Etiology of severe community-acquired pneumonia during the 2013 Hajj—part of the MERS-CoV surveillance program
Identifieur interne : 001083 ( Pmc/Checkpoint ); précédent : 001082; suivant : 001084Etiology of severe community-acquired pneumonia during the 2013 Hajj—part of the MERS-CoV surveillance program
Auteurs : Ziad A. Memish ; Malak Almasri ; Abdulhafeez Turkestani ; Ali M. Al-Shangiti ; Saber YezliSource :
- International Journal of Infectious Diseases [ 1201-9712 ] ; 2014.
Abstract
Pneumonia is the leading cause of hospital admission during the annual Islamic pilgrimage (Hajj). The etiology of severe pneumonia is complex and includes the newly emerged Middle East respiratory syndrome coronavirus (MERS-CoV). Since 2012, the Saudi Ministry of Health (MoH) has required screening for MERS-CoV for all cases of severe pneumonia requiring hospitalization. We aimed to screen Hajj pilgrims admitted to healthcare facilities in 2013 with severe community-acquired pneumonia (CAP) for MERS-CoV and to determine other etiologies.
Sputum samples were collected from all pilgrims admitted to 15 healthcare facilities in the cities of Makkah and Medina, Saudi Arabia, who were diagnosed with severe CAP on admission, presenting with bilateral pneumonia. The medical records were reviewed to collect information on age, gender, nationality, and patient outcome. Samples were screened for MERS-CoV by PCR, and a respiratory multiplex array was used to detect up to 22 other viral and bacterial respiratory pathogens.
Thirty-eight patients met the inclusion criteria; they were predominantly elderly (mean age 58.6 years, range 25–83 years) and male (68.4%), and all were from developing countries. Fourteen of the 38 patients died (36.8%). MERS-CoV was not detected in any of the samples. Other respiratory pathogens were detected in 26 (68.4%) samples. Of these, bacterial pathogens were detected in 84.6% (22/26) and viruses in 80.7% (21/26). Twenty-one (80.7%) samples were positive for more than one respiratory pathogen and 17 (65.3%) were positive for both bacteria and viruses. The most common respiratory virus was human rhinovirus, detected in 57.7% of the positive samples, followed by influenza A virus (23.1%) and human coronaviruses (19.2%).
MERS-CoV was not the cause of severe CAP in any of the hospitalized pilgrims investigated. However we identified a variety of other respiratory pathogens in the sputum of this small number of patients. This indicates that the etiology of severe CAP in Hajj is complex with implications regarding its management.
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DOI: 10.1016/j.ijid.2014.06.003
PubMed: 24970703
PubMed Central: 7110543
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Etiology of severe community-acquired pneumonia during the 2013 Hajj—part of the MERS-CoV surveillance program</title><author><name sortKey="Memish, Ziad A" sort="Memish, Ziad A" uniqKey="Memish Z" first="Ziad A." last="Memish">Ziad A. Memish</name><affiliation><nlm:aff id="aff0005">Global Center for Mass Gatherings Medicine (GCMGM), Ministry of Health, Riyadh 11176, Kingdom of Saudi Arabia</nlm:aff><wicri:noCountry code="subfield">Kingdom of Saudi Arabia</wicri:noCountry></affiliation><affiliation><nlm:aff id="aff0010">College of Medicine, Alfaisal University, Riyadh, Kingdom of Saudi Arabia</nlm:aff><wicri:noCountry code="subfield">Kingdom of Saudi Arabia</wicri:noCountry></affiliation></author><author><name sortKey="Almasri, Malak" sort="Almasri, Malak" uniqKey="Almasri M" first="Malak" last="Almasri">Malak Almasri</name><affiliation><nlm:aff id="aff0005">Global Center for Mass Gatherings Medicine (GCMGM), Ministry of Health, Riyadh 11176, Kingdom of Saudi Arabia</nlm:aff><wicri:noCountry code="subfield">Kingdom of Saudi Arabia</wicri:noCountry></affiliation></author><author><name sortKey="Turkestani, Abdulhafeez" sort="Turkestani, Abdulhafeez" uniqKey="Turkestani A" first="Abdulhafeez" last="Turkestani">Abdulhafeez Turkestani</name><affiliation><nlm:aff id="aff0015">Makkah Regional Health Affairs, Ministry of Health, Makkah, Kingdom of Saudi Arabia</nlm:aff><wicri:noCountry code="subfield">Kingdom of Saudi Arabia</wicri:noCountry></affiliation></author><author><name sortKey="Al Shangiti, Ali M" sort="Al Shangiti, Ali M" uniqKey="Al Shangiti A" first="Ali M." last="Al-Shangiti">Ali M. Al-Shangiti</name><affiliation><nlm:aff id="aff0020">National Health