Clinical and etiological characteristics of severe community-acquired pneumonia: A two-center retrospective analysis from Xi’an and Jiaxing in China
- 1Department of Critical Care Medicine, Xi’an People's Hospital (Xi’an Fourth Hospital), China
- 2Department of Critical Care Medicine, First Hospital of Pinghu, China
- 3Department of Respiratory and Critical Care Medicine, Xi’an People's Hospital (Xi’an Fourth Hospital), China
Abstract
Objective: This study was conducted to evaluate the baseline clinical profile, causative pathogens, and treatment patterns of severe community-acquired pneumonia across two medical centers (Xi’an and Jiaxing) from January 2023 to August 2025.
Methods: We extracted data regarding medical profile, demographic characteristics, comorbidities, laboratory parameters, treatments during hospitalization, and outcomes for these patients from electronic records. Pathogens were detected using a combination of sputum culture/throat-swab polymerase chain reaction with metagenomic next-generation sequencing or targeted next-generation sequencing.
Results: Among the 204 severe community-acquired pneumonia patients, majority were men (72.55%, 95% confidence interval: 66.05%–78.21%); the age range of the population was 65–79 years (41.18%, 95% confidence interval: 34.65%–48.03%), and chronic obstructive pulmonary disease was the predominant chronic pulmonary condition, present in 28.92% of the study participants. Laboratory evaluations revealed high illness severity scores (Acute Physiology and Chronic Health Evaluation II score: 19.00 (14.00, 24.00) and Sequential Organ Failure Assessment score: 7.00 (6.00, 10.00)). Pathogens were identified using metagenomic next-generation sequencing or targeted next-generation sequencing of blood/sputum/bronchoalveolar lavage fluid and polymerase chain reaction of sputum culture/throat-swab in 117 and 85 cases, respectively. Klebsiella pneumoniae was the most common pathogen, present in 20.10% of the participants (95% confidence interval: 15.18%–26.13%), followed by coronavirus 2019 (16.18%, 95% confidence interval: 11.76%–21.85%), and influenza A virus (12.75%, 95% confidence interval: 8.85%–18.02%). Most frequently administered medicines were β-lactam/β-lactamase-inhibitor combinations (89.22%) and carbapenems (60.78%). All patients received respiratory support, with 15.69% undergoing continuous renal-replacement therapy and 5.39% receiving extracorporeal membrane oxygenation. The in-hospital mortality rate was 38.73% (79/204, 95% confidence interval: 32.31%–45.56%).
Conclusion: Severe community-acquired pneumonia, which is most often caused by K. pneumoniae in our region, regularly complicates chronic obstructive pulmonary disease and other chronic pulmonary diseases, requires broad-spectrum antibiotics and life-support, and is associated with a relatively high mortality rate.
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BibTeX
@article{ma2026clinical,
title = {{Clinical and etiological characteristics of severe community-acquired pneumonia: A two-center retrospective analysis from Xi’an and Jiaxing in China}},
author = {Xiaoni Ma and Lin Zhong and Ting Wang and Yi Zhang and Xiaoqian Liu and Sirui Ma and Dan Dang},
journal = {The Journal of International Medical Research},
year = {2026},
month = sep,
doi = {10.1177/03000605261489324},
url = {https://doi.org/10.1177/03000605261489324},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Clinical and etiological characteristics of severe community-acquired pneumonia: A two-center retrospective analysis from Xi’an and Jiaxing in China
AU - Xiaoni Ma
AU - Lin Zhong
AU - Ting Wang
AU - Yi Zhang
AU - Xiaoqian Liu
AU - Sirui Ma
AU - Dan Dang
PY - 2026
DA - 2026/09/17
JO - The Journal of International Medical Research
DO - 10.1177/03000605261489324
UR - https://doi.org/10.1177/03000605261489324
AB - Objective: This study was conducted to evaluate the baseline clinical profile, causative pathogens, and treatment patterns of severe community-acquired pneumonia across two medical centers (Xi’an and Jiaxing) from January 2023 to August 2025. Methods: We extracted data regarding medical profile, demographic characteristics, comorbidities, laboratory parameters, treatments during hospitalization, and outcomes for these patients from electronic records. Pathogens were detected using a combination of sputum culture/throat-swab polymerase chain reaction with metagenomic next-generation sequencing or targeted next-generation sequencing. Results: Among the 204 severe community-acquired pneumonia patients, majority were men (72.55%, 95% confidence interval: 66.05%–78.21%); the age range of the population was 65–79 years (41.18%, 95% confidence interval: 34.65%–48.03%), and chronic obstructive pulmonary disease was the predominant chronic pulmonary condition, present in 28.92% of the study participants. Laboratory evaluations revealed high illness severity scores (Acute Physiology and Chronic Health Evaluation II score: 19.00 (14.00, 24.00) and Sequential Organ Failure Assessment score: 7.00 (6.00, 10.00)). Pathogens were identified using metagenomic next-generation sequencing or targeted next-generation sequencing of blood/sputum/bronchoalveolar lavage fluid and polymerase chain reaction of sputum culture/throat-swab in 117 and 85 cases, respectively. Klebsiella pneumoniae was the most common pathogen, present in 20.10% of the participants (95% confidence interval: 15.18%–26.13%), followed by coronavirus 2019 (16.18%, 95% confidence interval: 11.76%–21.85%), and influenza A virus (12.75%, 95% confidence interval: 8.85%–18.02%). Most frequently administered medicines were β-lactam/β-lactamase-inhibitor combinations (89.22%) and carbapenems (60.78%). All patients received respiratory support, with 15.69% undergoing continuous renal-replacement therapy and 5.39% receiving extracorporeal membrane oxygenation. The in-hospital mortality rate was 38.73% (79/204, 95% confidence interval: 32.31%–45.56%). Conclusion: Severe community-acquired pneumonia, which is most often caused by K. pneumoniae in our region, regularly complicates chronic obstructive pulmonary disease and other chronic pulmonary diseases, requires broad-spectrum antibiotics and life-support, and is associated with a relatively high mortality rate.
SN - 0300-0605
SN - 1473-2300
ER -