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Table 1 Characteristics of 1904 patients aged ≥5 years hospitalized with community-acquired acute lower respiratory infection from April 2007 to December 2009, Kampong Cham and Takeo provinces, Cambodia

From: Acute lower respiratory infections in ≥5 year -old hospitalized patients in Cambodia, a low-income tropical country: clinical characteristics and pathogenic etiology

   Pneumonia [1] Pleural Effusions alone [2] ALRI with sequelae [3] ALRI with normal CXR [4] P values from comparisons between group [1], [2], [3] and [4] by Chi-squared or adjusted Chi-squared test
Grand total Total Cavitations [1a] No cavitations[1b] n (%) n (%) n (%) [1a] vs. [1b] [1] vs.[2] [1] vs.[3] [1] vs. [4] [3] vs. [4]
1904 (%) 959 (50.4) 289 (30.1) 670 (69.9) 169 (8.9) 455 (24.3) 321 (17.1)      
Median age in years (IQR*) 53 (38–65) 51 50 52 (35–65) 52 (40–66) 60 (51–70) 44 (17–59) NS NS <0.001 <0.001 <0.001
Mean age in years 50.0 48.6 49.3 48.3 51.0 59.0 40.5 NS NS <0.001 <0.001 <0.001
Age groups in years             
 5-14 154 (8.1%) 82 (8.6) 0 (0.0) 82 (12.2) 3 (1.8) 1 (0.2) 68 (21.2) <0.001 <0.001 <0.001 <0.001 <0.001
 15 - 49 659 (34.6%) 368 (38.4) 144 (49.8) 224 (33.4) 72 (42.6) 97 (21.3) 122 (38.0) <0.001 NS <0.001 NS <0.001
 ≥50 1091 (57.3) 509 (53.1) 145 (50.2) 364 (54.3) 94 (55.6) 357 (78.5) 131 (40.8) 0.249 NS <0.001 <0.001 <0.001
Gender, male (%) 941 (49.4) 502 (52.3) 157 (54.3) 345 (51.5) 90 (53.3) 205 (45.1) 144 (44.9) NS NS 0.011 0.026 NS
Signs and symptoms on admission             
 Wheezing 261 (13.9) 105 (11.1) 13 (4.5) 92 (14.0) 3 (1.8) 50 (11.0) 103 (32.8) <0.001 <0.001 NS <0.001 <0.001
 Dry cough 519 (27.3) 229 (23.9) 39 (13.5) 190 (28.4) 111 (65.7) 66 (14.5) 113 (35.2) <0.001 <0.001 <0.001 <0.001 <0.001
Time interval between presentation and symptoms onset in days (# of missing values = 112)             
 Median (IQR) 6 (4–9) 6 (4–9) 7 (4–10) 5 (4–9) 6 (4–10) 6 (4–10) 4 (4–8) <0.001 NS 0.032 0.004 <0.001
 Mean 6.3 6.3 7.0 5.9 6. 6 6.7 5.6 <0.002 NS 0.072 0.003 <0.001
Duration of hospital stay in days             
 Median (IQR) 7 (4–11) 7 (4–10) 6 (4–10) 7 (4–10) 5 (3–8) 9 (6–14) 7 (4–10) NS <0.001 <0.001 NS <0.001
 Mean 8.4 7.9 7.8 8 6.5 10.7 7.7 NS <0.001 <0.001 NS <0.001
Reports of medicine use prior to admission             
 No antibiotic used 932 (48.9) 455 (47.4) 116 (40.1) 339 (50.6) 103 (60.9) 211 (46.4) 163 (50.8) 0.004 0.002 NS NS NS
