High Incidence of Community-Acquired Pneumonia among Rapidly Aging Population in Japan: A Prospective Hospital-Based Surveillance

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  • Takaki Masahiro
    Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University
  • Nakama Takahiro
    Department of Respiratory Medicine, Chikamori Hospital
  • Ishida Masayuki
    Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University
  • Morimoto Hitomi
    Department of Laboratory, Chikamori Hospital
  • Nagasaki Yuka
    Department of Laboratory, Chikamori Hospital
  • Shiramizu Rina
    Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University
  • Hamashige Naohisa
    Department of Internal Medicine, Chikamori Hospital
  • Chikamori Masayuki
    Department of Dialysis, Chikamori Hospital
  • Yoshida Laymyint
    Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University
  • Ariyoshi Koya
    Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University
  • Suzuki Motoi
    Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University
  • Morimoto Konosuke
    Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University

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The age-group-specific incidence and etiological patterns of community-acquired pneumonia (CAP) have not been fully established in Japan. A 2-year prospective surveillance was conducted in Kochi city, Western Japan. All CAP patients aged ≥15 years who visited a community-based hospital were enrolled in the study. Clinical samples were examined by conventional bacterial culture and urinary antigen tests, and 6 bacterial pathogens and 16 respiratory viruses were identified from sputum samples by multiplex polymerase chain reaction assays. The age-group-specific incidence of CAP was estimated using a population-based data set of the total number of outpatients in the whole city. Ninety of the 131 enrolled patients, 68.7% were positive for respiratory pathogens. Streptococcus pneumoniae was the leading bacterial pathogen identified (28.2%). Respiratory viruses were identified in 36 patients (27.5%), and human entero–rhinovirus was the most common (13.3%) among them. The estimated overall incidence of adult CAP in Kochi was 9.6 per 1,000 person-years (PY); the estimated age group-specific incidence was 3.4, 10.7, and 42.9 per 1,000 PY for those aged 15–64, 65–74, and ≥75 years, respectively. The high incidence of CAP in these rural city of Japan, probably reflects the substantial aged population. S. pneumoniae and respiratory viruses play important roles in CAP in all age groups.

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