Table 1.
Characteristics of 1904 patients aged ≥5 years hospitalized with community-acquired acute lower respiratory infection from April 2007 to December 2009, Kampong Cham and Takeo provinces, Cambodia
| |
Pneumonia [1] |
Pleural Effusions alone [2] |
ALRI with sequelae [3] |
ALRI with normal CXR [4] |
P values from comparisons between group [1], [2], [3] and [4] by Chi-squared or adjusted Chi-squared test |
|||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
|
Grand total |
Total |
Cavitations [1a] |
No cavitations[1b] |
n (%) |
n (%) |
n (%) |
[1a] vs. [1b] |
[1] vs.[2] |
[1] vs.[3] |
[1] vs. [4] |
[3] vs. [4] |
|
| 1904 (%) | 959 (50.4) | 289 (30.1) | 670 (69.9) | 169 (8.9) | 455 (24.3) | 321 (17.1) | ||||||
|
Median age in years (IQR*) |
53 (38–65) |
51 |
50 |
52 (35–65) |
52 (40–66) |
60 (51–70) |
44 (17–59) |
NS |
NS |
<0.001 |
<0.001 |
<0.001 |
|
Mean age in years |
50.0 |
48.6 |
49.3 |
48.3 |
51.0 |
59.0 |
40.5 |
NS |
NS |
<0.001 |
<0.001 |
<0.001 |
|
Age groups in years |
|
|
|
|
|
|
|
|
|
|
|
|
| 5-14 |
154 (8.1%) |
82 (8.6) |
0 (0.0) |
82 (12.2) |
3 (1.8) |
1 (0.2) |
68 (21.2) |
<0.001 |
<0.001 |
<0.001 |
<0.001 |
<0.001 |
| 15 - 49 |
659 (34.6%) |
368 (38.4) |
144 (49.8) |
224 (33.4) |
72 (42.6) |
97 (21.3) |
122 (38.0) |
<0.001 |
NS |
<0.001 |
NS |
<0.001 |
| ≥50 |
1091 (57.3) |
509 (53.1) |
145 (50.2) |
364 (54.3) |
94 (55.6) |
357 (78.5) |
131 (40.8) |
0.249 |
NS |
<0.001 |
<0.001 |
<0.001 |
|
Gender, male (%) |
941 (49.4) |
502 (52.3) |
157 (54.3) |
345 (51.5) |
90 (53.3) |
205 (45.1) |
144 (44.9) |
NS |
NS |
0.011 |
0.026 |
NS |
|
Signs and symptoms on admission |
|
|
|
|
|
|
|
|
|
|
|
|
| Wheezing |
261 (13.9) |
105 (11.1) |
13 (4.5) |
92 (14.0) |
3 (1.8) |
50 (11.0) |
103 (32.8) |
<0.001 |
<0.001 |
NS |
<0.001 |
<0.001 |
| Dry cough |
519 (27.3) |
229 (23.9) |
39 (13.5) |
190 (28.4) |
111 (65.7) |
66 (14.5) |
113 (35.2) |
<0.001 |
<0.001 |
<0.001 |
<0.001 |
<0.001 |
|
Time interval between presentation and symptoms onset in days (# of missing values = 112) |
|
|
|
|
|
|
|
|
|
|
|
|
| Median (IQR) |
6 (4–9) |
6 (4–9) |
7 (4–10) |
5 (4–9) |
6 (4–10) |
6 (4–10) |
4 (4–8) |
<0.001 |
NS |
0.032 |
0.004 |
<0.001 |
| Mean |
6.3 |
6.3 |
7.0 |
5.9 |
6. 6 |
6.7 |
5.6 |
<0.002 |
NS |
0.072 |
0.003 |
<0.001 |
|
Duration of hospital stay in days |
|
|
|
|
|
|
|
|
|
|
|
|
| Median (IQR) |
7 (4–11) |
