New perspectives in aspiration community acquired Pneumonia

Rodríguez, A.; Restrepo, Marcos I.

doi:10.1080/17512433.2019.1663730

Cited by 23 publications

(28 citation statements)

References 104 publications

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“…Aspiration pneumonia is a subclass of CAP that is expected to contribute increasingly to mortality and morbidity, particularly among elderly populations over the coming decades. 20 Diagnosing aspiration pneumonia has been notoriously problematic, because standardized criteria for its diagnosis have yet to be established. Aspiration pneumonia is often diagnosed clinically, relying on the history and physical examination.…”

Section: Discussionmentioning

confidence: 99%

<p>Declined Functional Status Prolonged Hospital Stay for Community-Acquired Pneumonia in Seniors</p>

Hao¹,

Hara²,

Horita³

et al. 2020

CIA

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Among senior community-acquired pneumonia (CAP) survivors, functional status after hospitalization is often decreased. This study investigated the change of functional status affecting delayed discharge. Patients and Methods: This retrospective observational study was conducted in two medical facilities from January 2016 to December 2018. Hospitalized CAP patients >64 years old were divided into two groups: an early group discharged ≤1 week after ending antibiotic treatment and a delayed group discharged >1 week after ending antibiotic treatment. The primary outcome was decline in functional status. Results: The early group comprised 170 patients and the delayed group comprised 155 patients (median age: 78 vs 82 years; p = 0.007). Distribution of the causative microorganisms and initial prescription of antibiotics showed no significant differences in the two groups (p=0.38; p=0.83, respectively) More patients showed decline in functional status in the delayed group than the early group (16 (9.4%) vs 49 (31.6%), p<0.001), even if rehabilitation was more frequently conducted (77 (45.3%) vs 118 (76.1%); p<0.001). Higher medical expenses were observed in the delayed group ($8631 vs $3817, respectively; p<0.001). Multivariable regression analysis of factors contributing delayed discharge revealed that decreased functional status, pneumonia severity index (PSI) categories, rehabilitation enrolled, aspiration and age were independently associated with delayed discharge (odds ratio 4.31, 95% confidence interval (CI) 2.32-7.98; 2.34, 95% CI 1.43-3.82; 15.96, 95% CI 4.56-55.82 (PSI V vs II); 2.48, 95% CI 1.11-5.98; and 1.03, 95% CI 1.01-1.06; respectively). Conclusion: Functional status decline was independently associated with extended hospitalization.

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Section: Discussionmentioning

confidence: 99%

<p>Declined Functional Status Prolonged Hospital Stay for Community-Acquired Pneumonia in Seniors</p>

Hao¹,

Hara²,

Horita³

et al. 2020

CIA

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“…Aspiration pneumonia is also a concern for the elderly. Published studies have found that age is an independent risk factor for the aspiration pneumonia that commonly occurs with dysphagia (neurovascular and medication induced, such as antipsychotics) [ 20 ]. Likewise, Cilloniz et al [ 21 ] conducted a retrospective observational study and found that among patients with CAP, chronic renal and neurological diseases are both independent risk factors for mortality.…”

Section: Impact Of Aging In Community Acquired Pneumoniamentioning

confidence: 99%

Current Concepts in Community and Ventilator Associated Lower Respiratory Tract Infections in ICU Patients

Martín‐Loeches

2020

Antibiotics

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It is widely known that pneumonia (either community acquired or hospital acquired, as like ventilator associated pneumonia (VAP)), is the most frequent type of severe infection and continues to pose a significant burden on healthcare services worldwide. Despite new diagnostic developments, most pneumonia cases continue to be difficult to diagnose clinically, partly due to acquired antibiotic resistance and the lack of a ‘gold standard’ method of diagnosis. In other words, the lack of a rapid, accurate diagnostic test, as well as the uncertainty of the initial etiologic diagnosis and the risk stratification, results in empirical antibiotic treatments. There are significant changes in the aetiology of patients with ventilator associated lower respiratory tract infections (VA-LRTI), which are characterised by a higher incidence of multi drug resistant organisms. Evidence suggests that when patients with VA-LRTI develop organ failure, the associated mortality can be exceptionally high with frequent complications, including acute respiratory distress syndrome, acute kidney injury, and septic shock. Appropriate antibiotic treatments must consider that the present cardiovascular failure seen in patients has a different association with the patient’s mortality. Unlike patients with less severe clinical presentations, who have a higher chance of survival when the appropriate antibiotics are administered promptly, for patients with a severe subtype of the disease, the appropriateness of antibiotic treatment will impact the patient’s outcome to a lesser extent. The present review highlights certain factors detectable at the time of admission that could indicate patients who are at a high risk of bacteraemia and who, therefore, merit more intense therapy and stratified care.

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“…Olsenella uli can be detected in the oral cavity or gastrointestinal tract by culture or molecular analysis [5,7]. Interestingly, several studies have found that microorganisms colonizing the oropharynx, nasopharynx or upper gastrointestinal can be aspirated into the lung and cause aspiration pneumonia [13]. So we speculated this pneumonia case obtained the lung infection by aspirating the Olsenella uli of the oral cavity or upper gastrointestinal tract although a large number of further studies needed.…”

Section: Discussionmentioning

confidence: 93%

The Olsenella Uli Induced Pneumonia: A Case Report

Yan

et al. 2021

Preprint

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Olsenella uli is a Gram-positive bacterium common in the oral cavity or gastrointestinal tract. Here we reported a first case of human pneumonia caused by the Olsenella uli. The identification of Olsenella uli was based on micromorphology, sequence analysis and mass spectrometry analysis of the bacteria recovered from sputum. Ceftazidime，one of the third generation cephalosporins was used for the anti-infection treatment of the patient. CT results showed a significant improvement of the pulmonary lesion and pleural effusion and recovery from pulmonary infection after 10 days. The mechanism underlying Olsenella uli induced pneumonia is unclear, our report suggests a causative role of gingival bacteria in pathogenesis of pneumonia, and the intervention by Ceftazidime may offer a therapeutic strategy for Olsenella uli infection.

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New perspectives in aspiration community acquired Pneumonia

Cited by 23 publications

References 104 publications

<p>Declined Functional Status Prolonged Hospital Stay for Community-Acquired Pneumonia in Seniors</p>

<p>Declined Functional Status Prolonged Hospital Stay for Community-Acquired Pneumonia in Seniors</p>

Current Concepts in Community and Ventilator Associated Lower Respiratory Tract Infections in ICU Patients

The Olsenella Uli Induced Pneumonia: A Case Report

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