Table 3. Etiologic distribution of pneumonia: community-acquired pneumonia vs. healthcare-associated pneumonia.
| Country | Authors [reference] | Study periods/age | CAPa | HCAPa | ||
|---|---|---|---|---|---|---|
| US | Kollef et al. [59] | 2002–2003 year/≥18 years | Streptococcus pneumoniae (16.6) | Streptococcus pneumoniae (5.5) | ||
| Staphylococcus aureus (25.5) | Staphylococcus aureus (46.7) | |||||
| MSSA (12.0) | MSSA (20.2) | |||||
| MRSA (6.2) | MRSA (26.5) | |||||
| Haemophilus influenzae (16.6) | Haemophilus influenzae (5.8) | |||||
| Klebsiella spp. (9.5) | Klebsiella spp. (7.6) | |||||
| Pseudomonas aeruginosa (17.1) | Pseudomonas aeruginosa (25.3) | |||||
| Escherichia coli (4.8) | Escherichia coli (5.2) | |||||
| Micek et al. [60] | 2003–2005 year/≥18 years | Streptococcus pneumoniae (40.9) | Streptococcus pneumoniae (10.4) | |||
| Staphylococcus aureus (25.5) | Staphylococcus aureus (46.7) | |||||
| MSSA (16.6) | MSSA (14.3) | |||||
| MRSA (8.9) | MRSA (18.3) | |||||
| Haemophilus influenzae (17.3) | Haemophilus influenzae (4.2) | |||||
| Klebsiella spp. (3.4) | Klebsiella spp. (6.5) | |||||
| Pseudomonas aeruginosa (4.8) | Pseudomonas aeruginosa (25.5) | |||||
| Escherichia coli (5.8) | Escherichia coli (4.2) | |||||
| Atypical pathogens (3.4) | Atypical pathogens (0.2) | |||||
| South Korea | Jeon et al. [54] | 2007–2008 year/≥60 years | Streptococcus pneumoniae (33.3) | Streptococcus pneumoniae (6.7) | ||
| Staphylococcus aureus (11.1) | Staphylococcus aureus (40.0) | |||||
| MSSA (4.8) | MSSA (10.0) | |||||
| MRSA (6.3) | MRSA (30.0) | |||||
| Haemophilus influenzae (11.1) | Haemophilus influenzae (3.3) | |||||
| Klebsiella pneumoniae (20.6) | Klebsiella pneumoniae (26.7) | |||||
| Pseudomonas aeruginosa (6.3) | Pseudomonas aeruginosa (26.7) | |||||
| Mycoplasma pneumoniae (3.2) | Mycoplasma pneumoniae (0.0) | |||||
| Jeong et al. [5] | 2008–2010 year/≥18 years | Streptococcus pneumoniae (48.4) | Streptococcus pneumoniae (30.8) | |||
| Staphylococcus aureus (10.7) | Staphylococcus aureus (19.2) | |||||
| MSSA (9.0) | MSSA (9.2) | |||||
| MRSA (1.6) | MRSA (10.0) | |||||
| Haemophilus influenzae (5.7) | Haemophilus influenzae (6.9) | |||||
| Klebsiella pneumoniae (11.5) | Klebsiella pneumoniae (16.9) | |||||
| Pseudomonas aeruginosa (9.0) | Pseudomonas aeruginosa (15.4) | |||||
| Escherichia coli (0.8) | Escherichia coli (3.8) | |||||
| Kang et al. [49] | 2008–2014 year/≥65 years | Streptococcus pneumoniae (69.4) | Streptococcus pneumoniae (35.2) | |||
| Staphylococcus aureus (12.9) | Staphylococcus aureus (24.1) | |||||
| MSSA (11.3) | MSSA (3.7) | |||||
| MRSA (1.6) | MRSA (20.4) | |||||
| Haemophilus influenzae (11.3) | Haemophilus influenzae (0.0) | |||||
| Klebsiella spp. (4.8) | Klebsiella spp. (14.8) | |||||
| ESBL-producer (0.0) | ESBL-producer (7.4) | |||||
| Pseudomonas spp. (3.2) | Pseudomonas spp. (13.0) | |||||
| Escherichia coli (0.0) | Escherichia coli (9.3) | |||||
| ESBL-producer (0.0) | ESBL-producer (1.9) | |||||
| Seong et al. [55] | 2010–2011 year/≥18 years | Streptococcus pneumoniae (41.9) | Streptococcus pneumoniae (33.3) | |||
| Staphylococcus aureus (9.5) | Staphylococcus aureus (31.4) | |||||
| MSSA (6.7) | MSSA (15.7) | |||||
| MRSA (2.9) | MRSA (15.7) | |||||
| Haemophilus influenzae (1.0) | Haemophilus influenzae (0.0) | |||||
| Klebsiella spp. (5.7) | Klebsiella spp. (3.9) | |||||
| ESBL-producer (1.0) | ESBL-producer (2.0) | |||||
| Pseudomonas spp. (9.5) | Pseudomonas spp. (18.6) | |||||
| Mycoplasma pneumoniae (6.7) | Mycoplasma pneumoniae (0.0) | |||||
