Bacterial Patterns and Empiric Antibiotic Use in COPD Patients With Community-Acquired Pneumonia

Pascual-Guardia, Sergi; Amati, Francesco; Marín‐Corral, Judith; Aliberti, Stefano; Gea, Joaquim; Soni, Nilam J.; Rodríguez, Alejandro García; Sibila, Oriol; Sanz, Francisco; Sotgiu, Giovanni; Marcos, Pedro; Uranga, Ane; Milenković, Branislava; Meyer, Christian; Kolditz, Martin; Anzueto, Antonio; Restrepo, Marcos I.

doi:10.1016/j.arbres.2022.09.005

Cited by 7 publications

(11 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The mean CURB-65 score of the patients included in the study was found to be 1.30 ± 0.94, and it was higher in patients with COPD when compared with patients with asthma (p = 0.004; Figure 4). Patients with positive sputum culture showed a higher tendency to be homebound intensive Excluded: ILD (13), Immunosupressive (28), BE (14), ACOS (11), TB (3), No culture (622) J Bras Pneumol. 2024;50(2):e20230329 3/7 care patients (p = 0.040), receive long-term oxygen therapy (p < 0.001), and have a higher CURB-65 score (p = 0.014).…”

Section: Resultsmentioning

confidence: 99%

“…Pneumonia treatment guidelines recommend empirical antibiotic treatment targeting P. aeruginosa in patients with underlying chronic lung diseases. (20) In fact, a recent multicenter international study by Pascual-Guardia et al (11) reported P. aeruginosa as the most frequently isolated microorganism in CAP patients with COPD. Similarly, in our study, P. aeruginosa was the most commonly isolated microorganism in both CAP with asthma patients and CAP with COPD patients.…”

Section: Discussionmentioning

confidence: 99%

“…To be classified as pneumonia cases, patients needed to meet the following criteria within the first 48 h of hospital admission: identification of pulmonary infiltrations on chest X-ray or CT, presence of productive or dry cough, body temperature above 37.8°C or hypothermia below 36°C, and presence of at least one systemic inflammatory marker (leukocytosis > 10,000 mm 3 , leukopenia < 4,000 mm 3 , and elevated CRP or procalcitonin values). (11) We used the mental Confusion, Urea, Respiratory rate, Blood pressure, and age = 65 years (CURB-65) scoring system to assess the risk of mortality in CAP patients. A score of 1 is given to each of the criteria: presence of mental confusion; blood urea nitrogen level > 7 mmol/L or > 20 mg/dL; RR > 30 breaths/min; systolic blood pressure < 90 mmHg or diastolic blood pressure < 60 mmHg; and age > 65 years.…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Microbial variations in sputum cultures among hospitalized patients with community-acquired pneumonia: differences in sputum microbiota between asthma and COPD patients

Uzer1,

Karaboğa2,

Çalış3

et al. 2024

J Bras Pneumol.

View full text Add to dashboard Cite

Objective: To assess differences in the sputum microbiota of community-acquired pneumonia (CAP) patients with either COPD or asthma, specifically focusing on a patient population in Turkey. Methods: This retrospective study included hospitalized patients > 18 years of age with a diagnosis of pneumonia between January of 2021 and January of 2023. Participants were recruited from two hospitals, and three patient groups were considered: CAP patients with asthma, CAP patients with COPD, and CAP patients without COPD or asthma. Results: A total of 246 patients with CAP were included in the study, 184 (74.8%) and 62 (25.2%) being males and females, with a mean age of 66 ± 14 years. Among the participants, 52.9% had COPD, 14.2% had asthma, and 32.9% had CAP but no COPD or asthma. Upon analysis of sputum cultures, positive sputum culture growth was observed in 52.9% of patients. The most commonly isolated microorganisms were Pseudomonas aeruginosa (n = 40), Acinetobacter baumannii (n = 20), Klebsiella pneumoniae (n = 16), and Moraxella catarrhalis (n = 8). CAP patients with COPD were more likely to have a positive sputum culture (p = 0.038), a history of antibiotic use within the past three months (p = 0.03), utilization of long-term home oxygen therapy (p < 0.001), and use of noninvasive ventilation (p = 0.001) when compared with the other patient groups. Additionally, CAP patients with COPD had a higher CURB-65 score when compared with CAP patients with asthma (p = 0.004). Conclusions: This study demonstrates that CAP patients with COPD tend to have more severe presentations, while CAP patients with asthma show varied microbial profiles, underscoring the need for patient-specific management strategies in CAP.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Microbial variations in sputum cultures among hospitalized patients with community-acquired pneumonia: differences in sputum microbiota between asthma and COPD patients

Uzer1,

Karaboğa2,

Çalış3

et al. 2024

J Bras Pneumol.

