(Press-News.org) Viruses, not bacteria, are the most commonly detected respiratory pathogens in U.S. adults hospitalized with pneumonia, according to a New England Journal of Medicine study released today and conducted by researchers at Centers for Disease Control and Prevention (CDC) and hospitals in Chicago and Nashville, including Vanderbilt University Medical Center.
The findings highlight a need for more sensitive rapid diagnostic tests to identify pneumonia pathogens and target appropriate treatments when considering that neither viruses nor bacteria were detected in 62 percent of hospitalized adults during the two-and-a-half year study, researchers said.
"Pneumonia is a leading cause of hospitalization and death among adults in the United States and in 2011 the medical costs exceeded $10 billion," said CDC Director Tom Frieden, M.D., M.P.H. "Most of the time doctors are unable to pinpoint a specific cause of pneumonia. We urgently need more sensitive, rapid tests to identify causes of pneumonia and to promote better treatment."
Known as the CDC Etiology of Pneumonia in the Community (EPIC) study, it is one of the largest U.S. population-based pneumonia studies ever conducted.
The EPIC study team enrolled 2,488 eligible adults, of which 2,320 (93 percent) had pneumonia that was confirmed through chest x-rays and extensive diagnostic methods.
"We studied about 2,400 patients hospitalized with community-acquired pneumonia at five hospitals to understand if pneumonia continues to be a significant public health burden and to investigate what pathogens are causing pneumonia in our communities," said Vanderbilt lead author Wesley Self, M.D., MPH, assistant professor of Emergency Medicine at Vanderbilt University Medical Center.
"We found that, indeed, community-acquired pneumonia remains a very common reason for hospital admission in the US. We also found that viruses were more commonly associated with pneumonia than bacteria in our study. This highlights the urgent need to develop better diagnostic tests and treatment options for respiratory viral infections," he said.
Vanderbilt senior author Kathryn Edwards, M.D., Sarah H. Sell and Cornelius Vanderbilt Chair in Pediatrics and director of the Vanderbilt Vaccine Research Program, said she is pleased with the results of the study, a combined effort between investigators at Vanderbilt and at St. Thomas Hospital Midtown.
"These data will be used by practitioners throughout the country to diagnose and manage pneumonia. It also shows the impact of vaccines on pneumonia rates," Edwards said.
Viruses were detected in 27 percent of patients and bacteria in 14 percent of patients.
Human rhinovirus (HRV) was the most commonly detected virus among pneumonia patients; influenza was the second most common pathogen detected, with twice as many pneumonia hospitalizations due to influenza than any other pathogen (except HRV) in adults 80 years or older.
Streptococcus pneumonia, the most commonly detected bacterium, caused an estimated five times more pneumonia hospitalizations in adults 65 years and older than in younger adults.
"The frequency in which respiratory viruses were detected in adults hospitalized with pneumonia was higher than previously documented. This may be due to improved molecular diagnostics for viruses and also to the benefits of bacterial vaccines," said Seema Jain, M.D., lead author of the paper and medical epidemiologist in CDC's Influenza Division.
"However, what's most remarkable is that despite how hard we looked for pathogens, no discernible pathogen was detected in 62 percent of adults hospitalized with pneumonia in the EPIC study. This illustrates the need for more sensitive diagnostic methods that can both help guide treatment at the individual level as well as inform public health policy for adult pneumonia at a population level."
INFORMATION:
Many an injury will heal, but the damaged spinal cord is notoriously recalcitrant. There's new hope on the horizon, though. A team of researchers led by the University of South Carolina's Jeff Twiss just reported an innate repair mechanism in central nervous system axons that might be harnessed to regenerate nerves after brain or spinal cord injuries.
Twiss, a professor of biological sciences and the endowed SmartState chair of the Center for Childhood Neurotherapeutics, and graduate student Ashley Kalinski are building on breakthroughs that they and others have reported ...
If you can't tell a smile from a scowl, you're probably not getting enough sleep.
