures for detection of Mycoplasma pneumoniae in community outbreaks. Clin Infect Dis 2009; 48 (9) 1244-1249
  • 91 Lim WS, Baudouin SV, George RC , et al; Pneumonia Guidelines Committee of the BTS Standards of Care Committee. BTS guidelines for the management of community acquired pneumonia in adults: update 2009. Thorax 2009; 64 (Suppl. 03) iii1-iii55
  • 92 Infectious Diseases Society of Taiwan; Taiwan Society of Pulmonary and Critical Medicine; Medical Foundation in Memory of Dr. Deh-Lin Cheng; Foundation of Professor Wei-Chuan Hsieh for Infectious Diseases Research and Education; CY Lee's Research Foundation for Pediatric Infectious Diseases and Vaccines. Guidelines on antimicrobial therapy of pneumonia in adults in Taiwan, revised 2006. J Microbiol Immunol Infect 2007; 40 (3) 279-283
  • 93 Okazaki N, Narita M, Yamada S , et al. Characteristics of macrolide-resistant Mycoplasma pneumoniae strains isolated from patients and induced with erythromycin in vitro. Microbiol Immunol 2001; 45 (8) 617-620
  • 94 Matsuoka M, Narita M, Okazaki N , et al. Characterization and molecular analysis of macrolide-resistant Mycoplasma pneumoniae clinical isolates obtained in Japan. Antimicrob Agents Chemother 2004; 48 (12) 4624-4630
  • 95 Okazaki N, Ohya H, Sasaki T. Mycoplasma pneumoniae isolated from patients with respiratory infection in Kanagawa Prefecture in 1976-2006: emergence of macrolide-resistant strains. Jpn J Infect Dis 2007; 60 (5) 325-326
  • 96 Morozumi M, Takahashi T, Ubukata K. Macrolide-resistant Mycoplasma pneumoniae: characteristics of isolates and clinical aspects of community-acquired pneumonia. J Infect Chemother 2010; 16 (2) 78-86
  • 97 Liu Y, Ye X, Zhang H , et al. Antimicrobial susceptibility of Mycoplasma pneumoniae isolates and molecular analysis of macrolide-resistant strains from Shanghai, China. Antimicrob Agents Chemother 2009; 53 (5) 2160-2162
  • 98 Xin D, Mi Z, Han X , et al. Molecular mechanisms of macrolide resistance in clinical isolates of Mycoplasma pneumoniae from China. Antimicrob Agents Chemother 2009; 53 (5) 2158-2159
  • 99 Cao B, Zhao CJ, Yin YD , et al. High prevalence of macrolide resistance in Mycoplasma pneumoniae isolates from adult and adolescent patients with respiratory tract infection in China. Clin Infect Dis 2010; 51 (2) 189-194
  • 100 Hong KB, Choi EH, Lee HJ , et al. Macrolide resistance of Mycoplasma pneumoniae, South Korea, 2000-2011. Emerg Infect Dis 2013; 19 (8) 1281-1284
  • 101 Wu HM, Wong KS, Huang YC , et al. Macrolide-resistant Mycoplasma pneumoniae in children in Taiwan. J Infect Chemother 2013; 19 (4) 782-786
  • 102 Ho PL, Law PY, Chan BW , et al. Emergence of macrolide-resistant Mycoplasma pneumoniae in Hong Kong is linked to increasing macrolide resistance in multilocus variable-number tandem-repeat analysis type 4-5-7-2. J Clin Microbiol 2015; 53 (11) 3560-3564
  • 103 Xue G, Wang Q, Yan C , et al. Molecular characterizations of PCR-positive Mycoplasma pneumoniae specimens collected from Australia and China. J Clin Microbiol 2014; 52 (5) 1478-1482
  • 104 Ishiguro N, Koseki N, Kaiho M , et al. Regional Differences in Prevalence of Macrolide Resistance among Pediatric Mycoplasma pneumoniae Infections in Hokkaido, Japan. Jpn J Infect Dis 2015; 69 (3) 186-190