View full text Add to dashboard Cite

show abstract

“…37 A score ≥ 5 suggests the use of antipseudomonal drugs, however, some recent papers have challenged this course of action, pointing out the high risk of overtreatment it would entail. 45 46 Pascual-Guardia et al 47 , in this regard, have suggested a score that can reduce the overuse of antipseudomonal drugs from 54.1 to 6.2%, but further studies will be needed to confirm this result and assess the impact of such a tool in terms of patient outcomes.…”

Section: Mdr Infections' Risk Assessment and Empiric Antibiotic Presc...mentioning

confidence: 99%

New Guidelines for Severe Community-acquired Pneumonia

Calabretta,

Martìn-Loeches,

Torres

2024

Semin Respir Crit Care Med

View full text Add to dashboard Cite

In 2023, the new European guidelines on severe community-acquired pneumonia, providing clinical practice recommendations for the management of this life-threatening infection, characterized by a high burden of mortality, morbidity, and costs for the society. This review article aims to summarize the principal evidence related to eight different questions covered in the guidelines, by also highlighting the future perspectives for research activity.

show abstract

“…The diagnosis criteria of COPD consists of post-bronchodilator fixed ratio of FEV1/FVC < 70%, which means persistent airflow limitation [ 7 ]. A number of well designed large population based studies indicated that COPD is the strongest risk factor for CAP [ 8 – 10 ]. Meanwhile, several studies showed that CAP patients got worse disease severity in terms of Pneumonia Severity Index or CURB-65 when concomitant with COPD [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Exploring the microbiota difference of bronchoalveolar lavage fluid between community-acquired pneumonia with or without COPD based on metagenomic sequencing: a retrospective study

Wang,

Tan,

et al. 2024

BMC Pulm Med

View full text Add to dashboard Cite

Background Community-acquired pneumonia (CAP) patients with chronic obstructive pulmonary disease (COPD) have higher disease severity and mortality compared to those without COPD. However, deep investigation into microbiome distribution of lower respiratory tract of CAP with or without COPD was unknown. Methods So we used metagenomic next generation sequencing (mNGS) to explore the microbiome differences between the two groups. Results Thirty-six CAP without COPD and 11 CAP with COPD cases were retrieved. Bronchoalveolar lavage fluid (BALF) was collected and analyzed using untargeted mNGS and bioinformatic analysis. mNGS revealed that CAP with COPD group was abundant with Streptococcus, Prevotella, Bordetella at genus level and Cutibacterium acnes, Rothia mucilaginosa, Bordetella genomosp. 6 at species level. While CAP without COPD group was abundant with Ralstonia, Prevotella, Streptococcus at genus level and Ralstonia pickettii, Rothia mucilaginosa, Prevotella melaninogenica at species level. Meanwhile, both alpha and beta microbiome diversity was similar between groups. Linear discriminant analysis found that pa-raburkholderia, corynebacterium tuberculostearicum and staphylococcus hominis were more enriched in CAP without COPD group while the abundance of streptococcus intermedius, streptococcus constellatus, streptococcus milleri, fusarium was higher in CAP with COPD group. Conclusions These findings revealed that concomitant COPD have an mild impact on lower airway microbiome of CAP patients.

show abstract

Bacterial Patterns and Empiric Antibiotic Use in COPD Patients With Community-Acquired Pneumonia

Cited by 7 publications

References 39 publications

Microbial variations in sputum cultures among hospitalized patients with community-acquired pneumonia: differences in sputum microbiota between asthma and COPD patients

Microbial variations in sputum cultures among hospitalized patients with community-acquired pneumonia: differences in sputum microbiota between asthma and COPD patients

New Guidelines for Severe Community-acquired Pneumonia

Exploring the microbiota difference of bronchoalveolar lavage fluid between community-acquired pneumonia with or without COPD based on metagenomic sequencing: a retrospective study

Contact Info

Product

Resources

About