 Intake of unknown origin 776 (40.8) 405 (42.2) 143 (49.5) 262 (39.1) 43 (25.4) 211 (46.4) 117 (36.4) 0.004 <0.001 NS 0.078 0.013
 Antibiotic used 196 (10.3) 99 (10.3) 30 (10.4) 69 (10.3) 23 (13.6) 33 (7.3) 41 (12.8) NS NS 0.087 NS 0.014
Patient outcomes             
 Deceased 61 (3.2) 43 (4.5) 6 (2.1) 37 (5.5) 5 (3.0) 11 (2.4) 2 (0.6) 0.021 NS 0.076 0.003 NS
 Cured or improved 1264 (66.4) 572 (59.6) 117 (40.5) 455 (67.9) 79 (46.7) 321 (70.5) 292 (91.0) <0.001 0.002 <0.001 <0.001 <0.001
 Transferred 482 (25.3) 297 (31.0) 154 (53.3) 143 (21.3) 82 (48.5) 89 (19.6) 14 (4.4) <0.001 <0.001 <0.001 <0.001 <0.001
 Escaped 97 (5.1) 47 (4.9) 12 (4.2) 35 (5.2) 3 (1.8) 34 (7.5) 13 (4.0) NS NS 0.066 NS 0.031
Reported co-morbid conditions             
 Cardiovascular disorder 213 (11.2) 129 (13.5) 9 (3.1) 120 (17.9) 17 (10.1) 28 (6.2) 39 (12.1) <0.001 NS <0.001 NS 0.003
 Diabetes mellitus 195 (10.2) 111 (11.6) 32 (11.1) 79 (11.8) 22 (13.0) 40 (8.8) 22 (6.9) NS NS NS 0.023 NS
 Renal disorder 136 (7.1) 80 (8.3) 25 (8.7) 55 (8.2) 8 (4.7) 33 (7.3) 15 (4.7) NS NS NS 0.044 NS
 Liver disorder 16 (0.8) 10 (1.0) 3 (1.0) 7 (1.0) 3 (1.8) 1 (0.2) 2 (0.6) NS NS NS NS NFS
Severe cases 188 (9.9) 121 (12.6) 15 (5.2) 106 (15.6) 11 (6.5) 14 (3.1) 42 (13.1) <0.001 0.032 <0.001 NS <0.001
Laboratory results**             
 Leukocytosis (missing values = 12) 663 (34.8) 399 (41.9) 120 (41.7) 279 (42.2) 42(25.3) 133 (29.4) 89 (27.8) NS <0.001 <0.001 <0.001 NS
 Elevated neutrophils count (missing values = 65) 629 (33.0) 378 (40.9) 114 (40.6) 264 (41.1) 40 (24.4) 127 (28.9) 84 (27.0) NS <0.001 <0.001 <0.001 NS
 Lymphocytosis (missing values = 314) 99 (5.2) 46 (5.5) 7 (3.0) 39 (6.4) 8 (5.0) 22 (7.7) 23 (7.5) 0.004 NS NS NS NS
Patients tested by microbiology method (excluding contaminated samples or cultures)             
 Blood culture 1695 (89.0) 862 (89.9) 264 (91.3) 598 (89.3) 149 (88.2) 412 (90.5) 272 (84.7) NS NS NS 0.015 0.012
 Sputum culture 888 (46.6) 464 (48.4) 185 (64.0) 279 (41.6) 37 (21.9) 270 (59.3) 117 (36.4) <0.001 <0.001 <0.001 0.002 <0.001
 Blood or sputum culture 1789 (94.0) 905 (94.4) 280 (96.9) 625 (93.3) 152 (89.9) 437 (96.0) 295 (91.9) NS NS NS NS 0.016
 Sputum smear for acid-fast bacilli (AFB) 1682 (88.3) 850 (88.6) 280 (96.9) 570 (85.1) 140 (82.8) 434 (95.4) 258 (80.4) NS NS <0.001 0.001 <0.001
 Nasopharyngeal/throat swabs by PCR (a) 1855 (97.4) 935 (97.5) 281 (97.2) 654 (97.6) 164 (97.0) 442 (97.1) 314 (97.8) NS NS NS NS NS