"Recognizing the emotional expressions of someone else changes everything about whether or not you decide to interact with them, and in return, whether they interact with you," said study senior author Matthew Walker, a professor of psychology and neuroscience at UC Berkeley. The findings were published today in the Journal of Neuroscience.
"These findings are especially worrying considering that two-thirds of people in the developed nations fail to get sufficient sleep," Walker added.
Indeed, ...
University of Adelaide researchers have shown that intelligence in animal species can be estimated by the size of the holes in the skull through which the arteries pass.
Published online ahead of print in the Journal of Experimental Biology, the researchers in the School of Biological Sciences show that the connection between intelligence and hole size stems from brain activity being related to brain metabolic rate.
"A human brain contains nearly 100 billion nerve cells with connections measured in the trillions," says project leader, Professor Emeritus Roger Seymour. ...
An international team of researchers, including investigators from the University of Mississippi Medical Center (UMMC), has identified a gene that underlies healthy information processing -- a first step on a complicated road to understand cognitive aging and age-related diseases, such as Alzheimer's disease.
The study, published online and expected to come out this fall in a print edition of the journal Molecular Psychiatry, is one of the the largest genetics study to date to link a specific genetic mutation and information processing speed.
"It is well known that ...
Special efforts should be made to identify and treat depression and urinary incontinence in postmenopausal women with vaginal symptoms, according to UC San Francisco researchers, as these two common conditions not only tend to co-exist with vaginal symptoms but also may complicate the impact of these symptoms on women's daily activities and quality of life.
The study appears online on July 15, 2015, in Menopause and will be featured in the January 2016 print edition.
"Our findings suggest that depression and urinary incontinence may magnify the effects of vaginal symptoms ...
Hydrogen fuel cells promise clean cars that emit only water. Several major car manufacturers have recently announced their investment to increase the availability of fueling stations, while others are rolling out new models and prototypes. However, challenges remain, including the chemistry to produce and use hydrogen and oxygen gas efficiently. Today, in ACS Central Science, two research teams report advances on chemical reactions essential to fuel-cell technology in separate papers.
Hydrogen (H2) fuel cells react H2 and oxygen (O2) gases to produce energy. For that ...
The perceived trustworthiness of an inmate's face may determine the severity of the sentence he receives, according to new research using photos and sentencing data for inmates in the state of Florida. The research, published in Psychological Science, a journal of the Association for Psychological Science, reveals that inmates whose faces were rated as low in trustworthiness by independent observers were more likely to have received the death sentence than inmates whose faces were perceived as more trustworthy, even when the inmates were later exonerated of the crime.
"The ...
COLUMBUS, Ohio - Research has suggested yellow perch grow more rapidly during the short winters resulting from climate change, but a new study shows warmer water temperatures can lead to the production of less hardy eggs and larvae that have trouble surviving these early stages of life in Lake Erie.
The research also showed that yellow perch don't adjust spawning to match earlier spring-like temperatures. This poses a problem if the hatchlings' main food source, zooplankton, does make a temperature-based adjustment because supplies may be low by the time larvae are ready ...
Species invasions come at a high cost. In the United States, the annual cost to the economy tops $100 billion a year and invasive plant infestations affect 100 million acres. While it's tempting to focus attention on headline-grabbing cases of exceptionally fecund flora such as the kudzu vine, also known as "the vine that ate the South", basic questions remain about how and whether exotic species are functionally distinct from native species and why they tend to take over when introduced into new environments.
A new study, led by University of Minnesota College of Biological ...
When a rhythm stalls, the effect can be fatal - in a power grid it can mean a blackout, and in the human heart even death. An international team of scientists has now developed a new approach for revoking these undesired quenching states. They use an advanced mathematical methodology, building on complex networks analysis, and demonstrate it in experiments with chemical reactions.
This could one day help to stabilize the flow of electricity in power grids challenged by the variable input from renewable energy sources. Future research could apply it to other complex networks, ...
