Bacterial etiology of community-acquired pneumonia in immunocompetent hospitalized patients and appropriateness of empirical treatment recommendations: an international point-prevalence study.

Autor: Carugati M; Internal Medicine Department, Division of Infectious Diseases, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico Milano, Milan, Italy. ela.carugati@gmail.com.; Division of Infectious Diseases and International Health, Duke University, Durham, USA. ela.carugati@gmail.com., Aliberti S; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.; Internal Medicine Department, Respiratory Unit and Adult Cystic Fibrosis Center, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico Milano, Milan, Italy., Sotgiu G; Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy., Blasi F; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.; Internal Medicine Department, Respiratory Unit and Adult Cystic Fibrosis Center, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico Milano, Milan, Italy., Gori A; Internal Medicine Department, Division of Infectious Diseases, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico Milano, Milan, Italy.; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.; Centre for Multidisciplinary Research in Health Science, Milan, Italy., Menendez R; Pneumology Service, University and Polytechnic Hospital La Fe, Valencia, Spain., Encheva M; Clinic of Pulmonary Diseases, Military Medical Academy, Sofia, Bulgaria., Gallego M; Department of Respiratory Medicine, Hospital de Sabadell, Institut Universitari Parc Taulí-UAB, Sabadell, CIBER de Enfermedades Respiratorias, CIBERES, Bunyola, Spain., Leuschner P; Serviço de Medicina, Centro Hospitalar Universitario do Porto, Porto, Portugal., Ruiz-Buitrago S; Emergency Medicine Department, University Hospital Hairmyres, Glasgow, Scotland., Battaglia S; Pneumologia PROMISE, University of Palermo, Palermo, Italy., Fantini R; Respiratory Diseases Clinic, Policlinico di Modena, Modena, Italy., Pascual-Guardia S; Respiratory Department, Hospital del Mar - IMIM, DCEXS-UPF, CIBERES, BRN, Barcelona, Spain., Marin-Corral J; Critical Care Department, Hospital del Mar - IMIM, Barcelona, Spain., Restrepo MI; South Texas Veterans Health Care System and University of Texas Health San Antonio, San Antonio, USA.
Jazyk: angličtina
Zdroj: European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology [Eur J Clin Microbiol Infect Dis] 2020 Aug; Vol. 39 (8), pp. 1513-1525. Date of Electronic Publication: 2020 Apr 03.
DOI: 10.1007/s10096-020-03870-3
Abstrakt: An accurate knowledge of the epidemiology of community-acquired pneumonia (CAP) is key for selecting appropriate antimicrobial treatments. Very few etiological studies assessed the appropriateness of empiric guideline recommendations at a multinational level. This study aims at the following: (i) describing the bacterial etiologic distribution of CAP and (ii) assessing the appropriateness of the empirical treatment recommendations by clinical practice guidelines (CPGs) for CAP in light of the bacterial pathogens diagnosed as causative agents of CAP. Secondary analysis of the GLIMP, a point-prevalence international study which enrolled adults hospitalized with CAP in 2015. The analysis was limited to immunocompetent patients tested for bacterial CAP agents within 24 h of admission. The CAP CPGs evaluated included the following: the 2007 and 2019 American Thoracic Society/Infectious Diseases Society of America (ATS/IDSA), the European Respiratory Society (ERS), and selected country-specific CPGs. Among 2564 patients enrolled, 35.3% had an identifiable pathogen. Streptococcus pneumoniae (8.2%) was the most frequently identified pathogen, followed by Pseudomonas aeruginosa (4.1%) and Klebsiella pneumoniae (3.4%). CPGs appropriately recommend covering more than 90% of all the potential pathogens causing CAP, with the exception of patients enrolled from Germany, Pakistan, and Croatia. The 2019 ATS/IDSA CPGs appropriately recommend covering 93.6% of the cases compared with 90.3% of the ERS CPGs (p < 0.01). S. pneumoniae remains the most common pathogen in patients hospitalized with CAP. Multinational CPG recommendations for patients with CAP seem to appropriately cover the most common pathogens and should be strongly encouraged for the management of CAP patients.
Databáze: MEDLINE
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