Comparative analysis of the patients with community-acquired pneumonia (CAP) and health care-associated pneumonia (HCAP) requiring hospitalization

Kara, Sibel; Akçay, Şule; Ünsal, Zühal Ekici; Yilmaz, Hamiyet; Habeşoğlu, Mehmet

doi:10.5578/tt.68421

Cited by 9 publications

(4 citation statements)

References 4 publications

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“…The aetiology of CAP includes most often bacteria such as Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, or viral pathogens, such as influenza or rhinovirus. In a large proportion of cases, the pathologic agent remains unidentified, despite a complete microbiological workup [23,24]. During the last years, changes in the prevalence of different etiological agents of CAP were observed.…”

Section: Resultsmentioning

confidence: 99%

Antibiotic Resistance in Community-Acquired Pneumonia. A Romanian Perspective

Blejan¹

2020

FARMACIA

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Community-acquired pneumonia (CAP) is one of the most common communicable diseases with a high mortality rate worldwide. Treatment is administered empirically based on clinical symptoms and the most commonly incriminated microorganisms in lower respiratory infections responsible for CAP. This study aimed to identify microorganisms responsible for CAP in patients hospitalized in an Emergency Hospital in Bucharest, Romania; to assess the impact of patients' comorbidities and age on the survival level and to establish the degree of antimicrobial resistance of the most important isolated species. A total of 170 patients diagnosed with CAP from December 2017 through December 2018 were studied. Statistical analyses were performed considering the following data: survival rate, comorbidities, initiated pharmacotherapy, antibiogram results in case of refractory treatments. The overall survival rate was 36% among patients. Cardiovascular disease was incriminated as the highest risk factor. Concerning refractory antibiotic treatment, the microbiological results revealed that the most common bacterial strains detected were Klebsiella sp., Acinetobacter baumanii, S. aureus, E. coli and Pseudomonas, with high multiple antibiotic resistance (MAR) index. The results point out a real concern for patients with refractory CAP due to high antimicrobial resistance to the administered antibiotics in Romania. RezumatPneumonia comunitară (PC) este una dintre cele mai frecvente boli transmisibile cu o rată mare de mortalitate la nivel mondial. Tratamentul este administrat empiric pe baza simptomelor clinice și a microorganismelor cel mai frecvent incriminate în infecțiile respiratorii inferioare responsabile de PC. Acest studiu a urmărit identificarea microorganismelor responsabile de PC la pacienții internați într-un spital de urgență din București, România; pentru a evalua impactul comorbidităților și vârstei pacienților asupra nivelului de supraviețuire și a stabili gradul de rezistență antimicrobiană a celor mai importante specii izolate. Au fost studiați 170 de pacienți diagnosticați cu PC din decembrie 2017 până în decembrie 2018. Analizele statistice au fost efectuate ținând cont de următoarele date: rata de supraviețuire, comorbiditățile, farmacoterapia inițiată, rezultatul antibiogramei în cazul tratamentelor refractare. Rata de supraviețuire globală a fost de 36% în rândul pacienților. Boala cardiovasculară a fost incriminată drept cel mai mare factor de risc. În ceea ce privește tratamentul cu antibiotice refractare, rezultatele microbiologice au relevat că cele mai frecvente tulpini bacteriene detectate au fost Klebsiella sp., Acinetobacter baumanii, S. aureus, E. coli și Pseudomonas, cu un indice MAR (multiple antibiotic resistance) ridicat. Rezultatele subliniază importanța particulară a pneumoniei refractare datorită rezistenței antimicrobiene la antibioticele administrate în România.

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Section: Resultsmentioning

confidence: 99%

Antibiotic Resistance in Community-Acquired Pneumonia. A Romanian Perspective

Blejan¹

2020

FARMACIA

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“…Community-acquired pneumonia (CAP) is a major cause of morbidity and mortality. Mortality is mainly associated with progression into sepsis; this is reaching almost 28% among patients with CAP [ 1 , 2 ]. The ideal strategy for the management of pneumonia should rely on the early identification of the pathogen and the administration of targeted antimicrobial therapy.…”

Section: Introductionmentioning

confidence: 99%

BioFire® FilmArray® Pneumonia Panel for Severe Lower Respiratory Tract Infections: Subgroup Analysis of a Randomized Clinical Trial

et al. 2021

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Introduction The epidemiology of severe lower respiratory tract infections (LRTI) is constantly changing. We aimed to describe it using the BioFire ® FilmArray ® Pneumonia plus (PN plus ) Panel. Methods In a sub-study of the PROGRESS trial, sputum samples of 90 patients with sepsis and LRTI were retrospectively studied. The primary endpoint was the comparative detection rate of pathogens between conventional microbiology and PN plus Panel; secondary endpoints were microbiology and the association with the inflammatory host response. Results Fifty-six patients with community-acquired pneumonia without risk factors for multidrug-resistant (MDR) pathogens and another 34 patients with risk factors for MDR were studied; median pneumonia severity index (PSI) was 113 (88–135). PN plus detection rate was 72.2% compared to 10% by conventional microbiology ( p < 0.001); Streptococcus pneumoniae was the most common pathogen. PSI and procalcitonin were greater among patients with bacterial pathogens than viral pathogens. Median procalcitonin was 0.49 ng/ml and 0.18 ng/ml among patients with ≥ 10 5 and < 10 5 copies/ml of detected bacteria, respectively ( p = 0.004). Resistance reached 14.4%. Conclusion PN plus detects severe pneumonia pathogens at a greater rate than conventional microbiology. High levels of inflammation accompany bacterial detection. Trial Registration PROGRESS, ClinicalTrials.gov NCT03333304, 06/11/2017. Supplementary Information The online version contains supplementary material available at 10.1007/s40121-021-00459-x.

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“…For pneumonia patients, disease severity, need for ICU care, and the expected mortality rate thereafter are expected to increase with comorbid conditions (31). Since our primary aim was to examine D-dimer levels in CAP patients and we excluded potential comorbid conditions and malignancy that may affect D-dimer levels and/or mortality rates.…”

Section: Discussionmentioning

confidence: 99%

The prognostic and diagnostic value of plasma D-dimer levels in elderly patients with community-acquired pneumonia

BULUT¹

2022

tjgeri

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Comparative analysis of the patients with community-acquired pneumonia (CAP) and health care-associated pneumonia (HCAP) requiring hospitalization

Cited by 9 publications

References 4 publications

Antibiotic Resistance in Community-Acquired Pneumonia. A Romanian Perspective

Antibiotic Resistance in Community-Acquired Pneumonia. A Romanian Perspective

BioFire® FilmArray® Pneumonia Panel for Severe Lower Respiratory Tract Infections: Subgroup Analysis of a Randomized Clinical Trial

The prognostic and diagnostic value of plasma D-dimer levels in elderly patients with community-acquired pneumonia

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