Laboratory, Ministry of Health, Riyadh, Kingdom of Saudi Arabia</nlm:aff><wicri:noCountry code="subfield">Kingdom of Saudi Arabia</wicri:noCountry></affiliation></author><author><name sortKey="Yezli, Saber" sort="Yezli, Saber" uniqKey="Yezli S" first="Saber" last="Yezli">Saber Yezli</name><affiliation><nlm:aff id="aff0005">Global Center for Mass Gatherings Medicine (GCMGM), Ministry of Health, Riyadh 11176, Kingdom of Saudi Arabia</nlm:aff><wicri:noCountry code="subfield">Kingdom of Saudi Arabia</wicri:noCountry></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">24970703</idno><idno type="pmc">7110543</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7110543</idno><idno type="RBID">PMC:7110543</idno><idno type="doi">10.1016/j.ijid.2014.06.003</idno><date when="2014">2014</date><idno type="wicri:Area/Pmc/Corpus">000D64</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000D64</idno><idno type="wicri:Area/Pmc/Curation">000D64</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000D64</idno><idno type="wicri:Area/Pmc/Checkpoint">001083</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">001083</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Etiology of severe community-acquired pneumonia during the 2013 Hajj—part of the MERS-CoV surveillance program</title><author><name sortKey="Memish, Ziad A" sort="Memish, Ziad A" uniqKey="Memish Z" first="Ziad A." last="Memish">Ziad A. Memish</name><affiliation><nlm:aff id="aff0005">Global Center for Mass Gatherings Medicine (GCMGM), Ministry of Health, Riyadh 11176, Kingdom of Saudi Arabia</nlm:aff><wicri:noCountry code="subfield">Kingdom of Saudi Arabia</wicri:noCountry></affiliation><affiliation><nlm:aff id="aff0010">College of Medicine, Alfaisal University, Riyadh, Kingdom of Saudi Arabia</nlm:aff><wicri:noCountry code="subfield">Kingdom of Saudi Arabia</wicri:noCountry></affiliation></author><author><name sortKey="Almasri, Malak" sort="Almasri, Malak" uniqKey="Almasri M" first="Malak" last="Almasri">Malak Almasri</name><affiliation><nlm:aff id="aff0005">Global Center for Mass Gatherings Medicine (GCMGM), Ministry of Health, Riyadh 11176, Kingdom of Saudi Arabia</nlm:aff><wicri:noCountry code="subfield">Kingdom of Saudi Arabia</wicri:noCountry></affiliation></author><author><name sortKey="Turkestani, Abdulhafeez" sort="Turkestani, Abdulhafeez" uniqKey="Turkestani A" first="Abdulhafeez" last="Turkestani">Abdulhafeez Turkestani</name><affiliation><nlm:aff id="aff0015">Makkah Regional Health Affairs, Ministry of Health, Makkah, Kingdom of Saudi Arabia</nlm:aff><wicri:noCountry code="subfield">Kingdom of Saudi Arabia</wicri:noCountry></affiliation></author><author><name sortKey="Al Shangiti, Ali M" sort="Al Shangiti, Ali M" uniqKey="Al Shangiti A" first="Ali M." last="Al-Shangiti">Ali M. Al-Shangiti</name><affiliation><nlm:aff id="aff0020">National Health Laboratory, Ministry of Health, Riyadh, Kingdom of Saudi Arabia</nlm:aff><wicri:noCountry code="subfield">Kingdom of Saudi Arabia</wicri:noCountry></affiliation></author><author><name sortKey="Yezli, Saber" sort="Yezli, Saber" uniqKey="Yezli S" first="Saber" last="Yezli">Saber Yezli</name><affiliation><nlm:aff id="aff0005">Global Center for Mass Gatherings Medicine (GCMGM), Ministry of Health, Riyadh 11176, Kingdom of Saudi Arabia</nlm:aff><wicri:noCountry code="subfield">Kingdom of Saudi Arabia</wicri:noCountry></affiliation></author></analytic><series><title level="j">International Journal of Infectious Diseases</title><idno type="ISSN">1201-9712</idno><idno type="eISSN">1878-3511</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><title>Summary</title><sec><title>Background</title><p>Pneumonia is the leading cause of hospital admission during the annual Islamic pilgrimage (Hajj). The etiology of severe pneumonia is complex and includes the newly emerged Middle East respiratory syndrome coronavirus (MERS-CoV). Since 2012, the Saudi Ministry of Health (MoH) has required screening for MERS-CoV for all cases of severe pneumonia requiring hospitalization. We aimed to screen Hajj pilgrims admitted to healthcare facilities in 2013 with severe community-acquired pneumonia (CAP) for MERS-CoV and to determine other etiologies.