Burden of Community-Acquired Pneumonia and Unmet Clinical Needs

Ferreira‐Coimbra, João; Sarda, Cristina; Rello, Jordi

doi:10.1007/s12325-020-01248-7

Cited by 157 publications

(129 citation statements)

References 104 publications

(91 reference statements)

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“…Hospital mortality in our main cohort was 12.4%, which is higher than in many previous clinical studies [1,14] but comparable to that in other recent European population-based cohorts [15,16]. It is reasonable to assume that these differences result from exclusion of many high-risk patients in clinical trials.…”

Section: Discussionsupporting

confidence: 68%

Validation of the qSOFA score compared to the CRB-65 score for risk prediction in community-acquired pneumonia

Kesselmeier

Pletz

Blankenstein

et al. 2021

Clinical Microbiology and Infection

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Objective: The qSOFA (quick sepsis-related organ failure assessment) score shows similarities to the CRB-65 pneumonia score, but its prognostic accuracy in patients with community-acquired pneumonia (CAP) has not been extensively evaluated. Our aim was to validate the qSOFA (-65) score in a large cohort of CAP patients. Methods: We conducted a retrospective population-based cohort study including all CAP cases hospitalized between 1st January 2014 and 31st December 2018 from the German nationwide mandatory quality assurance programme. We excluded cases transferred from another hospital, with mechanical ventilation present on admission, and without documented respiratory rate. Predefined outcomes were hospital mortality and need for mechanical ventilation. Results: Among the 1,262,250 included cases, hospital mortality was 12.4% and the mechanical ventilation rate was 7.1%. All CRB and qSOFA criteria were associated with both outcomes, but the qSOFA had inferior sensitivity compared to the CRB-65 for mortality prediction. Including the age criterion 65 years, qSOFA-65 and CRB-65 performed similarly (AUC 0.69, 95%CI 0.69e0.69 versus 0.68, 95%CI 0.68e0.68). A qSOFA-65 of 0 was associated with fewer missed deaths (3328, 2.0%) compared to a CRB-65 of 0 (5480, 2.4%). The sensitivity of the suggested qSOFA cut-off of 2 for sepsis was low (mortality 25.8%, 95%CI 25.6e26.0%; mechanical ventilation 24.1%, 95%CI 23.8e24.4%). Results were similar when frail and palliative patients were excluded. Conclusions: The qSOFA parameters show prognostic accuracy similar to the CRB parameters in CAP, but the sepsis cut-off of 2 lacked sensitivity. For sensitive mortality prediction, the age criterion 65 years should be added to the qSOFA.

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Section: Discussionsupporting

confidence: 68%

Validation of the qSOFA score compared to the CRB-65 score for risk prediction in community-acquired pneumonia

Kesselmeier

Pletz

Blankenstein

et al. 2021

Clinical Microbiology and Infection

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“…Infection by Streptococcus pneumoniae can present in a number of ways, including pneumonia, meningitis and sepsis and these infections are associated with high levels of both morbidity and mortality (Ferreira‐Coimbra, Sarda, & Rello, 2020). Colonisation of target cells by S. pneumoniae begins with an initial association based on bacterial pili that can recognise glycoconjugates on the cell surface (Weiser, Ferreira, & Paton, 2018).…”

Section: Tetraspanin‐dependent Invasion and Colonisation Of Host Cellmentioning

confidence: 99%

The roles of tetraspanins in bacterial infections

Karam

Méresse

Kremer

et al. 2020

Cellular Microbiology

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Tetraspanins, a wide family composed of 33 transmembrane proteins, are associated with different types of proteins through which they arbitrate important cellular processes such as fusion, adhesion, invasion, tissue differentiation and immunological responses. Tetraspanins share a comparable structural design, which consists of four hydrophobic transmembrane domains with cytoplasmic and extracellular loops. They cooperate with different proteins, including other tetraspanins, receptors or signalling proteins to compose functional complexes at the cell surface, designated tetraspanin‐enriched microdomains (TEM). Increasing evidences establish that tetraspanins are exploited by numerous intracellular pathogens as a doorway for entering and replicating within human cells. Although previous surveys focused mainly on viruses and parasites, it is now becoming clear that bacteria interact with tetraspanins, using TEM as a “gateway” to infection. In this review, we examine the biological functions of tetraspanins that are relevant to bacterial infective procedures and consider the available data that reveal how different bacteria benefit from host cell tetraspanins in infection and in the pathogenesis of diseases. We will also emphasise the stimulating potentials of targeting tetraspanins for preventing bacterial infectious diseases, using specific neutralising antibodies or anti‐adhesion peptide‐based therapies. Such innovative therapeutic opportunities may deliver alternatives for fighting difficult‐to‐manage and drug‐resistant bacterial pathogens.

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“…Between 2001 and 2014, the median pneumonia mortality across the European Union was 19.8/100 000 and 6.9/100 000 for men and women, respectively 2 . Several studies found that the incidence of community‐acquired pneumonia (CAP) is increasing and is highly influenced by age and comorbidities 3‐5 . Quan et al 6 concluded that hospital admissions for CAP were increasing in the United Kingdom by ≈9% per year between 2009 and 2014.…”

Section: Introductionmentioning

confidence: 99%

Gender differences in incidence and in‐hospital outcomes of community‐acquired, ventilator‐associated and nonventilator hospital‐acquired pneumonia in Spain

et al. 2020

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Aims We aim to compare the incidence and in‐hospital outcomes of community‐acquired pneumonia (CAP), ventilator‐associated pneumonia (VAP) and nonventilator hospital‐acquired pneumonia (NV‐HAP) according to gender. Methods This was a retrospective observational epidemiological study using the Spanish National Hospital Discharge Database for the years 2016 and 2017. Results Of 277 785 hospital admissions, CAP was identified in 257 455 (41.04% females), VAP was identified in 3261 (30.42% females) and NV‐HAP was identified in 17 069 (36.58% females). The incidence of all types of pneumonia was higher amongst males (CAP: incidence rate ratio [IRR] 1.05, 95% CI 1.03‐1.06; VAP: IRR 1.36, 95% CI 1.26‐1.46; and NV‐HAP: IRR 1.16, 95% CI 1.14‐1.18). The crude in‐hospital mortality (IHM) rate for CAP was 11.44% in females and 11.80% in males (P = .005); for VAP IHM, the rate was approximately 35% in patients of both genders and for NV‐HAP IHM, the rate was 23.97% for females and 26.40% for males (P < .001). After multivariable adjustment, in patients of both genders, older age and comorbidities were factors associated with IHM in the three types of pneumonia analysed. Female gender was a risk factor for IHM after VAP (OR 1.24; 95% CI 1.06‐1.44), and no gender differences were found for CAP or NV‐HAP. Conclusions Our findings show a difference between females and males, with females presenting a lower incidence of all types of pneumonia. However, female gender was a risk factor for IHM after VAP.

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Burden of Community-Acquired Pneumonia and Unmet Clinical Needs

Cited by 157 publications

References 104 publications

Validation of the qSOFA score compared to the CRB-65 score for risk prediction in community-acquired pneumonia

Validation of the qSOFA score compared to the CRB-65 score for risk prediction in community-acquired pneumonia

The roles of tetraspanins in bacterial infections

Gender differences in incidence and in‐hospital outcomes of community‐acquired, ventilator‐associated and nonventilator hospital‐acquired pneumonia in Spain

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