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Risk for hospitalization from community-acquired pneumonia significantly higher in older adults

The incidence of community-acquired pneumonia requiring hospitalization is highest among adults aged 65 years and older, according to study results.

The researchers noted a lack of pathogens in the majority of patients’ diagnostic tests, and a more frequent existence of respiratory viruses than bacteria.

Seema Jain

“In [62%] of patients, no pathogen was detected, highlighting the need for development of new, more sensitive rapid diagnostic tests and methods to accurately identify pneumonia pathogens and target appropriate treatment,” Seema Jain, MD, medical epidemiologist for the Epidemiology and Prevention Branch in the Influenza Division at the Centers for Disease and Control Prevention, told Healio.com/Pulmonology.

Jain and colleagues conducted an active population-based surveillance study of 2,488 adults from January 2010 through June 2012 at five hospitals in Chicago and Nashville. 

Ninety-three percent of the participants in the study had radiographic evidence of pneumonia and had a median age of 57 years.

Less than 500 patients (21%) required intensive care and 2% died. The researchers had available results for bacteria and viruses in 97% of patients with radiographic evidence of pneumonia.

Researchers identified pathogens in 38% of patients, and one or more viruses in 23% of patients. The researchers also found one or more bacteria in 11% of patients and both bacterial and viral pathogens in 3% of patients.

The results indicated the most common pathogens as being human rhinovirus (9%), influenza virus (6%) and S. pneumoniae (5%).

The researchers noted the annual incidence of pneumonia as 24.8 cases per 10,000 adults. The highest incidence came in adults aged 65 to 79 years (63 cases per 10,000 adults) and adults aged 80 years and older (164.3 cases per 10,000 adults).

Jain told Healio.com/Pulmonology the importance of using certain identifying microbiological causes of pneumonia.

“Pneumonia continues to be a challenging infectious process that has a large burden on adults, especially those who are older,” she said. “We need to remain vigilant and look for potential microbiological causes as is feasible in our institutions.  It is very likely that even with extensive testing, we may not find a cause but where there are tools such as urine antigen testing, respiratory viral molecular panels, and deeper specimen availability, it may be helpful and may reduce antibiotic over-use.” – by Ryan McDonald

Disclosure: Jain reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.