Aetiology of severe community-acquired pneumonia and antimicrobial susceptibility of <i>Streptococcus pneumoniae</i> in adults in Russia

Sir, Community-acquired pneumonia (CAP) is considered to be one of the most common acute infectious diseases worldwide. An early and adequate antimicrobial therapy is one of the few factors improving prognosis.1 Our study aimed to determine the aetiology of severe CAP in adults and perform antimicrobial susceptibility testing (AST) for Streptococcus pneumoniae. It was conducted in primary care hospitals in six Russian cities from April 2014 to March 2018. Immunocompetent adults with confirmed diagnosis of CAP were prospectively recruited. The diagnosis of CAP and the severity assessment was performed in accordance with the national guidelines and was based on conventional criteria.2 Pathogens were identified by cultivation of blood, respiratory (sputum, endotracheal aspirate) and autopsy samples. Real-time PCR was applied to detect RNA/DNA of Mycoplasma pneumoniae, Chlamydophila pneumoniae, Legionella pneumophila, influenza viruses A and B, human respiratory syncytial virus, human adenovirus, human metapneumovirus, human coronaviruses...