7 (4–10) |
6 (4–10) |
7 (4–10) |
5 (3–8) |
9 (6–14) |
7 (4–10) |
NS |
<0.001 |
<0.001 |
NS |
<0.001 |
| Mean |
8.4 |
7.9 |
7.8 |
8 |
6.5 |
10.7 |
7.7 |
NS |
<0.001 |
<0.001 |
NS |
<0.001 |
|
Reports of medicine use prior to admission |
|
|
|
|
|
|
|
|
|
|
|
|
| No antibiotic used |
932 (48.9) |
455 (47.4) |
116 (40.1) |
339 (50.6) |
103 (60.9) |
211 (46.4) |
163 (50.8) |
0.004 |
0.002 |
NS |
NS |
NS |
| Intake of unknown origin |
776 (40.8) |
405 (42.2) |
143 (49.5) |
262 (39.1) |
43 (25.4) |
211 (46.4) |
117 (36.4) |
0.004 |
<0.001 |
NS |
0.078 |
0.013 |
| Antibiotic used |
196 (10.3) |
99 (10.3) |
30 (10.4) |
69 (10.3) |
23 (13.6) |
33 (7.3) |
41 (12.8) |
NS |
NS |
0.087 |
NS |
0.014 |
|
Patient outcomes |
|
|
|
|
|
|
|
|
|
|
|
|
| Deceased |
61 (3.2) |
43 (4.5) |
6 (2.1) |
37 (5.5) |
5 (3.0) |
11 (2.4) |
2 (0.6) |
0.021 |
NS |
0.076 |
0.003 |
NS |
| Cured or improved |
1264 (66.4) |
572 (59.6) |
117 (40.5) |
455 (67.9) |
79 (46.7) |
321 (70.5) |
292 (91.0) |
<0.001 |
0.002 |
<0.001 |
<0.001 |
<0.001 |
| Transferred |
482 (25.3) |
297 (31.0) |
154 (53.3) |
143 (21.3) |
82 (48.5) |
89 (19.6) |
14 (4.4) |
<0.001 |
<0.001 |
<0.001 |
<0.001 |
<0.001 |
| Escaped |
97 (5.1) |
47 (4.9) |
12 (4.2) |
35 (5.2) |
3 (1.8) |
34 (7.5) |
13 (4.0) |
NS |
NS |
0.066 |
NS |
0.031 |
|
Reported co-morbid conditions |
|
|
|
|
|
|
|
|
|
|
|
|
| Cardiovascular disorder |
213 (11.2) |
129 (13.5) |
9 (3.1) |
120 (17.9) |
17 (10.1) |
28 (6.2) |
39 (12.1) |
<0.001 |
NS |
<0.001 |
NS |
0.003 |
| Diabetes mellitus |
195 (10.2) |
111 (11.6) |
32 (11.1) |
79 (11.8) |
22 (13.0) |
40 (8.8) |
22 (6.9) |
NS |
NS |
NS |
0.023 |
NS |
| Renal disorder |
136 (7.1) |
80 (8.3) |
25 (8.7) |
55 (8.2) |
8 (4.7) |
33 (7.3) |
15 (4.7) |
NS |
NS |
NS |
0.044 |
NS |
| Liver disorder |
16 (0.8) |
10 (1.0) |
3 (1.0) |
7 (1.0) |
3 (1.8) |
1 (0.2) |
2 (0.6) |
NS |
NS |
NS |
NS |
NFS |
|
Severe cases |
188 (9.9) |
121 (12.6) |
15 (5.2) |
106 (15.6) |
11 (6.5) |
14 (3.1) |
42 (13.1) |
<0.001 |
0.032 |
<0.001 |
NS |
<0.001 |
|
Laboratory results** |
|
|
|
|
|
|
|
|
|
|
|
|
| Leukocytosis (missing values = 12) |
663 (34.8) |
399 (41.9) |
120 (41.7) |
279 (42.2) |
42(25.3) |
133 (29.4) |
89 (27.8) |
NS |
<0.001 |
<0.001 |
<0.001 |
NS |
| Elevated neutrophils count (missing values = 65) |
629 (33.0) |
378 (40.9) |
114 (40.6) |
264 (41.1) |
40 (24.4) |
127 (28.9) |
