Atypical pneumonia

Basarab, Marina; Macrae, M. Bruce; Curtis, Carmel M.

doi:10.1097/mcp.0000000000000048

Cited by 32 publications

(28 citation statements)

References 46 publications

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“…However, macrolides have been reported to have additional benefits in patients with community-acquired pneumonia, irrespective of their antimicrobial effects [27]. Moreover, diagnosis of infections with atypical bacteria is a considerable challenge, such that the occurrence of these infections may be underestimated [28].…”

Section: Discussionmentioning

confidence: 99%

The Intensive Care Global Study on Severe Acute Respiratory Infection (IC-GLOSSARI): a multicenter, multinational, 14-day inception cohort study

Sakr¹,

Ferrer

Reinhart³

et al. 2016

Intensive Care Med

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Purpose: In this prospective, multicenter, 14-day inception cohort study, we investigated the epidemiology, patterns of infections, and outcome in patients admitted to the intensive care unit (ICU) as a result of severe acute respiratory infections (SARIs). Methods:All patients admitted to one of 206 participating ICUs during two study weeks, one in November 2013 and the other in January 2014, were screened. SARI was defined as possible, probable, or microbiologically confirmed respiratory tract infection with recent onset dyspnea and/or fever. The primary outcome parameter was in-hospital mortality within 60 days of admission to the ICU. Results:Among the 5550 patients admitted during the study periods, 663 (11.9 %) had SARI. On admission to the ICU, Gram-positive and Gram-negative bacteria were found in 29.6 and 26.2 % of SARI patients but rarely atypical bacteria (1.0 %); viruses were present in 7.7 % of patients. Organ failure occurred in 74.7 % of patients in the ICU, mostly respiratory (53.8 %), cardiovascular (44.5 %), and renal (44.6 %). ICU and in-hospital mortality rates in patients with SARI were 20.2 and 27.2 %, respectively. In multivariable analysis, older age, greater severity scores at ICU admission, and hematologic malignancy or liver disease were independently associated with an increased risk of in-hospital death, whereas influenza vaccination prior to ICU admission and adequate antibiotic administration on ICU admission were associated with a lower risk.*Correspondence: yasser.sakr@med.uni-jena.de 1 Department of Anesthesiology and Intensive Care, Uniklinikum Jena, Erlanger Allee 103, 07743 Jena, Germany Full list of author information is available at the end of the article Take-home message: Admission to the ICU for SARI is common and associated with high morbidity and mortality rates. We identified several risk factors for in-hospital death that may be useful for risk stratification in these patients.On behalf of the IC-GLOSSARI Investigators and the Trials Group of the European Society of Intensive Care (ESICM), Rue Belliard, 19, 1040 Brussels, Belgium. Email: research@esicm.org.A complete list of IC-GLOSSARI investigators is provided in the "Appendix". Conclusions:Admission to the ICU for SARI is common and associated with high morbidity and mortality rates. We identified several risk factors for in-hospital death that may be useful for risk stratification in these patients.

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Section: Discussionmentioning

confidence: 99%

The Intensive Care Global Study on Severe Acute Respiratory Infection (IC-GLOSSARI): a multicenter, multinational, 14-day inception cohort study

Sakr¹,

Ferrer

Reinhart³

et al. 2016

Intensive Care Med

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“…The intracellular pathogens that are well-established as causes of CAP are: Legionella pneumophila , Mycoplasma pneumoniae , Chlamydophila pneumoniae , Chlamydophila psittaci and Coxiella burnetii [18,19]. No clinical features exist that make it possible to distinguish intracellular pathogens from classical pathogens (pneumococcus) in pneumonia, although extra-pulmonary manifestations are often associated with intracellular pathogens in CAP [20]. …”

