{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T15:08:52Z","timestamp":1792076932531,"version":"4.4.0"},"reference-count":49,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2015,3,30]],"date-time":"2015-03-30T00:00:00Z","timestamp":1427673600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"DOI":"10.1371\/journal.pone.0122247","type":"journal-article","created":{"date-parts":[[2015,3,31]],"date-time":"2015-03-31T07:54:57Z","timestamp":1427788497000},"page":"e0122247","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":179,"title":["The Burden and Etiology of Community-Onset Pneumonia in the Aging Japanese Population: A Multicenter Prospective Study"],"prefix":"10.1371","volume":"10","author":[{"given":"Konosuke","family":"Morimoto","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Motoi","family":"Suzuki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoko","family":"Ishifuji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makito","family":"Yaegashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norichika","family":"Asoh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naohisa","family":"Hamashige","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiko","family":"Abe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Aoshima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koya","family":"Ariyoshi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Adult Pneumonia Study Group - Japan (APSG-J)","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2015,3,30]]},"reference":[{"issue":"Suppl 2","key":"ref1","doi-asserted-by":"crossref","first-page":"S27","DOI":"10.1086\/511159","article-title":"Infectious Diseases Society of America\/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults","volume":"44","author":"LA Mandell","year":"2007","journal-title":"Clinical infectious diseases: an official publication of the Infectious Diseases Society of America"},{"issue":"Suppl 3","key":"ref2","first-page":"iii1","article-title":"BTS guidelines for the management of community acquired pneumonia in adults: update 2009","volume":"64","author":"WS Lim","year":"2009","journal-title":"Thorax"},{"issue":"9859","key":"ref3","doi-asserted-by":"crossref","first-page":"2095","DOI":"10.1016\/S0140-6736(12)61728-0","article-title":"Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010","volume":"380","author":"R Lozano","year":"2012","journal-title":"Lancet"},{"issue":"1","key":"ref4","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1136\/thx.2009.129502","article-title":"Clinical and economic burden of community-acquired pneumonia among adults in Europe","volume":"67","author":"T Welte","year":"2012","journal-title":"Thorax"},{"issue":"10","key":"ref5","doi-asserted-by":"crossref","first-page":"1589","DOI":"10.1093\/infdis\/jis240","article-title":"Aging population and future burden of pneumococcal pneumonia in the United States","volume":"205","author":"PC Wroe","year":"2012","journal-title":"The Journal of infectious diseases"},{"issue":"4","key":"ref6","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1093\/geront\/gnr067","article-title":"Japan: super-aging society preparing for the future","volume":"51","author":"N Muramatsu","year":"2011","journal-title":"The Gerontologist"},{"key":"ref7","unstructured":"Vital Statistics, 2013 [Internet]. Statistics Bureau. 2013. Available from: http:\/\/www.e-stat.go.jp\/SG1\/estat\/GL08020101.do?_toGL08020101_&tstatCode=000001028897&requestSender=dsearch<\/ext-link>."},{"issue":"9796","key":"ref8","doi-asserted-by":"crossref","first-page":"1106","DOI":"10.1016\/S0140-6736(11)60828-3","article-title":"Japanese universal health coverage: evolution, achievements, and challenges","volume":"378","author":"N Ikegami","year":"2011","journal-title":"Lancet"},{"issue":"4","key":"ref9","doi-asserted-by":"crossref","first-page":"e60273","DOI":"10.1371\/journal.pone.0060273","article-title":"Estimating the burden of pneumococcal pneumonia among adults: a systematic review and meta-analysis of diagnostic techniques","volume":"8","author":"MA Said","year":"2013","journal-title":"PloS one"},{"issue":"9","key":"ref10","doi-asserted-by":"crossref","first-page":"5262","DOI":"10.1128\/AAC.02582-14","article-title":"Epidemiology and predictors of multidrug-resistant community-acquired and health care-associated pneumonia","volume":"58","author":"AE Gross","year":"2014","journal-title":"Antimicrobial