  • 105 Suzuki S, Yamazaki T, Narita M , et al. Clinical evaluation of macrolide-resistant Mycoplasma pneumoniae . Antimicrob Agents Chemother 2006; 50 (2) 709-712
  • 106 Matsubara K, Morozumi M, Okada T , et al. A comparative clinical study of macrolide-sensitive and macrolide-resistant Mycoplasma pneumoniae infections in pediatric patients. J Infect Chemother 2009; 15 (6) 380-383
  • 107 Ma Z, Zheng Y, Deng J, Ma X, Liu H. Characterization of macrolide resistance of Mycoplasma pneumoniae in children in Shenzhen, China. Pediatr Pulmonol 2014; 49 (7) 695-700
  • 108 Okada T, Morozumi M, Tajima T , et al. Rapid effectiveness of minocycline or doxycycline against macrolide-resistant Mycoplasma pneumoniae infection in a 2011 outbreak among Japanese children. Clin Infect Dis 2012; 55 (12) 1642-1649
  • 109 Kawai Y, Miyashita N, Kubo M , et al. Therapeutic efficacy of macrolides, minocycline, and tosufloxacin against macrolide-resistant Mycoplasma pneumoniae pneumonia in pediatric patients. Antimicrob Agents Chemother 2013; 57 (5) 2252-2258
  • 110 Principi N, Esposito S. Macrolide-resistant Mycoplasma pneumoniae: its role in respiratory infection. J Antimicrob Chemother 2013; 68 (3) 506-511
  • 111 Rémond MG, Ralph AP, Brady SJ, Martin J, Tikoft E, Maguire GP. Community-acquired pneumonia in the central desert and north-western tropics of Australia. Intern Med J 2010; 40 (1) 37-44
  • 112 Loh LC, Khoo SK, Quah SY , et al. Adult community-acquired pneumonia in Malaysia: prediction of mortality from severity assessment on admission. Respirology 2004; 9 (3) 379-386
  • 113 Liam CK, Lim KH, Wong CM. Community-acquired pneumonia in patients requiring hospitalization. Respirology 2001; 6 (3) 259-264
  • 114 Ko WC, Paterson DL, Sagnimeni AJ , et al. Community-acquired Klebsiella pneumoniae bacteremia: global differences in clinical patterns. Emerg Infect Dis 2002; 8 (2) 160-166
  • 115 Lin YT, Jeng YY, Chen TL, Fung CP. Bacteremic community-acquired pneumonia due to Klebsiella pneumoniae: clinical and microbiological characteristics in Taiwan, 2001-2008. BMC Infect Dis 2010; 10: 307
  • 116 Rammaert B, Goyet S, Beauté J , et al. Klebsiella pneumoniae related community-acquired acute lower respiratory infections in Cambodia: clinical characteristics and treatment. BMC Infect Dis 2012; 12: 3
  • 117 Ito R, Shindo Y, Kobayashi D , et al. Molecular epidemiological characteristics of Klebsiella pneumoniae associated with bacteremia among patients with pneumonia. J Clin Microbiol 2015; 53 (3) 879-886
  • 118 Tsang KW, File Jr TM. Respiratory infections unique to Asia. Respirology 2008; 13 (7) 937-949
  • 119 Currie BJ. Melioidosis: an important cause of pneumonia in residents of and travellers returned from endemic regions. Eur Respir J 2003; 22 (3) 542-550
  • 120 Currie BJ, Ward L, Cheng AC. The epidemiology and clinical spectrum of melioidosis: 540 cases from the 20 year Darwin prospective study. PLoS Negl Trop Dis 2010; 4 (11) e900
  • 121 Gibney KB, Cheng AC, Currie BJ. Cutaneous melioidosis in the tropical top end of Australia: a prospective study and review of the literature. Clin Infect Dis 2008; 47 (5) 603-609
  • 122 Bhengsri S, Lertiendumrong J, Baggett HC , et al. Economic burden of bacteremic melioidosis in eastern and northeastern, Thailand. Am J Trop Med Hyg 2013; 89 (2) 369-373
