Streptococcus pneumoniae as a Cause of Community-Acquired Pneumonia in Indian Adolescents and Adults: A Systematic Review and Meta-Analysis. Issue 13 (July 2019)

• Record Type: Journal Article
• Authors: Ghia, Canna J.; Dhar, Raja; Koul, Parvaiz A; Rambhad, Gautam; Fletcher, Mark A
• Is Part Of: Clinical medicine insights. Issue 13(2019)
• Publication Date: 2019-07
• Subjects: Community-acquired pneumonia -- Streptococcus pneumoniae -- bacterial pneumonia -- pneumonia -- aetiology; Cardiovascular system -- Diseases -- Periodicals; Respiratory organs -- Diseases -- Periodicals; Blood Circulation; Respiration; Lung Diseases; Cardiovascular system -- Diseases; Respiratory organs -- Diseases; Electronic journals; Periodicals; Periodicals; 616.1005
• DOI: 10.1177/1179548419862790
• Languages: English
• ISSNs: 1179-5484

Abstract

Background: Streptococcus pneumoniae is one of the primary cause of community-acquired pneumonia (CAP) worldwide. However, scant data are available on the prevalence of etiological organisms for CAP in adolescent and adult Indian population. Objective: We performed a systematic review and meta-analysis to determine the contribution of S. pneumoniae in the causation of CAP in Indian patients aged 12 years or above. Methodology: We performed a systematic search of both indexed and non-indexed publications using PubMed, databases of National Institute of Science Communication and Information Resources (NISCAIR), Annotated Bibliography of Indian Medicine (ABIM), Google Scholar, and hand search including cross-references using key terms 'community acquired pneumonia AND India'. All studies, published between January 1990 and January 2017, that evaluated Indian patients aged above 12 years with a confirmed diagnosis of CAP were eligible for inclusion. Our search retrieved a total of 182 studies, of which only 17 and 12 qualified for inclusion in the systematic review of all etiological organisms, and meta-analysis of S. pneumonia, respectively. Results: A total of 1435 patients met the inclusion criteria. The pooled proportion of patients with S. pneumoniae infection was 19% (95% confidence interval [CI]: 12%-26%; I 2 = 94.5% where I 2 represents heterogeneity, P < .01). Other major etiological agents are Mycoplasma pneumoniae (15.5% [1.1%-35.5%]), Klebsiella pneumoniae (10.5% [1.6%-24.0%]), and Legionella pneumophila (7.3% [2.5%-23.8%]). Conclusions: Analysis found approximately a one-fifth proportion of adult Indian patients of CAP with S. pneumoniae infection, suggesting it as a leading organism for causing CAP compared with other etiological organisms.