Section: Microbial Etiology Of Community-acquired Pneumonia (Cap)mentioning

confidence: 99%

Microbial Etiology of Pneumonia: Epidemiology, Diagnosis and Resistance Patterns

Cillóniz

Martín‐Loeches

García-Vidal

et al. 2016

IJMS

219

161

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Globally, pneumonia is a serious public health concern and a major cause of mortality and morbidity. Despite advances in antimicrobial therapies, microbiological diagnostic tests and prevention measures, pneumonia remains the main cause of death from infectious disease in the world. An important reason for the increased global mortality is the impact of pneumonia on chronic diseases, along with the increasing age of the population and the virulence factors of the causative microorganism. The increasing number of multidrug-resistant bacteria, difficult-to-treat microorganisms, and the emergence of new pathogens are a major problem for clinicians when deciding antimicrobial therapy. A key factor for managing and effectively guiding appropriate antimicrobial therapy is an understanding of the role of the different causative microorganisms in the etiology of pneumonia, since it has been shown that the adequacy of initial antimicrobial therapy is a key factor for prognosis in pneumonia. Furthermore, broad-spectrum antibiotic therapies are sometimes given until microbiological results are available and de-escalation cannot be performed quickly. This review provides an overview of microbial etiology, resistance patterns, epidemiology and microbial diagnosis of pneumonia.

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“…Pneumonia caused by C. burnetii is generally mild but progression to ARDS can occur [8]. Fever and headache are the most frequent symptoms in patients with Q fever pneumonia [76].…”

Section: Coxiella Burnetiimentioning

confidence: 99%

“…Doxycycline is the treatment of choice for acute Q fever, and 2 weeks of therapy is recommended for adults [8]. Doxycycline has been shown to result in a mean time to defervescence of 2-3 days after the start of therapy [96].…”

Section: Coxiella Burnetiimentioning

confidence: 99%

“…Although extrapulmonary manifestations are often associated with these pathogens in pneumonia, no clinical features allow them to be reliably distinguished from classical bacterial agents of pneumonia such as Streptococcus pneumoniae (pneumococcus) [8] (mainly in patients who need hospitalization). Because these bacteria are naturally resistant to β-lactams, they should be promptly identified.…”

Section: Introductionmentioning

confidence: 99%

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Community-acquired pneumonia related to intracellular pathogens

Cillóniz¹,

Niederman

Eerden

et al. 2016

Intensive Care Med

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Community-acquired pneumonia (CAP) is associated with high rates of morbidity and mortality worldwide; the annual incidence of CAP among adults in Europe has ranged from 1.5 to 1.7 per 1000 population. Intracellular bacteria are common causes of CAP. However, there is considerable variation in the reported incidence between countries and change over time. The intracellular pathogens that are well established as causes of pneumonia are Legionella pneumophila, Mycoplasma pneumoniae, Chlamydophila pneumoniae, Chlamydophila psittaci, and Coxiella burnetii. Since it is known that antibiotic treatment for severe CAP is empiric and includes coverage of typical and atypical pathogens, microbiological diagnosis bears an important relationship to prognosis of pneumonia. Factors such as adequacy of initial antibiotic or early de-escalation of therapy are important variables associated with outcomes, especially in severe cases. Intracellular pathogens sometimes appear to cause more severe disease with respiratory failure and multisystem dysfunction associated with fatal outcomes. The clinical relevance of intracellular pathogens in severe CAP has not been specifically investigated. We review the prevalence, general characteristics, and outcomes of severe CAP cases caused by intracellular pathogens.

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Atypical pneumonia

Cited by 32 publications

References 46 publications

The Intensive Care Global Study on Severe Acute Respiratory Infection (IC-GLOSSARI): a multicenter, multinational, 14-day inception cohort study

The Intensive Care Global Study on Severe Acute Respiratory Infection (IC-GLOSSARI): a multicenter, multinational, 14-day inception cohort study

Microbial Etiology of Pneumonia: Epidemiology, Diagnosis and Resistance Patterns

Community-acquired pneumonia related to intracellular pathogens

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