Microbiological testing of adults hospitalised with community-acquired pneumonia: an international study

Carugati, Manuela; Aliberti, Stefano; Reyes, Luis Felipe; Franco Sadud, Ricardo; Irfan, Muhammad; Prat, Cristina; Soni, Nilam J.; Faverio, Paola; Gori, Andrea; Blasi, Francesco; Restrepo, Marcos I.

First, a pathogen was identified in one-third of adult inpatients with CAP. This pathogen-detection yield is similar to previously reported investigations [14] [15] [16] [17] [18] [19] [20] [21] and consistent with the EPIC (Etiology of Pneumonia in the Community) study [1] . Despite extensive laboratory testing, the EPIC study identified a pathogen in 38% of 2259 patients hospitalised with CAP in the USA. The low pathogen-detection yield reported in this and other CAP studies highlights how limited our understanding is of CAP aetiologies among adult inpatients and how current empirical antimicrobial recommendations are based on weak evidence. Studies aimed at collecting as much data as possible to identify the aetiology using state-of-the-art diagnostic techniques and innovative pathogen-discovery approaches are urgently needed. Furthermore, aetiological studies should use novel analytical techniques in order to incorporate evidence from multiple specimens to account for the imperfect sensitivity and specificity of the diagnostic tests used [22] . Once a more accurate estimate of the aetiological distribution of CAP among adult inpatients is available, empirical antimicrobial recommendations should be updated.