Epidemiological Investigation On The Etiology And Human Coronavirus Of Adult Community Acquired Pneumonia In Central China

Objective: Community acquired pneumonia(CAP) is a common infectious respiratory disease that puts heavy hygeian and economic burden on human society. The presence of human coronavirus(HCo V) especially SARS coronavirus(SARS-Co V) and Middle East respiratory syndrome coronavirus(MERS-Co V) has brought great harm to human health. CAP etiology in different regions has its own characteristics, so it is significant to understand the distribution of CAP in a region. It is significant to obtain the CAP etiology to guide treatment in a place as CAP in different regions has its own etiological characteristics. Therefore, we conducted this study to work out the etiological feature of and epidemiological characteristics of HCo V in CAP hospitalized in the central China so as to provide theoretical support for empiric antimicrobial therapy as well as to enhance China’s emergency handling ability to deal with new outbreaks of respiratory tract infectious diseases caused by new coronavirus.Methods: We recruited CAP patients hospitalized at department of respiratory and critical care medicine, Tongji hospital from May 2014 through January 2015, collecting clinical data including gender, age, height, weight, occupation, clinical symptoms and signs, comorbidities, radiographic manifestations, laboratory tests, pathogens, antibiotic therapy, hospitalization duration and outcomes etc., collecting sputum specimens for pathogen detection through polymerase chain reaction(PCR). Collected data and the results of the pathogen detection were analysed statistically.Results: A total of 78 patients with CAP were included in this study, including 73.1%(57/78) male and 26.9%(21/78) female with the ratio of male to female 2.71:1. The age range was 18 to 85 years old with the average age 55.19 ± 16.01 years old. Patients were mainly in the age of 40 years old and older(82.1%). 37.68%(26/69) of sputum cultures were positive, including 34 strains of pathogenic bacteria, with pseudomonas aeruginosa, acinetobacter baumannii and candida predominate. 80.77% of the patients were positive for pathogen nucleic acid detection, predominantly Klebsiella pneumoniae, cytomegalovirus and influenza A, which was statistically higher than culture results. Coinfection accounted for 48.72%(38 / 78). The positive rates of HCo V-NL63, HCo V-229 E and HCo V-OC43 were 5.13%, 2.56% and 1.28%, respectively, yet HCo V-HKU1 was not detected.Conclusion: In central China, CAP patients were predominantly in the age of 40 years old or older, pathogens were mainly gram negative bacilli. Although PCR may improve the positive rate of pathogen detection, we still need to continue improving our detection skill and to find out the most possible pathogen according to the comprehensive characteristics of the patients. Human coronaviruses such as HCo V-OC43, HCo V-229 E, HCo V-NL63 but not HCo V-HKU1 were detected in patients with CAP, yet the role of them in the pathogenesis of CAP was still not clear, and further study was needed.