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Wertheim, The bacterial aetiology of adult community-acquired pneumonia in Asia: Community-acquired pneumonia CAP is a major cause of adult mortality in Asia.
Appropriate empirical treatment depends on knowledge of the pathogens commonly responsible. However, assessing the aetiological significance of identified organisms is often difficult, particularly with sputum isolates that might represent contamination with oropharyngeal flora.
A systematic review of all adult CAP aetiology studies from Asia, excluding the Middle East, published in English between 1 January and 1 March was conducted. Data from large parts of Asia were unavailable and there was substantial heterogeneity in methodology. As in western studies, Streptococcus pneumoniae , Mycoplasma pneumoniae , Chlamydophila pneumoniae , Legionella spp.
However, compared with western studies, S. Gram-negative bacilli and Mycobacterium tuberculosis were more important, and in northeast Thailand Burkholderia pseudomallei was a major pathogen. These data have major implications for diagnostic strategies and empirical treatment.
Narrow-spectrum antibiotics targeting S. Community-acquired pneumonia CAP is one of the most common life-threatening infections, with most deaths occurring in developing countries. Antibiotic treatment of CAP is usually empirical as the causative pathogen is rarely identified, even among hospitalised patients in developed countries, and almost never in time to direct immediate treatment. Appropriate selection of empirical treatment depends on the common pathogens identified in previous aetiological studies and on relevant treatment trials.