SHM Converge Scientific Abstract ePoster Gallery-Etiologic Agents of Non-Covid Community-Acquired Pneumonia Requiring Hospitalization

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This retrospective cohort study examined changes in diagnostic testing and pathogen detection among 62,340 adults hospitalized with non-COVID community-acquired pneumonia (CAP) across 68 Michigan hospitals from 2017 to 2024. Patients were older on average (mean age 69 years) and about half were male. Most patients received microbiologic testing (92.8%), with a median of 4 etiologic tests per tested patient.<br /><br />The study found that testing remained very common despite 2019 guideline recommendations to limit traditional bacterial testing in non-severe CAP. Over time, molecular diagnostic testing increased substantially after the COVID-19 pandemic, but overall pathogen detection remained low. In 2024, any pathogen was detected in 17.4% of cases, compared with 14.6% in 2017; across the full study period, a pathogen was found in only 15.9% of patients.<br /><br />Bacterial pathogens were identified in 10.5% of patients overall, with Streptococcus pneumoniae the most common bacterial cause, followed by Pseudomonas aeruginosa, Mycoplasma pneumoniae, Staphylococcus aureus, and Legionella pneumophila. Viral pathogens were detected in 6.3% overall and increased notably over time, especially influenza, rhinovirus/enterovirus, and RSV. Bacterial-viral co-detection was uncommon (0.8%).<br /><br />The main conclusion is that, despite heavy testing and increased use of molecular diagnostics, the cause of CAP remains unidentified in most hospitalized patients. The authors suggest that diagnostic strategies should be reassessed to improve value and better allocate resources in the post-pandemic era.

Asset Subtitle

Valerie M. Vaughn

Meta Tag

Author List Anurag N. Malani, Ashwin B. Gupta, Claire Ciarkowski, Danielle Cook, David Ratz, Jennifer K. Horowitz, Lindsay A. Petty, Nak-Hyun Kim, Nora Fino, Preeti Misra, Scott A. Flanders, Tejal N. Gandhi, Valerie M. Vaughn

Category Research

Concept Community-Acquired Pneumonia

Concept Pathogen Detection

Concept Diagnostic Testing

Concept Microbiological Testing

Concept Low Diagnostic Yield

Distinguished Non-Finalist

Presenter Organization Division of General Internal Medicine, Department of Internal Medicine, the University of Utah School of Medicine, Salt Lake City, Utah, USA

Presenting Author Valerie M. Vaughn

Track Outcomes Research

Keywords

community-acquired pneumonia

diagnostic testing

pathogen detection

molecular diagnostics

hospitalized adults

retrospective cohort study

bacterial pathogens

viral pathogens

Streptococcus pneumoniae

Michigan hospitals

Community-Acquired Pneumonia

Pathogen Detection

Diagnostic Testing

Microbiological Testing

Low Diagnostic Yield