  • 123 Currie B, Howard D, Nguyen VT, Withnall K, Merianos A. The 1990-1991 outbreak of melioidosis in the Northern Territory of Australia: clinical aspects. Southeast Asian J Trop Med Public Health 1993; 24 (3) 436-443
  • 124 Scott IA, Bell AM, Staines DR. Fatal human melioidosis in south-eastern Queensland. Med J Aust 1997; 166 (4) 197-199
  • 125 Currie BJ, Fisher DA, Howard DM , et al. Endemic melioidosis in tropical northern Australia: a 10-year prospective study and review of the literature. Clin Infect Dis 2000; 31 (4) 981-986
  • 126 Currie BJ, Fisher DA, Howard DM , et al. The epidemiology of melioidosis in Australia and Papua New Guinea. Acta Trop 2000; 74 (2–3) 121-127
  • 127 Vong S, Guillard B, Borand L , et al. Acute lower respiratory infections in ≥ 5 year -old hospitalized patients in Cambodia, a low-income tropical country: clinical characteristics and pathogenic etiology. BMC Infect Dis 2013; 13: 97
  • 128 Rammaert B, Beauté J, Borand L , et al. Pulmonary melioidosis in Cambodia: a prospective study. BMC Infect Dis 2011; 11: 126
  • 129 So SY, Chau PY, Leung YK, Lam WK. First report of septicaemic melioidosis in Hong Kong. Trans R Soc Trop Med Hyg 1984; 78 (4) 456-459
  • 130 Vidyalakshmi K, Lipika S, Vishal S, Damodar S, Chakrapani M. Emerging clinico-epidemiological trends in melioidosis: analysis of 95 cases from western coastal India. Int J Infect Dis 2012; 16 (7) e491-e497
  • 131 Chou DW, Chung KM, Chen CH, Cheung BM. Bacteremic melioidosis in southern Taiwan: clinical characteristics and outcome. J Formos Med Assoc 2007; 106 (12) 1013-1022
  • 132 Fang Y, Chen H, Li YL, Li Q, Ye ZJ, Mao XH. Melioidosis in Hainan, China: a restrospective study. Trans R Soc Trop Med Hyg 2015; 109 (10) 636-642
  • 133 Stephens DP, Thomas JH, Ward LM, Currie BJ. Melioidosis causing critical illness: a review of 24 years of experience from the Royal Darwin Hospital ICU. Crit Care Med 2016; 44 (8) 1500-1505
  • 134 Reechaipichitkul W. Clinical manifestation of pulmonary melioidosis in adults. Southeast Asian J Trop Med Public Health 2004; 35 (3) 664-669
  • 135 Kim SW, Kwon GY, Kim B, Kwon D, Shin J, Bae GR. Imported melioidosis in South Korea: a case series with a literature review. Osong Public Health Res Perspect 2015; 6 (6) 363-368
  • 136 Simpson AJ, Suputtamongkol Y, Smith MD , et al. Comparison of imipenem and ceftazidime as therapy for severe melioidosis. Clin Infect Dis 1999; 29 (2) 381-387
  • 137 Cheng AC, Fisher DA, Anstey NM, Stephens DP, Jacups SP, Currie BJ. Outcomes of patients with melioidosis treated with meropenem. Antimicrob Agents Chemother 2004; 48 (5) 1763-1765
  • 138 Samuel M, Ti TY. Interventions for treating melioidosis. Cochrane Database Syst Rev 2002; (4) CD001263
  • 139 Chuang YY, Huang YC. Molecular epidemiology of community-associated meticillin-resistant Staphylococcus aureus in Asia. Lancet Infect Dis 2013; 13 (8) 698-708
  • 140 Francis JS, Doherty MC, Lopatin U , et al. Severe community-onset pneumonia in healthy adults caused by methicillin-resistant Staphylococcus aureus carrying the Panton-Valentine leukocidin genes. Clin Infect Dis 2005; 40 (1) 100-107