 Samples collected for bacterial & AFB etiologies (b) 1796 (94.3) 911 (95.0) 283 (97.9) 628 (93.7) 152 (89.9) 438 (96.3) 295 (91.9) NS NS NS NS 0.008
 Samples collected for bacterial & viral etiologies (c) 1747 (91.8) 887 (92.5) 275 (95.2) 612 (91.3) 147 (87.0) 425 (93.4) 288 (89.7) NS NS NS NS 0.064
Bacterial or viral yield ‡             
 Positive blood culture 33 (2.0) 27 (3.1) 5 (1.9) 22 (3.7) 4 (2.7) 2 (0.5) 0 (0.0) NS NS 0.007 0.007 NS
 Positive sputum culture 272 (30.6) 138 (29.7) 44 (23.8) 94 (33.7) 8 (21.6) 95 (35.2) 31 (26.5) 0.029 NS NS NS NS
 Positive blood or sputum culture (d) 300 (16.8) 161 (17.8) 47 (16.8) 114 (18.2) 12 (7.9) 96 (22.0) 31 (10.5) NS 0.003 0.079 0.007 <0.001
 Positive AFB smear (e) 264 (15.7) 218 (25.7) 153 (54.6) 65 (11.4) 2 (1.4) 42 (9.7) 2 (0.8) <0.001 <0.001 <0.001 <0.001 <0.001
 Positive PCR for viruses (f) 305 (16.4) 138 (14.8) 22 (7.8) 116 (17.7) 17 (10.4) 68 (15.4) 82 (26.1) <0.001 NS NS <0.001 0.004
Bacterial etiologies†             
H. influenzae 114 (38.0) 52 (32.3) 13 (27.7) 39 (34.2) 0 (0.0) 46 (47.9) 16 (51.6) NS 0.005 0.002 NS 0.022
- In sputum 1 114 (41.9) 52 (37.7) 13 (29.5) 39 (41.5) 0 (0.0) 46 (48.4) 16 (51.6)      
- In blood 2 1 (3.0) 1 (3.7) 1 (20.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0)      
S. pneumoniae 53 (17.7) 22 (13.7) 6 (12.8) 16 (14.0) 1 (8.3) 23 (24.0) 7 (22.6) NS NS 0.009 NS NS
- In sputum 1 51 (18.8) 20 (14.5) 6 (13.6) 14 (14.9) 1 (12.5) 23 (24.2) 7 (22.6)      
- In blood 2 2 (6.0) 2 (7.4) 0 (0.0) 2 (9.1) 0 (0.0) 0 (0.0) 0 (0.0)      
B. pseudomallei 28 (9.3) 25 (15.5) 10 (21.3) 15 (13.2) 1 (8.3) 1 (1.0) 1 (3.2) NS NS <0.001 0.020 NS
- In sputum 1 16 (5.9) 14 (10.1) 7 (15.9) 7 (7.4) 1 (12.5) 0 (0.0) 1 (3.2)      
- In blood 2 15 (45.5) 14 (51.9) 4 (9.0) 10 (10.6) 0 (0.0) 1 (1.1) 0 (0.0)      
K. pneumoniae 43 (14.3) 28 (17.4) 10 (21.3) 18 (15.8) 2 (16.7) 8 (8.3) 5 (16.1) NS NS NS NS NS
- In sputum 1 42 (15.4) 27 (19.6) 10 (22.7) 17 (18.1) 2 (25.0) 8 (8.4) 5 (16.1)      
- In blood 2 1 (3.0) 1 (3.7) 0 (0.0) 1 (4.6) 0 (0.0) 0 (0.0) 0 (0.0)      
P. aeruginosa 37 (12.3) 19 (11.8) 6 (12.8) 13 (11.4) 1 (8.3) 15 (15.6) 2 (6.5) NS NS NS NS 0.037
S. aureus 11 (3.7) 5 (3.1) 2 (4.3) 3 (2.6) 1 (8.3) 4 (4.2) 1 (3.2) NS NS NS NS NS
 Other bacteria 39 (13.0) 22 (13.7) 4 (8.5) 18 (15.8) 7 (58.3) 9 (9.4) 1 (3.2) NS NS NS 0.040 NS
 AFB-positive*** 264 (15.7) 218 (25.6) 153 (54.6) 65 (11.4) 2 (1.4) 42 (9.7) 2 (0.8) <0.001 <0.001 <0.001 <0.001 <0.001
Positive PCR results ^             