| Lee et al. [46]b | 2011–2013 year/≥18 years | Streptococcus pneumoniae (13.5) | Streptococcus pneumoniae (6.5) | |||
| Staphylococcus aureus (37.8) | Staphylococcus aureus (26.1) | |||||
| MSSA (29.7) | MSSA (8.7) | |||||
| MRSA (8.1) | MRSA (19.6) | |||||
| Haemophilus influenzae (0.0) | Haemophilus influenzae (0.0) | |||||
| Klebsiella pneumoniae (23.3) | Klebsiella pneumoniae (45.6) | |||||
| Pseudomonas aeruginosa (10.8) | Pseudomonas aeruginosa (10.9) | |||||
| Escherichia coli (5.4) | Escherichia coli (15.3) | |||||
| Koh et al. [7]c | 2012–2013 year/≥65 years | Streptococcus pneumoniae (46.8) | Streptococcus pneumoniae (46.7) | |||
| Staphylococcus aureus (14.5) | Staphylococcus aureus (23.3) | |||||
| MSSA (3.2) | MSSA (3.3) | |||||
| MRSA (11.3) | MRSA (20.0) | |||||
| Haemophilus influenzae (3.2) | Haemophilus influenzae (0.0) | |||||
| Klebsiella pneumoniae (14.5) | Klebsiella pneumoniae (16.7) | |||||
| Pseudomonas aeruginosa (6.5) | Pseudomonas aeruginosa (16.7) | |||||
| Mycoplasma pneumoniae (8.1) | Mycoplasma pneumoniae (20.0) | |||||
| Ahn et al. [44] | 2012–2014 year/≥18 years | Streptococcus pneumoniae (32.8) | Streptococcus pneumoniae (17.0) | |||
| Staphylococcus aureus (5.7) | Staphylococcus aureus (18.9) | |||||
| MSSA (1.7) | MSSA (2.6) | |||||
| MRSA (4.0) | MRSA (16.3) | |||||
| Klebsiella pneumoniae (19.8) | Klebsiella pneumoniae (21.6) | |||||
| Pseudomonas aeruginosa (14.5) | Pseudomonas aeruginosa (19.6) | |||||
| ESBL-producing Enterobacteriaceae (2.3) | ESBL-producing Enterobacteriaceae (17.6) | |||||
| Mycoplasma pneumoniae (14.7) | Mycoplasma pneumoniae (6.5) | |||||
| Kim et al. [45] | 2016 year/≥18 years | Streptococcus pneumoniae (38.3) | Streptococcus pneumoniae (21.8) | |||
| Staphylococcus aureus (23.4) | Staphylococcus aureus (25.7) | |||||
| MSSA (17.0) | MSSA (7.9) | |||||
| MRSA (6.4) | MRSA (17.8) | |||||
| Haemophilus influenzae (2.1) | Haemophilus influenzae (6.9) | |||||
| Klebsiella pneumoniae (21.3) | Klebsiella pneumoniae (21.8) | |||||
| Pseudomonas aeruginosa (8.5) | Pseudomonas aeruginosa (19.8) | |||||
| Escherichia coli (4.3) | Escherichia coli (9.9) | |||||
| Mycoplasma pneumoniae (4.3) | Mycoplasma pneumoniae (0.0) | |||||
| Japan | Ishida et al. [62] | 2008–2010 year/≥18 years | Streptococcus pneumoniae (58.2) | Streptococcus pneumoniae (31.8) | ||
| Staphylococcus aureus (0.0) | Staphylococcus aureus (19.1) | |||||
| MSSA (0.0) | MSSA (11.0) | |||||
| MRSA (0.0) | MRSA (8.1) | |||||
| Haemophilus influenzae (14.9) | Haemophilus influenzae (9.2) | |||||
| Klebsiella pneumoniae (5.0) | Klebsiella pneumoniae (11.6) | |||||
| Pseudomonas aeruginosa (3.0) | Pseudomonas aeruginosa (13.3) | |||||
| Escherichia coli (1.0) | Escherichia coli (7.5) | |||||
| Mycoplasma pneumoniae (3.5) | Mycoplasma pneumoniae (0.6) | |||||
| Maruyama et al. [9] | 2009–2011 year/≥18 years | Streptococcus pneumoniae (58.5) | Streptococcus pneumoniae (54.4) | |||
| Staphylococcus aureus (1.9) | Staphylococcus aureus (19.0) | |||||
| MSSA (1.9) | MSSA (7.7) | |||||
| MRSA (0.0) | MRSA (11.3) | |||||
| Haemophilus influenzae (15.1) | Haemophilus influenzae (5.6) | |||||
| Klebsiella pneumoniae (3.8) | Klebsiella pneumoniae (6.2) | |||||
| Pseudomonas aeruginosa (1.9) | Pseudomonas aeruginosa (11.3) | |||||
| Escherichia coli (1.9) | Escherichia coli (3.6) | |||||
| Mycoplasma pneumoniae (20.8) | Mycoplasma pneumoniae (6.7) | |||||
| Kosai et al. [8] | 2009–2012 year/≥18 years | Streptococcus pneumoniae (54.4) | Streptococcus pneumoniae (45.7) | |||