  • 141 Gillet Y, Issartel B, Vanhems P , et al. Association between Staphylococcus aureus strains carrying gene for Panton-Valentine leukocidin and highly lethal necrotising pneumonia in young immunocompetent patients. Lancet 2002; 359 (9308) 753-759
  • 142 Rubinstein E, Kollef MH, Nathwani D. Pneumonia caused by methicillin-resistant Staphylococcus aureus . Clin Infect Dis 2008; 46 (Suppl. 05) S378-S385
  • 143 Riley TV, Rouse IL. Methicillin-resistant Staphylococcus aureus in Western Australia, 1983-1992. J Hosp Infect 1995; 29 (3) 177-188
  • 144 Chua AP, Lee KH. Fatal bacteraemic pneumonia due to community-acquired methicillin-resistant Staphylococcus aureus . Singapore Med J 2006; 47 (6) 546-548
  • 145 Chen CJ, Su LH, Chiu CH , et al. Clinical features and molecular characteristics of invasive community-acquired methicillin-resistant Staphylococcus aureus infections in Taiwanese children. Diagn Microbiol Infect Dis 2007; 59 (3) 287-293
  • 146 Ito T, Iijima M, Fukushima T , et al. Pediatric pneumonia death caused by community-acquired methicillin-resistant Staphylococcus aureus, Japan. Emerg Infect Dis 2008; 14 (8) 1312-1314
  • 147 Geng W, Yang Y, Wu D , et al. Community-acquired, methicillin-resistant Staphylococcus aureus isolated from children with community-onset pneumonia in China. Pediatr Pulmonol 2010; 45 (4) 387-394
  • 148 Sohn KM, Chung DR, Baek JY , et al. Post-influenza pneumonia caused by the USA300 community-associated methicillin-resistant Staphylococcus aureus in Korea. J Korean Med Sci 2012; 27 (3) 313-316
  • 149 Joo EJ, Chung DR, Ha YE , et al. Clinical predictors of community-genotype ST72-methicillin-resistant Staphylococcus aureus-SCCmec type IV in patients with community-onset S. aureus infection. J Antimicrob Chemother 2012; 67 (7) 1755-1759
  • 150 Song JH, Hsueh PR, Chung DR , et al; ANSORP Study Group. Spread of methicillin-resistant Staphylococcus aureus between the community and the hospitals in Asian countries: an ANSORP study. J Antimicrob Chemother 2011; 66 (5) 1061-1069
  • 151 Boussaud V, Parrot A, Mayaud C , et al. Life-threatening hemoptysis in adults with community-acquired pneumonia due to Panton-Valentine leukocidin-secreting Staphylococcus aureus . Intensive Care Med 2003; 29 (10) 1840-1843
  • 152 Song JY, Choi JY, Lee JS , et al. Clinical and economic burden of invasive pneumococcal disease in adults: a multicenter hospital-based study. BMC Infect Dis 2013; 13: 202
  • 153 Lee JY, Yoo CG, Kim HJ, Jung KS, Yoo KH. Disease burden of pneumonia in Korean adults aged over 50 years stratified by age and underlying diseases. Korean J Intern Med 2014; 29 (6) 764-773
  • 154 Fujiki R, Kawayama T, Ueyama T, Ichiki M, Aizawa H. The risk factors for mortality of community-acquired pneumonia in Japan. J Infect Chemother 2007; 13 (3) 157-165
  • 155 Chen YH, Yang GY, Loh CH , et al. Cost benefits of targeting the pneumococcal vaccination program to the elderly population in Taiwan. Am J Infect Control 2006; 34 (9) 597-599
  • 156 Zhou QT, He B, Zhu H. Potential for cost-savings in the care of hospitalized low-risk community-acquired pneumonia patients in China. Value Health 2009; 12 (1) 40-46
  • 157 Wei L, Liu W, Zhang XA , et al. Detection of viral and bacterial pathogens in hospitalized children with acute respiratory illnesses, Chongqing, 2009-2013. Medicine (Baltimore) 2015; 94 (16) e742
