Chalmers James, Campling James, Ellsbury Gillian, Hawkey Peter M, Madhava Harish, Slack Mary
University of Dundee, Ninewells Hospital and Medical School, Dundee, DD1 9SY UK.
Division of Molecular & Clinical Medicine, School of Medicine, Ninewells Hospital and Medical School, Dundee, DD1 9SY UK.
Pneumonia (Nathan). 2017 Oct 5;9:15. doi: 10.1186/s41479-017-0039-9. eCollection 2017.
Pneumococcal disease has a high burden in adults in the United Kingdom (UK); however, the total burden is underestimated, principally because most cases of community-acquired pneumonia (CAP) are non-invasive. Research into pneumonia receives poor funding relative to its disease burden (global mortality, disability-adjusted life years, and years lived with disability), ranking just 20 out of 25 for investment in infectious diseases in the UK. The current accuracy of data for establishing incidence rates is questionable, and it is a reflection of the paucity of research that much of the background information available derives from nearly 30 years ago. Given the relationship between CAP and mortality (pneumonia accounts for 29,000 deaths per annum in the UK, and 5-15% of patients hospitalised with CAP die within 30 days of admission), and the increasing threat of antimicrobial resistance associated with inappropriate antibiotic prescribing, such neglect of a highly prevalent problem is concerning. In this Call to Action, we explore the poorly understood burden of CAP in the UK, discuss the importance of an accurate diagnosis and appropriate treatment, and suggest how national collaboration could improve the management of an often life-threatening, yet potentially preventable disease.
肺炎球菌疾病在英国成年人中负担沉重;然而,总体负担被低估了,主要是因为大多数社区获得性肺炎(CAP)病例是非侵袭性的。相对于其疾病负担(全球死亡率、伤残调整生命年和带病生存年数),肺炎研究获得的资金不足,在英国传染病投资中仅排名第20位(共25种疾病)。目前用于确定发病率的数据准确性存疑,而且现有的许多背景信息都来自近30年前,这反映出研究的匮乏。鉴于CAP与死亡率之间的关系(在英国,肺炎每年导致29,000人死亡,5-15%的CAP住院患者在入院后30天内死亡),以及与不适当抗生素处方相关的抗菌药物耐药性威胁日益增加,对这样一个高度普遍的问题如此忽视令人担忧。在本行动呼吁中,我们探讨了英国对CAP了解不足的负担,讨论了准确诊断和适当治疗的重要性,并提出国家合作如何能够改善对这种往往危及生命但有可能预防的疾病的管理。