The Incidence and Etiology of Influenza-Associated Community-Acquired Pneumonia i

项目概要/摘要 肺炎仍然是美国发病率和死亡率的主要传染性原因。尽管其 重大的公共卫生负担，最近在美国肺炎发病率的测量是 令人惊讶的稀缺和研究方法的差异使得现有估计数的比较 有问题此外，我们目前对社区获得性肺炎病原体分布的了解 肺炎（CAP）的研究是有限的，主要基于几十年前或国外进行的病例系列或研究。 新分子技术的出现为重新评估这一知识提供了机会 系统地如果没有目前大规模的基于人群的研究来告知临床医生最有可能的 肺炎的病原学和耐药微生物的鉴定，临床医生将继续评估， 像过去几十年一样治疗肺炎患者。自2010年1月以来， 在所有年龄段的受试者中进行积极的基于人群的肺炎监测， 研究，“住院患者流感相关性肺炎的发病率和病因。“这位 已建立了招募和检测合格肺炎患者的程序;数据收集 制定并测试了表格;制定了疾病控制和预防中心认可的实验室程序; 目前正在收集大量数据，并将其系统地输入总项目数据库; 每个肺炎病例的X光片都由研究放射科医生进行评估。有了这些完善的 研究方法和经验，我们有能力继续CDC资助的肺炎项目 再延长两年我们建议利用我们现有的基础设施、技术人员、网络能力， 和既往经验进行多中心、基于人群的前瞻性队列研究，以确定 导致儿童和成人住院的肺炎的发病率和病因。我们的项目 包括以下具体目标：1）确定社区住院率- 获得性肺炎的儿童和成人生活在田纳西州中部; 2）以确定相对 不同呼吸道病原体对社区获得性肺炎病因学的贡献 在田纳西州中部住院的儿童和成人;和，3）建立流感相关的负担 在田纳西州中部住院的儿童和成人中患有社区获得性肺炎。

PROJECT SUMMARY / ABSTRACT Pneumonia remains the leading infectious cause of morbidity and mortality in the United States. In spite of its substantial public health burden, recent measurements of pneumonia incidence in the United States are surprisingly scarce and differences in research methodologies make the comparison of available estimates problematic. Moreover, our current knowledge of the distribution of etiologic organisms for community-acquired pneumonia (CAP) is limited and largely based on case series or studies performed decades ago or abroad. The availability of novel molecular techniques provides opportunities to reassess this knowledge systematically. Without current large-scale population-based studies to inform clinicians about the most likely etiologies of pneumonia and the identification of resistant organisms, clinicians would continue to assess and treat patients with pneumonia as they have for the past several decades. Since January 2010 we have conducted active population-based surveillance for pneumonia in subjects of all ages through the CDC-funded study, "The incidence and etiology of influenza-associated pneumonia in hospitalized persons." The procedures for enrolling and testing eligible pneumonia patients have been well established; data collection forms have been developed and tested; CDC-endorsed laboratory procedures have been established; extensive data are now being collected and systematically entered into the master project databases; and radiographs from each pneumonia case are being evaluated by study radiologists. With these well established study methodologies and experience, we are well positioned to continue the CDC-funded pneumonia project for two additional years. We propose to use our existing infrastructure, skilled personnel, network capabilities, and previous experience to perform a multicenter, population-based, prospective cohort study to determine the incidence and etiologies of pneumonia leading to hospitalization for both children and adults. Our project encompasses the following specific aims: 1)To determine the incidence of hospitalization for community- acquired pneumonia in children and adults living in Middle Tennessee; 2) To determine the relative contributions of the different respiratory pathogens to the etiology of community-acquired pneumonia in children and adults hospitalized in Middle Tennessee; and, 3)To establish the burden of influenza associated with community-acquired pneumonia in children and adults hospitalized in Middle Tennessee.