 Rhinovirus 151 (49.5) 68 (49.3) 10 (45.5) 58 (50.0) 8 (47.1) 30 (44.1) 45 (54.9) 0.007 NS NS <0.001 0.001
 Respiratory syncytial virus 54 (17.7) 23 (16.7) 5 (23.7) 18 (15.5) 5 (29.4) 11 (16.2) 15 (18.3) NS NS NS 0.064 NS
 Influenza viruses 37 (12.1) 16 (11.6) 3 (13.6) 13 (11.2) 0 (0.0) 11 (16.2) 10 (12.2) NS NS NS NS NS
 Coronaviruses 31 (10.2) 18 (13.0) 2 (9.9) 16 (13.8) 1 (5.9) 11 (16.2) 1 (1.2) NS NS NS 0.080 0.001
 Human metapneumovirus 14 (4.6) 7 (5.1) 0 (0.0) 7 (6.0) 2 (11.8) 2 (2.9) 3 (3.7) NS NS NS NS NS
 Other viruses 20 (6.6) 6 (4.3) 2 (9.1) 4 (3.5) 2 (11.8) 5 (7.4) 7 (8.5) NS NS NS NS NS
Mixed infections             
 >1 pathogen (AFB, bact. or virus) (% = n*100/d) 63 (21.0) 35 (21.7) 16 (34.0) 19 (16.7) 2 (16.7) 22 (22.9) 4 (12.9) NS NS NS NS NS
 >1 bacterium identified (% = n*100/d) 24 (8.0) 12 (7.5) 4 (8.5) 8 (7.0) 0 (0.0) 10 (10.4) 2 (6.5) NS NS NS NS NS
 AFB and ≥1 bacterium identified (% = n*100/d) 30 (10.0) 24 (14.9) 16 (34.0) 8 (7.0) 0 (0.0) 6 (6.3) 0 (0.0) NS NS NS NS NS
 AFB & virus (% = n*100/f) 26 (8.5) 18 (13.0) 14 (63.6) 4 (3.5) 0 (0.0) 8 (11.8) 0 (0.0) 0.005 NS NS NS NS
 >1 virus (% = n*100/f) 9 (3.0) 3 (2.2) 1 (4.5) 2 (1.7) 2 (1.7) 2 (2.9) 2 (2.4) NS NS NS NS NS
Overall etiology results             
 Bacterial etiologies incl. AFB (% = n*100/b) 520 (29.0) 355 (39.0) 184 (65.0) 171 (27.2) 0 (0.0) 132 (30.1) 33 (11.2) <0.001 <0.001 0.002 <0.001 <0.001
 Viral detection (% = n*100/a) 298 (16.1) 135 (14.4) 21 (7.5) 114 (17.4) 13 (7.9) 68 (15.4) 82 (26.1) NS 0.033 NS <0.001 NS
 Identified etiologies (% = n*100/c) 749 (42.9) 449 (50.6) 192 (69.8) 257 (42.0) 13 (8.8) 178 (41.9) 109 (37.8) <0.001 <0.001 0.004 <0.001 <0.001
  1. IQR: interquartile range; NS, not significant (NS is displayed when p value is >10%); PCR, polymerase chain reaction;
  2. ALRI = acute lower respiratory infection; Other viruses include Parainfluenza viruses, Bocaviruses, Adenoviruses.
  3. **Hyperleukocytosis: Leukocytes count ≥11 for 5–10 year-olds or ≥10 for ≥11 year-olds.
  4. **Elevated neutrophils count ≥6 for 5–10 year-olds or ≥7.5 for ≥11 year-olds.
  5. *** % = proportion of AFB-positive by # of patients tested for AFB.
  6. ‡ % = proportion of positive results by # of patients tested.
  7. † % = proportion of positive bacteria by # of patients tested positive by sputum or blood culture.
  8. 1 and 2 % = proportion of positive bacteria by # of patients tested positive by sputum and blood culture respectively.
  9. ^ % = proportion of virus of interest by # of positive PCR.