</p></sec><sec><title>Methods</title><p>Sputum samples were collected from all pilgrims admitted to 15 healthcare facilities in the cities of Makkah and Medina, Saudi Arabia, who were diagnosed with severe CAP on admission, presenting with bilateral pneumonia. The medical records were reviewed to collect information on age, gender, nationality, and patient outcome. Samples were screened for MERS-CoV by PCR, and a respiratory multiplex array was used to detect up to 22 other viral and bacterial respiratory pathogens.</p></sec><sec><title>Results</title><p>Thirty-eight patients met the inclusion criteria; they were predominantly elderly (mean age 58.6 years, range 25–83 years) and male (68.4%), and all were from developing countries. Fourteen of the 38 patients died (36.8%). MERS-CoV was not detected in any of the samples. Other respiratory pathogens were detected in 26 (68.4%) samples. Of these, bacterial pathogens were detected in 84.6% (22/26) and viruses in 80.7% (21/26). Twenty-one (80.7%) samples were positive for more than one respiratory pathogen and 17 (65.3%) were positive for both bacteria and viruses. The most common respiratory virus was human rhinovirus, detected in 57.7% of the positive samples, followed by influenza A virus (23.1%) and human coronaviruses (19.2%). <italic>Haemophilus influenzae</italic> and <italic>Streptococcus pneumoniae</italic> were the predominant bacteria, detected in 57.7% and 53.8%, respectively, of the positive samples, followed by <italic>Moraxella catarrhalis</italic> (36.4%).</p></sec><sec><title>Conclusions</title><p>MERS-CoV was not the cause of severe CAP in any of the hospitalized pilgrims investigated. However we identified a variety of other respiratory pathogens in the sputum of this small number of patients. This indicates that the etiology of severe CAP in Hajj is complex with implications regarding its management.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Madani, T A" uniqKey="Madani T">T.A. 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Int J Infect Dis</journal-id><journal-id journal-id-type="iso-abbrev">Int. J. Infect. Dis</journal-id><journal-title-group><journal-title>International Journal of Infectious Diseases</journal-title></journal-title-group><issn pub-type="ppub">1201-9712</issn><issn pub-type="epub">1878-3511</issn><publisher><publisher-name>The Authors. Published by Elsevier Ltd.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">24970703</article-id><article-id pub-id-type="pmc">7110543</article-id><article-id pub-id-type="publisher-id">S1201-9712(14)01535-5</article-id><article-id pub-id-type="doi">10.1016/j.ijid.2014.06.003</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Etiology of severe community-acquired pneumonia during the 2013 Hajj—part of the MERS-CoV surveillance program</article-title></title-group><contrib-group><contrib contrib-type="author" id="aut0005"><name><surname>Memish</surname><given-names>Ziad A.</given-names></name><email>zmemish@yahoo.com</email><xref rid="aff0005" ref-type="aff">a</xref><xref rid="aff0010" ref-type="aff">b</xref><xref rid="cor0005" ref-type="corresp">⁎</xref></contrib><contrib contrib-type="author" id="aut0010"><name><surname>Almasri</surname><given-names>Malak</given-names></name><xref rid="aff0005" ref-type="aff">a</xref></contrib><contrib contrib-type="author" id="aut0015"><name><surname>Turkestani</surname><given-names>Abdulhafeez</given-names></name><xref rid="aff0015" ref-type="aff">c</xref></contrib><contrib contrib-type="author" id="aut0020"><name><surname>Al-Shangiti</surname><given-names>Ali M.</given-names></name><xref rid="aff0020" ref-type="aff">d</xref></contrib><contrib contrib-type="author" id="aut0025"><name><surname>Yezli</surname><given-names>Saber</given-names></name><xref rid="aff0005" ref-type="aff">a</xref></contrib></contrib-group><aff id="aff0005"><label>a</label>Global Center for Mass Gatherings Medicine (GCMGM), Ministry of Health, Riyadh 11176, Kingdom of Saudi Arabia</aff><aff id="aff0010"><label>b</label>College of Medicine, Alfaisal University, Riyadh, Kingdom of Saudi Arabia</aff><aff id="aff0015"><label>c</label>Makkah Regional Health Affairs, Ministry of Health, Makkah, Kingdom of Saudi Arabia</aff><aff id="aff0020"><label>d</label>National Health Laboratory, Ministry of Health, Riyadh, Kingdom of Saudi Arabia</aff><author-notes><corresp id="cor0005"><label>⁎</label>Corresponding author. Tel.: +966 11 2124052; fax: +966 11 2125052. <email>zmemish@yahoo.com</email></corresp></author-notes><pub-date pub-type="pmc-release"><day>23</day><month>6</month><year>2014</year></pub-date><pmc-comment> PMC Release delay is 0 months and 0 days and was based on .</pmc-comment>
