Community-acquired pneumonia in Japan: a prospective ambulatory and hospitalized patient study

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Abstract
In this study the aetiology of community-acquired pneumonia (CAP) in Japan was investigated and the incidence of causative pathogens in ambulatory and hospitalized patients was compared. In addition, the roles ofChlamydophila felisandChlamydophila pecorumas causes of CAP were investigated. Five hundred and six patients with CAP who visited an outpatient clinic or were admitted to one of three different hospitals were enrolled in this study; 106 of them were outpatients and 400 were hospitalized patients. Among the 506 CAP cases,Mycoplasma pneumoniaewas the most common pathogen found in the outpatients andStreptococcus pneumoniaewas the most common in the hospitalized patients. No cases ofChlamydophila pecorumpneumonia were observed and only one patient had an antibody titre suggestive of recent infection with the feline strain ofChlamydophila. The incidence of infection withM. pneumoniaeandChlamydophila pneumoniaewas higher among the outpatients than among hospitalized patients, whereas the incidence of infection withS. pneumoniaeandHaemophilus influenzaewas higher among the hospitalized patients. Recognition of these results will allow prompt and appropriate antimicrobial therapy to be provided using Japanese CAP guidelines.