{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T18:10:59Z","timestamp":1785521459408,"version":"3.56.0"},"reference-count":27,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T00:00:00Z","timestamp":1747612800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Respirology"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background and Objective<\/jats:title><jats:p>Knowing the Pattern of pathogens in community\u2010acquired lung abscess (CALA) is important in the choice of initial empiric antibiotics. Early studies established the anaerobes as the predominant pathogen, followed by aerobic streptococci and aerobic Gram\u2010negative bacilli. However, recent reports indicated that <jats:styled-content style=\"fixed-case\">\n<jats:italic>Klebsiella pneumoniae<\/jats:italic>\n<\/jats:styled-content> and aerobic streptococci predominated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a retrospective study on CALA cases from all public hospitals in Hong Kong over a nine\u2010year period. Only cases with uncontaminated specimens sent for bacterial culture were included. Cases caused by mycobacteria and fungi were excluded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 606 eligible subjects\u2013episodes. Mean age of subjects was 57.7\u2009years and male to female ratio was 3.3:1. Two hundred and thirty\u2010two subjects had at least one positive bacterial culture, with a total of 338 pathogens isolated. Anaerobes were the predominant pathogen group with 103 isolates (30.5% of total). This was followed by aerobic streptococci (90, 26.6%), aerobic Gram\u2010negative bacilli (67, 19.8%), and <jats:styled-content style=\"fixed-case\">\n<jats:italic>Staphylococcus aureus<\/jats:italic>\n<\/jats:styled-content> (56, 16.6%). Isolation of <jats:styled-content style=\"fixed-case\">\n<jats:italic>Staphylococcus aureus<\/jats:italic>\n<\/jats:styled-content> was closely linked to intravenous drug abuse, while isolation of <jats:styled-content style=\"fixed-case\">\n<jats:italic>Klebsiella pneumoniae<\/jats:italic>\n<\/jats:styled-content> (28 cases) was related to extrapulmonary abscesses, particularly of the liver. There were 14 cases of <jats:styled-content style=\"fixed-case\">\n<jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n<\/jats:styled-content> with underlying chronic lung disease and major organ failure being risk factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Anaerobes and aerobic streptococci appear to be the major pathogens for primary CALA. Secondary lung abscess caused by haematogenous spread is commonly attributable to <jats:styled-content style=\"fixed-case\">\n<jats:italic>Staphylococcus aureus<\/jats:italic>\n<\/jats:styled-content> or <jats:styled-content style=\"fixed-case\">\n<jats:italic>Klebsiella pneumoniae<\/jats:italic>\n<\/jats:styled-content>. Choice of empiric antibiotics should take these into consideration together with local patterns of antibiotic resistance.<\/jats:p><\/jats:sec>","DOI":"10.1111\/resp.70050","type":"journal-article","created":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T07:35:30Z","timestamp":1747640130000},"page":"882-892","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Aetiology of Adult Community\u2010Acquired Lung Abscess in Hong Kong"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6543-0472","authenticated-orcid":false,"given":"Wai Cho","family":"Yu","sequence":"first","affiliation":[{"name":"Department of Medicine &amp; Geriatrics Princess Margaret Hospital  Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Man Ying","family":"Ho","sequence":"additional","affiliation":[{"name":"Department of Medicine &amp; Geriatrics Princess Margaret Hospital  Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5768-2100","authenticated-orcid":false,"given":"Ellen Lok\u2010Man","family":"Yu","sequence":"additional","affiliation":[{"name":"Clinical Research Centre Hospital Authority Kowloon West Cluster  Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Microbiology Faculty of Medicine, The Chinese University of Hong Kong  Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cindy","family":"Tse","sequence":"additional","affiliation":[{"name":"Department of Microbiology Kwong Wah Hospital  Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8163-5846","authenticated-orcid":false,"given":"Ka Pang","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Medicine &amp; Therapeutics Faculty of Medicine, The Chinese University of Hong Kong  Hong\u00a0Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pik Shan","family":"Cheung","sequence":"additional","affiliation":[{"name":"Department of Medicine &amp; Geriatrics United Christian Hospital  Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kit Man","family":"Sin","sequence":"additional","affiliation":[{"name":"Department of Medicine Tuen Mun Hospital  Hong\u00a0Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wai Man Johnny","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Medicine Queen Elizabeth Hospital  Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0004-2660","authenticated-orcid":false,"given":"David Chi Leung","family":"Lam","sequence":"additional","affiliation":[{"name":"Department of Medicine Faculty of Medicine, The University of Hong Kong  Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kah Lin","family":"Choo","sequence":"additional","affiliation":[{"name":"Department of Medicine North District Hospital  Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi Kai","family":"Chow","sequence":"additional","affiliation":[{"name":"Department of Medicine &amp; Geriatrics Caritas Medical Centre  Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu Hong","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Medicine &amp; Geriatrics Princess Margaret Hospital  Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming Chiu","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Medicine &amp; Geriatrics Princess Margaret Hospital  Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kin Keung","family":"Kwong","sequence":"additional","affiliation":[{"name":"Department of Medicine &amp; Geriatrics Princess Margaret Hospital  Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret","family":"Ip","sequence":"additional","affiliation":[{"name":"Department of Microbiology Faculty of Medicine, The Chinese University of Hong Kong  Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the Hong Kong Thoracic Society and Chest Delegation Hong Kong & Macau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,19]]},"reference":[{"key":"e_1_2_10_2_1","first-page":"607","volume-title":"Textbook of Pulmonary Diseases","author":"Bartlett J. 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