Contemporary Situation of Community-acquired Pneumonia in China: A Systematic Review

Abstract

The prevalence and microbial pattern reported for Community-acquired pneumonia (CAP) differ considerably and contemporary situation remains changing over time. We therefore searched both international and domestic databases for relevant references and pooled incidence of CAP and etiological distribution were estimated separately between children and adults groups. The results showed that CAP remained a major public health issue in China, with a relatively higher incidence than that reported in Western countries. Although pathogens were not detected in nearly half of patients, Mycoplasma pneumoniae remained to be the most frequently detected agent across age groups, the detection yield of which was lower than that reported from other countries. Notably, the incidence of influenza virus A in adults was almost four times higher than that in children while the prevalence of respiratory syncytial virus was much less common in adults than that in children. Despite some limitations, the value of this review, approaching to systematically review grey published data, is to sketch out the contemporary epidemiological and etiological situation of CAP in our country, which could be useful to help policymakers and clinicians make informed choices and to inspire future studies and surveillance.

Keywords: antibiotics resistance; community acquired pneumonia; epidemiology; etiology.

Figure 1

Overall pathogens detected yield among adults and children depending on regions. (A) Overall pathogens detected yield among adults and children; (B) Pathogens detected yield depending on designed regions; (C) Colors labeled on the map of China showed the designed areas in Panel C. Yellow (Northern area): provinces of Beijing, Tianjin, Heilongjiang, Jilin, Liaoning, Hebei, Henan, Shan(1)xi and Inner Mongolia. Red (Eastern area): provinces of Shanghai, Jiangsu, Zhejiang, Shandong, Anhui and Fujian. Green (Central & Southernarea): provinces of Hubei, Hunan, Jiangxi, Guangdong, Guangxi and Hainan. Blue (Western area): provinces of Shan(3)xi, Sichuan, Chongqing, Guizhou, Yunnan, Ningxia, Gansu, Qinghai, Xinjiang and Tibet.

Figure 2

The overall estimated distribution of CAP etiology. N = 154 in adult publications, N = 115 in kid publications.