agents and chemotherapy"},{"issue":"Suppl 4","key":"ref11","doi-asserted-by":"crossref","first-page":"S296","DOI":"10.1093\/cid\/cir045","article-title":"Diagnostic tests for agents of community-acquired pneumonia","volume":"52","author":"JG Bartlett","year":"2011","journal-title":"Clinical infectious diseases: an official publication of the Infectious Diseases Society of America"},{"issue":"9","key":"ref12","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1056\/NEJM200103013440908","article-title":"Aspiration pneumonitis and aspiration pneumonia","volume":"344","author":"PE Marik","year":"2001","journal-title":"The New England journal of medicine"},{"issue":"4","key":"ref13","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1164\/rccm.200405-644ST","article-title":"Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia","volume":"171","year":"2005","journal-title":"American journal of respiratory and critical care medicine"},{"issue":"4","key":"ref14","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1086\/499955","article-title":"Viral pneumonia in older adults","volume":"42","author":"AR Falsey","year":"2006","journal-title":"Clinical infectious diseases: an official publication of the Infectious Diseases Society of America"},{"issue":"7","key":"ref15","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1016\/j.jiac.2014.03.004","article-title":"Relationship between public subsidies and vaccination rates with the 23-valent pneumococcal vaccine in elderly persons, including the influence of the free vaccination campaign after the Great East Japan Earthquake","volume":"20","author":"T Naito","year":"2014","journal-title":"Journal of infection and chemotherapy: official journal of the Japan Society of Chemotherapy"},{"issue":"Suppl 2","key":"ref16","doi-asserted-by":"crossref","first-page":"S27","DOI":"10.1086\/511159","article-title":"Infectious Diseases Society of America\/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults","volume":"44","author":"LA Mandell","year":"2007","journal-title":"Clinical infectious diseases: an official publication of the Infectious Diseases Society of America"},{"issue":"4","key":"ref17","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1164\/rccm.200405-644ST","article-title":"Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia","volume":"171","year":"2005","journal-title":"American journal of respiratory and critical care medicine"},{"key":"ref18","first-page":"473","article-title":"A Study of Techniques for the Examination of Sputum in a Field Survey of Chronic Bronchitis","volume":"88","author":"DL Miller","year":"1963","journal-title":"The American review of respiratory disease"},{"issue":"1","key":"ref19","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1097\/INF.0b013e3181f111a2","article-title":"Association between nasopharyngeal load of Streptococcus pneumoniae, viral coinfection, and radiologically confirmed pneumonia in Vietnamese children","volume":"30","author":"HT Vu","year":"2011","journal-title":"The Pediatric infectious disease journal"},{"issue":"1","key":"ref20","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1097\/INF.0b013e3181af61e9","article-title":"Viral pathogens associated with acute respiratory infections in central vietnamese children","volume":"29","author":"LM Yoshida","year":"2010","journal-title":"The Pediatric infectious disease journal"},{"issue":"2","key":"ref21","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1111\/j.1532-5415.2005.00608.x","article-title":"Differences in the features of aspiration pneumonia according to site of acquisition: community or continuing care facility","volume":"54","author":"M Reza Shariatzadeh","year":"2006","journal-title":"Journal of the American Geriatrics Society"},{"issue":"4","key":"ref22","doi-asserted-by":"crossref","first-page":"269","DOI":"10.7883\/yoken.67.269","article-title":"High incidence of community-acquired pneumonia among rapidly aging population in Japan: a prospective hospital-based surveillance","volume":"67","author":"M Takaki","year":"2014","journal-title":"Jpn J Infect Dis"},{"key":"ref23","unstructured":"Patient survey, 2011 [Internet]. 2011. Available from: http:\/\/www.e-stat.go.jp\/SG1\/estat\/GL08020101.do?_toGL08020101_&tstatCode=000001031167&requestSender=dsearch<\/ext-link>."