<pub-date pub-type="ppub"><month>8</month><year>2014</year></pub-date><pub-date pub-type="epub"><day>23</day><month>6</month><year>2014</year></pub-date><volume>25</volume><fpage>186</fpage><lpage>190</lpage><history><date date-type="received"><day>11</day><month>6</month><year>2014</year></date><date date-type="accepted"><day>11</day><month>6</month><year>2014</year></date></history><permissions><copyright-statement>© 2014 The Authors</copyright-statement><copyright-year>2014</copyright-year><license><license-p>Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.</license-p></license></permissions><abstract id="abs0005"><title>Summary</title><sec><title>Background</title><p>Pneumonia is the leading cause of hospital admission during the annual Islamic pilgrimage (Hajj). The etiology of severe pneumonia is complex and includes the newly emerged Middle East respiratory syndrome coronavirus (MERS-CoV). Since 2012, the Saudi Ministry of Health (MoH) has required screening for MERS-CoV for all cases of severe pneumonia requiring hospitalization. We aimed to screen Hajj pilgrims admitted to healthcare facilities in 2013 with severe community-acquired pneumonia (CAP) for MERS-CoV and to determine other etiologies.</p></sec><sec><title>Methods</title><p>Sputum samples were collected from all pilgrims admitted to 15 healthcare facilities in the cities of Makkah and Medina, Saudi Arabia, who were diagnosed with severe CAP on admission, presenting with bilateral pneumonia. The medical records were reviewed to collect information on age, gender, nationality, and patient outcome. Samples were screened for MERS-CoV by PCR, and a respiratory multiplex array was used to detect up to 22 other viral and bacterial respiratory pathogens.</p></sec><sec><title>Results</title><p>Thirty-eight patients met the inclusion criteria; they were predominantly elderly (mean age 58.6 years, range 25–83 years) and male (68.4%), and all were from developing countries. Fourteen of the 38 patients died (36.8%). MERS-CoV was not detected in any of the samples. Other respiratory pathogens were detected in 26 (68.4%) samples. Of these, bacterial pathogens were detected in 84.6% (22/26) and viruses in 80.7% (21/26). Twenty-one (80.7%) samples were positive for more than one respiratory pathogen and 17 (65.3%) were positive for both bacteria and viruses. The most common respiratory virus was human rhinovirus, detected in 57.7% of the positive samples, followed by influenza A virus (23.1%) and human coronaviruses (19.2%). <italic>Haemophilus influenzae</italic> and <italic>Streptococcus pneumoniae</italic> were the predominant bacteria, detected in 57.7% and 53.8%, respectively, of the positive samples, followed by <italic>Moraxella catarrhalis</italic> (36.4%).</p></sec><sec><title>Conclusions</title><p>MERS-CoV was not the cause of severe CAP in any of the hospitalized pilgrims investigated. However we identified a variety of other respiratory pathogens in the sputum of this small number of patients. This indicates that the etiology of severe CAP in Hajj is complex with implications regarding its management.</p></sec></abstract><kwd-group id="kwd0005"><title>Keywords</title><kwd>Pneumonia</kwd><kwd>Hajj</kwd><kwd>MERS-CoV</kwd><kwd><italic>Streptococcus pneumoniae</italic></kwd><kwd><italic>Haemophilus influenzae</italic></kwd><kwd><italic>Moraxella catarrhalis</italic></kwd><kwd>Viruses</kwd></kwd-group></article-meta><notes><p id="misc0005"><bold>Corresponding Editor:</bold> Eskild Petersen, Aarhus, Denmark</p></notes></front></pmc><affiliations><list></list><tree><noCountry><name sortKey="Al Shangiti, Ali M" sort="Al Shangiti, Ali M" uniqKey="Al Shangiti A" first="Ali M." last="Al-Shangiti">Ali M. Al-Shangiti</name><name sortKey="Almasri, Malak" sort="Almasri, Malak" uniqKey="Almasri M" first="Malak" last="Almasri">Malak Almasri</name><name sortKey="Memish, Ziad A" sort="Memish, Ziad A" uniqKey="Memish Z" first="Ziad A." last="Memish">Ziad A. Memish</name><name sortKey="Turkestani, Abdulhafeez" sort="Turkestani, Abdulhafeez" uniqKey="Turkestani A" first="Abdulhafeez" last="Turkestani">Abdulhafeez Turkestani</name><name sortKey="Yezli, Saber" sort="Yezli, Saber" uniqKey="Yezli S" first="Saber" last="Yezli">Saber Yezli</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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