| Staphylococcus aureus (15.8) | Staphylococcus aureus (28.6) | |||||
| MSSA (8.8) | MSSA (5.7) | |||||
| MRSA (7.0) | MRSA (14.0) | |||||
| Haemophilus influenzae (19.3) | Haemophilus influenzae (8.6) | |||||
| Klebsiella pneumoniae (3.5) | Klebsiella pneumoniae (17.1) | |||||
| Pseudomonas aeruginosa (3.5) | Pseudomonas aeruginosa (8.6) | |||||
| Escherichia coli (1.8) | Escherichia coli (5.7) | |||||
| Mycoplasma pneumoniae (33.3) | Mycoplasma pneumoniae (28.6) | |||||
| Fukuyama et al. [61] | 2010–2012 year/≥18 years | Streptococcus pneumoniae (36.9) | Streptococcus pneumoniae (29.9) | |||
| Staphylococcus aureus (1.0) | Staphylococcus aureus (4.3) | |||||
| Haemophilus influenzae (29.6) | Haemophilus influenzae (28.9) | |||||
| Klebsiella pneumoniae (5.3) | Klebsiella pneumoniae (15.2) | |||||
| Pseudomonas aeruginosa (5.8) | Pseudomonas aeruginosa (8.1) | |||||
| Mycoplasma pneumoniae (4.4) | Mycoplasma pneumoniae (0.5) | |||||
| Kamata et al. [6] | 2010–2013 year/≥18 years | Streptococcus pneumoniae (40.6) | Streptococcus pneumoniae (59.2) | |||
| Staphylococcus aureus (7.5) | Staphylococcus aureus (26.2) | |||||
| MSSA (7.5) | MSSA (14.6) | |||||
| MRSA (0.0) | MRSA (11.6) | |||||
| Haemophilus influenzae (7.5) | Haemophilus influenzae (10.7) | |||||
| Klebsiella pneumoniae (1.0) | Klebsiella pneumoniae (16.5) | |||||
| Pseudomonas aeruginosa (2.8) | Pseudomonas aeruginosa (20.4) | |||||
| Mycoplasma pneumoniae (15.1) | Mycoplasma pneumoniae (6.8) | |||||
| Parrott et al. [63] | 2011–2013 year/≥18 years | Streptococcus pneumoniae (35.2) | Streptococcus pneumoniae (29.5) | |||
| Staphylococcus aureus (9.3) | Staphylococcus aureus (11.4) | |||||
| MSSA (7.4) | MSSA (6.8) | |||||
| MRSA (1.9) | MRSA (4.5) | |||||
| Haemophilus influenzae (25.9) | Haemophilus influenzae (18.2) | |||||
| Klebsiella pneumoniae (3.7) | Klebsiella pneumoniae (15.9) | |||||
| Pseudomonas aeruginosa (3.7) | Pseudomonas aeruginosa (15.9) | |||||
| Escherichia coli (0.0) | Escherichia coli (9.1) | |||||
| ESBL-producer (0.0) | ESBL-producer (4.5) | |||||
| Mycoplasma pneumoniae (3.7) | Mycoplasma pneumoniae (0.0) | |||||
| Spain | Polverino et al. [64] | 2008–2010 year/≥18 years | Streptococcus pneumoniae (70.8) | Streptococcus pneumoniae (62.7) | ||
| Staphylococcus aureus (2.8) | Staphylococcus aureus (2.4) | |||||
| Haemophilus influenzae (1.4) | Haemophilus influenzae (1.2) | |||||
| Pseudomonas aeruginosa (1.4) | Pseudomonas aeruginosa (4.8) | |||||
| Gram-negative bacilli (5.6) | Gram-negative bacilli (7.2) | |||||
| Atypical pathogens (4.2) | Atypical pathogens (2.4) | |||||
| Valles et al. [65] | 2011–2012 year/≥18 years | Streptococcus pneumoniae (63.6) | Streptococcus pneumoniae (44.8) | |||
| Staphylococcus aureus (4.1) | Staphylococcus aureus (10.3) | |||||
| MSSA (3.7) | MSSA (5.2) | |||||
| MRSA (0.4) | MRSA (5.2) | |||||
| Haemophilus influenzae (3.3) | Haemophilus influenzae (8.6) | |||||
| Pseudomonas aeruginosa (2.9) | Pseudomonas aeruginosa (6.9) | |||||
| Enterobacteriaceae (7.0) | Enterobacteriaceae (10.3) | |||||
| Atypical pathogens (2.5) | Atypical pathogens (3.4) | |||||
CAP, community-acquired pneumonia; HCAP, healthcare-associated pneumonia; MSSA, methicillin-susceptible Staphylococcus aureus; MRSA, methicillin-resistant Staphylococcus aureus; ESBL, extended-spectrum beta-lactamases.
aProportion (%) among cases with identified bacteria.
bCases requiring intensive care unit (ICU) care.
cComparison between community-acquired pneumonia vs. nursing home-acquired pneumonia.