84 (27.0) |
NS |
<0.001 |
<0.001 |
<0.001 |
NS |
| Lymphocytosis (missing values = 314) |
99 (5.2) |
46 (5.5) |
7 (3.0) |
39 (6.4) |
8 (5.0) |
22 (7.7) |
23 (7.5) |
0.004 |
NS |
NS |
NS |
NS |
|
Patients tested by microbiology method (excluding contaminated samples or cultures) |
|
|
|
|
|
|
|
|
|
|
|
|
| Blood culture |
1695 (89.0) |
862 (89.9) |
264 (91.3) |
598 (89.3) |
149 (88.2) |
412 (90.5) |
272 (84.7) |
NS |
NS |
NS |
0.015 |
0.012 |
| Sputum culture |
888 (46.6) |
464 (48.4) |
185 (64.0) |
279 (41.6) |
37 (21.9) |
270 (59.3) |
117 (36.4) |
<0.001 |
<0.001 |
<0.001 |
0.002 |
<0.001 |
| Blood or sputum culture |
1789 (94.0) |
905 (94.4) |
280 (96.9) |
625 (93.3) |
152 (89.9) |
437 (96.0) |
295 (91.9) |
NS |
NS |
NS |
NS |
0.016 |
| Sputum smear for acid-fast bacilli (AFB) |
1682 (88.3) |
850 (88.6) |
280 (96.9) |
570 (85.1) |
140 (82.8) |
434 (95.4) |
258 (80.4) |
NS |
NS |
<0.001 |
0.001 |
<0.001 |
| Nasopharyngeal/throat swabs by PCR (a) |
1855 (97.4) |
935 (97.5) |
281 (97.2) |
654 (97.6) |
164 (97.0) |
442 (97.1) |
314 (97.8) |
NS |
NS |
NS |
NS |
NS |
| Samples collected for bacterial & AFB etiologies (b) |
1796 (94.3) |
911 (95.0) |
283 (97.9) |
628 (93.7) |
152 (89.9) |
438 (96.3) |
295 (91.9) |
NS |
NS |
NS |
NS |
0.008 |
| Samples collected for bacterial & viral etiologies (c) |
1747 (91.8) |
887 (92.5) |
275 (95.2) |
612 (91.3) |
147 (87.0) |
425 (93.4) |
288 (89.7) |
NS |
NS |
NS |
NS |
0.064 |
|
Bacterial or viral yield ‡ |
|
|
|
|
|
|
|
|
|
|
|
|
| Positive blood culture |
33 (2.0) |
27 (3.1) |
5 (1.9) |
22 (3.7) |
4 (2.7) |
2 (0.5) |
0 (0.0) |
NS |
NS |
0.007 |
0.007 |
NS |
| Positive sputum culture |
272 (30.6) |
138 (29.7) |
44 (23.8) |
94 (33.7) |
8 (21.6) |
95 (35.2) |
31 (26.5) |
0.029 |
NS |
NS |
NS |
NS |
| Positive blood or sputum culture (d) |
300 (16.8) |
161 (17.8) |
47 (16.8) |
114 (18.2) |
12 (7.9) |
96 (22.0) |
31 (10.5) |
NS |
0.003 |
0.079 |
0.007 |
<0.001 |
| Positive AFB smear (e) |
264 (15.7) |
218 (25.7) |
153 (54.6) |
65 (11.4) |
2 (1.4) |
42 (9.7) |
2 (0.8) |
<0.001 |
<0.001 |
<0.001 |
<0.001 |
<0.001 |
| Positive PCR for viruses (f) |
305 (16.4) |
138 (14.8) |
22 (7.8) |
116 (17.7) |
17 (10.4) |
68 (15.4) |
82 (26.1) |
<0.001 |
NS |
NS |
<0.001 |
0.004 |
|
Bacterial etiologies† |
|
|
|
|
|
|
|
|
|
|
|
|
| H. influenzae |
114 (38.0) |
52 (32.3) |
13 (27.7) |
39 (34.2) |