  • 158 Liu J, Ai H, Xiong Y , et al. Prevalence and correlation of infectious agents in hospitalized children with acute respiratory tract infections in Central China. PLoS ONE 2015; 10 (3) e0119170
  • 159 Wu Z, Li Y, Gu J, Zheng H, Tong Y, Wu Q. Detection of viruses and atypical bacteria associated with acute respiratory infection of children in Hubei, China. Respirology 2014; 19 (2) 218-224
  • 160 Chen K, Jia R, Li L, Yang C, Shi Y. The aetiology of community associated pneumonia in children in Nanjing, China and aetiological patterns associated with age and season. BMC Public Health 2015; 15: 113
  • 161 Chiang WC, Teoh OH, Chong CY, Goh A, Tang JP, Chay OM. Epidemiology, clinical characteristics and antimicrobial resistance patterns of community-acquired pneumonia in 1702 hospitalized children in Singapore. Respirology 2007; 12 (2) 254-261
  • 162 Hasan R, Rhodes J, Thamthitiwat S , et al. Incidence and etiology of acute lower respiratory tract infections in hospitalized children younger than 5 years in rural Thailand. Pediatr Infect Dis J 2014; 33 (2) e45-e52
  • 163 Chen Y, Deng W, Wang SM , et al. Burden of pneumonia and meningitis caused by Streptococcus pneumoniae in China among children under 5 years of age: a systematic literature review. PLoS ONE 2011; 6 (11) e27333
  • 164 Thomas K, Mukkai Kesavan L, Veeraraghavan B , et al; IBIS Study Group IndiaCLEN Network. Invasive pneumococcal disease associated with high case fatality in India. J Clin Epidemiol 2013; 66 (1) 36-43
  • 165 Ishiwada N, Kurosaki T, Terashima I, Kohno Y. The incidence of pediatric invasive pneumococcal disease in Chiba prefecture, Japan (2003-2005). J Infect 2008; 57 (6) 455-458
  • 166 Le CF, Palanisamy NK, Mohd Yusof MY, Sekaran SD. Capsular serotype and antibiotic resistance of Streptococcus pneumoniae isolates in Malaysia. PLoS ONE 2011; 6 (5) e19547
  • 167 Sombrero L, Nissinen A, Esparar G, Lindgren M, Siira L, Virolainen A ; ARIVAC consortium. Low incidence of antibiotic resistance among invasive and nasopharyngeal isolates of Streptococcus pneumoniae from children in rural Philippines between 1994 and 2000. Eur J Clin Microbiol Infect Dis 2008; 27 (10) 929-935
  • 168 Lee CY, Chiu CH, Huang YC , et al. Invasive pneumococcal infections: a clinical and microbiological analysis of 53 patients in Taiwan. Clin Microbiol Infect 2003; 9 (7) 614-618
  • 169 Hsieh YC, Huang YC, Lin HC , et al. Characterization of invasive isolates of Streptococcus pneumoniae among Taiwanese children. Clin Microbiol Infect 2009; 15 (11) 991-996
  • 170 Sangthawan P, Chantaratchada S, Chanthadisai N, Wattanathum A. Prevalence and clinical significance of community-acquired penicillin-resistant pneumococcal pneumonia in Thailand. Respirology 2003; 8 (2) 208-212
  • 171 Hoa NQ, Trung NV, Larsson M , et al. Decreased Streptococcus pneumoniae susceptibility to oral antibiotics among children in rural Vietnam: a community study. BMC Infect Dis 2010; 10: 85
  • 172 Kim HI, Kim SW, Chang HH , et al. Mortality of community-acquired pneumonia in Korea: assessed with the pneumonia severity index and the CURB-65 score. J Korean Med Sci 2013; 28 (9) 1276-1282