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Epidemiology of community-acquired respiratory tract infections
in adults. Incidence, etiology, and impact.
Autor – Garibaldi RA
Zeitschrift/Erscheinungsdatum –
Am J Med 1985 Jun 28;78(6B):32-7.
STUDY OBJECTIVES:
Upper respiratory tract infections are the most common types of infectious
diseases among adults. It is estimated that each adult in the United States
experiences two to four respiratory infections annually. The morbidity
of these infections is measured by an estimated 75 million physician visits
per year, almost 150 million days lost from work, and more than $10 billion
in costs for medical care. Serotypes of the rhinoviruses account for 20
to 30 percent of episodes of the common cold. However, the specific causes
of most upper respiratory infections are undefined. Pneumonia remains
an important cause of morbidity and mortality for nonhospitalized adults
despite the widespread use of effective antimicrobial agents. There are
no accurate figures on the number of episodes of pneumonia that occur
each year in ambulatory patients. In younger adults, the atypical pneumonia
syndrome is the most common clinical presentation; Mycoplasma pneumoniae
is the most frequently identified causative agent. Other less common agents
include Legionella pneumophila, influenza viruses, adenoviruses, and Chlamydia.
More than half a million adults are hospitalized each year with pneumonia.
Persons older than 65 years of age have the highest rate of pneumonia
admissions, 11.5 per 1,000 population. Pneumonia ranks as the sixth leading
cause of death in the United States. The pathogens responsible for community-acquired
pneumonias are changing. Forty years ago, Streptococcus pneumoniae accounted
for the majority of infections. Today, a broad array of community-acquired
pathogens have been implicated as etiologic agents including Legionella
species, gram-negative bacilli, Hemophilus influenzae, Staphylococcus
aureus and nonbacterial pathogens. Given the diversity of pathogenic agents,
it has become imperative for clinicians to establish a specific etiologic
diagnosis before initiating therapy or to consider the diagnostic possibilities
and treat with antimicrobial agents that are effective against the most
likely pathogens.
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