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Background:  To summarize the distribution of pathogenic bacteria in elderly Chinese patients with pneumonia and provide guidance for the clinical application of antibiotics.   Methods:  The electronic databases of PubMed, Embase, Cochrane library, and China National Knowledge Infrastructure were searched. The primary outcomes included the prevalence of gram-positive cocci, gram-negative bacilli, and fungus. The summary prevalence and 95% confidence interval (CI) were calculated using the random-effects model.   Results:  A total of 17 retrospective studies reporting a total of 5,729 elderly patients with pneumonia were selected for final analysis. The summary prevalence of gram-positive cocci was 25% (95% CI: 20–30%;  p  < 0.001), whereas the prevalence of gram-negative bacilli was 56% (95% CI: 46–67%;  p  < 0.001). Moreover, the pooled prevalence of fungus in elderly patients with pneumonia was 11% (95% CI: 8–14%;  p  < 0.001). The most common gram-positive cocci were  Staphylococcus aureus  (ES: 8%; 95% CI: 6–11%;  p  <0.001),  Streptococcus hemolyticus  (ES: 7%; 95% CI: 6–8%;  p  < 0.001), and  Streptococcus pneumoniae  (ES: 5%; 95% CI: 3–7%;  p  < 0.001).  Pseudomonas aeruginosa  (ES: 18%; 95% CI: 14–22%;  p  <0.001) and  Klebsiella pneumoniae  (ES: 14%; 95% CI: 11–18%;  p  <0.001) were most common gram-negative bacilli. Furthermore, the pooled prevalence of  Candida albicans  in elderly patients with pneumonia was 6% (95% CI: 5–8%;  p  < 0.001).   Conclusions:  The findings demonstrated the comprehensive distribution of pathogenic bacteria in elderly Chinese patients with pneumonia, which could guide further antibiotic therapies.

Distribution of Pathogens in Elderly Chinese Patients With Pneumonia: A Systematic Review and Meta-Analysis