0 (0.0) |
46 (47.9) |
16 (51.6) |
NS |
0.005 |
0.002 |
NS |
0.022 |
| - In sputum1 |
114 (41.9) |
52 (37.7) |
13 (29.5) |
39 (41.5) |
0 (0.0) |
46 (48.4) |
16 (51.6) |
|
|
|
|
|
| - In blood2 |
1 (3.0) |
1 (3.7) |
1 (20.0) |
0 (0.0) |
0 (0.0) |
0 (0.0) |
0 (0.0) |
|
|
|
|
|
| S. pneumoniae |
53 (17.7) |
22 (13.7) |
6 (12.8) |
16 (14.0) |
1 (8.3) |
23 (24.0) |
7 (22.6) |
NS |
NS |
0.009 |
NS |
NS |
| - In sputum1 |
51 (18.8) |
20 (14.5) |
6 (13.6) |
14 (14.9) |
1 (12.5) |
23 (24.2) |
7 (22.6) |
|
|
|
|
|
| - In blood2 |
2 (6.0) |
2 (7.4) |
0 (0.0) |
2 (9.1) |
0 (0.0) |
0 (0.0) |
0 (0.0) |
|
|
|
|
|
| B. pseudomallei |
28 (9.3) |
25 (15.5) |
10 (21.3) |
15 (13.2) |
1 (8.3) |
1 (1.0) |
1 (3.2) |
NS |
NS |
<0.001 |
0.020 |
NS |
| - In sputum1 |
16 (5.9) |
14 (10.1) |
7 (15.9) |
7 (7.4) |
1 (12.5) |
0 (0.0) |
1 (3.2) |
|
|
|
|
|
| - In blood2 |
15 (45.5) |
14 (51.9) |
4 (9.0) |
10 (10.6) |
0 (0.0) |
1 (1.1) |
0 (0.0) |
|
|
|
|
|
| K. pneumoniae |
43 (14.3) |
28 (17.4) |
10 (21.3) |
18 (15.8) |
2 (16.7) |
8 (8.3) |
5 (16.1) |
NS |
NS |
NS |
NS |
NS |
| - In sputum1 |
42 (15.4) |
27 (19.6) |
10 (22.7) |
17 (18.1) |
2 (25.0) |
8 (8.4) |
5 (16.1) |
|
|
|
|
|
| - In blood2 |
1 (3.0) |
1 (3.7) |
0 (0.0) |
1 (4.6) |
0 (0.0) |
0 (0.0) |
0 (0.0) |
|
|
|
|
|
| P. aeruginosa |
37 (12.3) |
19 (11.8) |
6 (12.8) |
13 (11.4) |
1 (8.3) |
15 (15.6) |
2 (6.5) |
NS |
NS |
NS |
NS |
0.037 |
| S. aureus |
11 (3.7) |
5 (3.1) |
2 (4.3) |
3 (2.6) |
1 (8.3) |
4 (4.2) |
1 (3.2) |
NS |
NS |
NS |
NS |
NS |
| Other bacteria |
39 (13.0) |
22 (13.7) |
4 (8.5) |
18 (15.8) |
7 (58.3) |
9 (9.4) |
1 (3.2) |
NS |
NS |
NS |
0.040 |
NS |
| AFB-positive*** |
264 (15.7) |
218 (25.6) |
153 (54.6) |
65 (11.4) |
2 (1.4) |
42 (9.7) |
2 (0.8) |
<0.001 |
<0.001 |
<0.001 |
<0.001 |
<0.001 |
|
Positive PCR results ^ |
|
|
|
|
|
|
|
|
|
|
|
|
| Rhinovirus |
151 (49.5) |
68 (49.3) |
10 (45.5) |
58 (50.0) |
8 (47.1) |
30 (44.1) |
45 (54.9) |
0.007 |
NS |
NS |
<0.001 |
0.001 |
| Respiratory syncytial virus |
54 (17.7) |
23 (16.7) |
5 (23.7) |
18 (15.5) |
5 (29.4) |
11 (16.2) |
15 (18.3) |
NS |
NS |
NS |
0.064 |
NS |
| Influenza viruses |
37 (12.1) |
16 (11.6) |
3 (13.6) |
13 (11.2) |
0 (0.0) |
11 (16.2) |
10 (12.2) |
NS |
NS |
NS |
NS |
NS |
| Coronaviruses |
31 (10.2) |
18 (13.0) |
2 (9.9) |
16 (13.8) |
1 (5.9) |
11 (16.2) |
1 (1.2) |
NS |
NS |
NS |
0.080 |
0.001 |