},{"key":"ref24","article-title":"Age standardization of rates: a new WHO standard (GPE Discussion Paper Series: No. 31)","author":"O Ahmad","year":"2001"},{"issue":"11","key":"ref25","doi-asserted-by":"crossref","first-page":"1642","DOI":"10.1086\/425615","article-title":"The burden of community-acquired pneumonia in seniors: results of a population-based study","volume":"39","author":"ML Jackson","year":"2004","journal-title":"Clinical infectious diseases: an official publication of the Infectious Diseases Society of America"},{"issue":"2","key":"ref26","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/j.rmed.2008.08.006","article-title":"Epidemiology of community-acquired pneumonia in older adults: a population-based study","volume":"103","author":"A Vila-Corcoles","year":"2009","journal-title":"Respiratory medicine"},{"issue":"9","key":"ref27","doi-asserted-by":"crossref","first-page":"e75131","DOI":"10.1371\/journal.pone.0075131","article-title":"Incidence of community-acquired lower respiratory tract infections and pneumonia among older adults in the United Kingdom: a population-based study","volume":"8","author":"ER Millett","year":"2013","journal-title":"PloS one"},{"issue":"5","key":"ref28","doi-asserted-by":"crossref","first-page":"727","DOI":"10.3201\/eid1405.071011","article-title":"Increasing hospital admissions for pneumonia, England","volume":"14","author":"CL Trotter","year":"2008","journal-title":"Emerging infectious diseases"},{"issue":"3","key":"ref29","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1136\/thx.2006.067371","article-title":"The CURB65 pneumonia severity score outperforms generic sepsis and early warning scores in predicting mortality in community-acquired pneumonia","volume":"62","author":"G Barlow","year":"2007","journal-title":"Thorax"},{"issue":"5","key":"ref30","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1016\/j.jinf.2010.07.015","article-title":"Study of community-acquired pneumonia: incidence, patterns of care, and outcomes in primary and hospital care","volume":"61","author":"A Capelastegui","year":"2010","journal-title":"The Journal of infection"},{"issue":"3","key":"ref31","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1111\/j.1532-5415.2008.01597.x","article-title":"High incidence of aspiration pneumonia in community- and hospital-acquired pneumonia in hospitalized patients: a multicenter, prospective study in Japan","volume":"56","author":"S Teramoto","year":"2008","journal-title":"Journal of the American Geriatrics Society"},{"issue":"1","key":"ref32","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/j.1741-2358.2012.00637.x","article-title":"Oral health care and aspiration pneumonia in frail older people: a systematic literature review","volume":"30","author":"CD van der Maarel-Wierink","year":"2013","journal-title":"Gerodontology"},{"issue":"8","key":"ref33","doi-asserted-by":"crossref","first-page":"985","DOI":"10.1164\/rccm.201301-0079OC","article-title":"Risk factors for drug-resistant pathogens in community-acquired and healthcare-associated pneumonia","volume":"188","author":"Y Shindo","year":"2013","journal-title":"American journal of respiratory and critical care medicine"},{"issue":"3","key":"ref34","doi-asserted-by":"crossref","first-page":"317","DOI":"10.2169\/internalmedicine.52.8830","article-title":"Etiology and factors contributing to the severity and mortality of community-acquired pneumonia","volume":"52","author":"T Ishiguro","year":"2013","journal-title":"Internal medicine"},{"issue":"Suppl 3","key":"ref35","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1177\/00333549111260S313","article-title":"Changing disparities in invasive pneumococcal disease by socioeconomic status and race\/ethnicity in Connecticut, 1998\u20132008","volume":"126","author":"K Soto","year":"2011","journal-title":"Public health reports"},{"issue":"33","key":"ref36","doi-asserted-by":"crossref","first-page":"5386","DOI":"10.1016\/j.vaccine.2011.05.082","article-title":"The epidemiology of community acquired bacteremic pneumonia, due to Streptococcus pneumoniae, in the Top End of the Northern Territory, Australia\u2014over 22 years","volume":"29","author":"SP Jacups","year":"2011","journal-title":"Vaccine"},{"key":"ref37","first-page":"CD000422","article-title":"Vaccines for preventing pneumococcal infection in adults","volume":"1","author":"S Moberley","year":"2013","journal-title":"The Cochrane database of systematic reviews"},{"issue":"5","key":"ref38","first-page":"10","article-title":"Pneumococcal