| Human metapneumovirus |
14 (4.6) |
7 (5.1) |
0 (0.0) |
7 (6.0) |
2 (11.8) |
2 (2.9) |
3 (3.7) |
NS |
NS |
NS |
NS |
NS |
| Other viruses |
20 (6.6) |
6 (4.3) |
2 (9.1) |
4 (3.5) |
2 (11.8) |
5 (7.4) |
7 (8.5) |
NS |
NS |
NS |
NS |
NS |
|
Mixed infections |
|
|
|
|
|
|
|
|
|
|
|
|
| >1 pathogen (AFB, bact. or virus) (% = n*100/d) |
63 (21.0) |
35 (21.7) |
16 (34.0) |
19 (16.7) |
2 (16.7) |
22 (22.9) |
4 (12.9) |
NS |
NS |
NS |
NS |
NS |
| >1 bacterium identified (% = n*100/d) |
24 (8.0) |
12 (7.5) |
4 (8.5) |
8 (7.0) |
0 (0.0) |
10 (10.4) |
2 (6.5) |
NS |
NS |
NS |
NS |
NS |
| AFB and ≥1 bacterium identified (% = n*100/d) |
30 (10.0) |
24 (14.9) |
16 (34.0) |
8 (7.0) |
0 (0.0) |
6 (6.3) |
0 (0.0) |
NS |
NS |
NS |
NS |
NS |
| AFB & virus (% = n*100/f) |
26 (8.5) |
18 (13.0) |
14 (63.6) |
4 (3.5) |
0 (0.0) |
8 (11.8) |
0 (0.0) |
0.005 |
NS |
NS |
NS |
NS |
| >1 virus (% = n*100/f) |
9 (3.0) |
3 (2.2) |
1 (4.5) |
2 (1.7) |
2 (1.7) |
2 (2.9) |
2 (2.4) |
NS |
NS |
NS |
NS |
NS |
|
Overall etiology results |
|
|
|
|
|
|
|
|
|
|
|
|
| Bacterial etiologies incl. AFB (% = n*100/b) |
520 (29.0) |
355 (39.0) |
184 (65.0) |
171 (27.2) |
0 (0.0) |
132 (30.1) |
33 (11.2) |
<0.001 |
<0.001 |
0.002 |
<0.001 |
<0.001 |
| Viral detection (% = n*100/a) |
298 (16.1) |
135 (14.4) |
21 (7.5) |
114 (17.4) |
13 (7.9) |
68 (15.4) |
82 (26.1) |
NS |
0.033 |
NS |
<0.001 |
NS |
| Identified etiologies (% = n*100/c) | 749 (42.9) | 449 (50.6) | 192 (69.8) | 257 (42.0) | 13 (8.8) | 178 (41.9) | 109 (37.8) | <0.001 | <0.001 | 0.004 | <0.001 | <0.001 |
IQR: interquartile range; NS, not significant (NS is displayed when p value is >10%); PCR, polymerase chain reaction;
ALRI = acute lower respiratory infection; Other viruses include Parainfluenza viruses, Bocaviruses, Adenoviruses.
**Hyperleukocytosis: Leukocytes count ≥11 for 5–10 year-olds or ≥10 for ≥11 year-olds.
**Elevated neutrophils count ≥6 for 5–10 year-olds or ≥7.5 for ≥11 year-olds.
*** % = proportion of AFB-positive by # of patients tested for AFB.
‡ % = proportion of positive results by # of patients tested.
† % = proportion of positive bacteria by # of patients tested positive by sputum or blood culture.
1 and 2 % = proportion of positive bacteria by # of patients tested positive by sputum and blood culture respectively.
^ % = proportion of virus of interest by # of positive PCR.