conjugate vaccines for adults: Reasons for optimism and for caution","author":"DM Weinberger","year":"2014","journal-title":"Human vaccines & immunotherapeutics"},{"issue":"9","key":"ref39","first-page":"378","article-title":"Rationale and design of CAPITA: a RCT of 13-valent conjugated pneumococcal vaccine efficacy among older adults","volume":"66","author":"E Hak","year":"2008","journal-title":"The Netherlands journal of medicine"},{"issue":"1","key":"ref40","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1017\/S0950268809990239","article-title":"Serotype and antibiotic resistance of isolates from patients with invasive pneumococcal disease in Japan","volume":"138","author":"N Chiba","year":"2010","journal-title":"Epidemiology and infection"},{"issue":"6","key":"ref41","doi-asserted-by":"crossref","first-page":"854","DOI":"10.1093\/cid\/cit800","article-title":"Pneumococcal serotype diversity among adults in various countries, influenced by pediatric pneumococcal vaccination uptake","volume":"58","author":"JD Grabenstein","year":"2014","journal-title":"Clinical infectious diseases: an official publication of the Infectious Diseases Society of America"},{"issue":"1","key":"ref42","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1136\/thx.2006.075077","article-title":"Incidence and characteristics of viral community-acquired pneumonia in adults","volume":"63","author":"LC Jennings","year":"2008","journal-title":"Thorax"},{"issue":"2","key":"ref43","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1086\/648678","article-title":"Etiology of community-acquired pneumonia: increased microbiological yield with new diagnostic methods","volume":"50","author":"N Johansson","year":"2010","journal-title":"Clinical infectious diseases: an official publication of the Infectious Diseases Society of America"},{"issue":"4","key":"ref44","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1164\/rccm.201112-2240OC","article-title":"Viral infection in patients with severe pneumonia requiring intensive care unit admission","volume":"186","author":"SH Choi","year":"2012","journal-title":"American journal of respiratory and critical care medicine"},{"issue":"46","key":"ref45","first-page":"909","article-title":"Outbreaks of human metapneumovirus in two skilled nursing facilities-West Virginia and Idaho, 2011\u20132012","volume":"62","year":"2013","journal-title":"MMWR Morbidity and mortality weekly report"},{"issue":"3","key":"ref46","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1111\/j.1532-5415.2008.02153.x","article-title":"Respiratory syncytial virus outbreak in a long-term care facility detected using reverse transcriptase polymerase chain reaction: an argument for real-time detection methods","volume":"57","author":"LB Caram","year":"2009","journal-title":"Journal of the American Geriatrics Society"},{"issue":"2","key":"ref47","first-page":"CD004876","article-title":"Vaccines for preventing influenza in the elderly","author":"T Jefferson","year":"2010","journal-title":"The Cochrane database of systematic reviews"},{"issue":"12","key":"ref48","doi-asserted-by":"crossref","first-page":"1062","DOI":"10.1136\/thx.2008.109785","article-title":"New perspectives on community-acquired pneumonia in 388 406 patients. Results from a nationwide mandatory performance measurement programme in healthcare quality","volume":"64","author":"S Ewig","year":"2009","journal-title":"Thorax"},{"issue":"3","key":"ref49","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1016\/j.jinf.2005.11.006","article-title":"The influence of age and gender on the population-based incidence of community-acquired pneumonia caused by different microbial pathogens","volume":"53","author":"F Gutierrez","year":"2006","journal-title":"The Journal of infection"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/dx.plos.org\/10.1371\/journal.pone.0122247","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,8,22]],"date-time":"2019-08-22T13:26:52Z","timestamp":1566480412000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0122247"}},"subtitle":[],"editor":[{"given":"Cecile","family":"Viboud","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2015,3,30]]},"references-count":49,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2015,3,30]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0122247","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,3,30]]}}}