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24. Protocol for an international, multicentre, prospective, observational study of nosocomial pneumonia in intensive care units: The PneumoINSPIRE study

Author

Koulenti, D. Armaganidis, A. Arvaniti, K. Blot, S. Brun-Buisson, C. Deja, M. De Waele, J. Du, B. Dulhunty, J.M. Garcia-Diaz, J. Judd, M. Paterson, D.L. Putensen, C. Reina, R. Rello, J. Restrepo, M.I. Roberts, J.A. Sjovall, F. Timsit, J.-F. Tsiodras, S. Zahar, J.-R. Zhang, Y. Lipman, J. Working Group on Pneumonia of the European Society of Intensive Care Medicine

Abstract

Background: Nosocomial pneumonia in the critical care setting is associated with increased morbidity, significant crude mortality rates and high health care costs. Ventilator-associated pneumonia represents about 80% of nosocomial pneumonia cases in intensive care units (ICUs). Wide variance in incidence of nosocomial pneumonia and diagnostic techniques used has been reported, while successful treatment remains complex and a matter of debate. Objective: To describe the epidemiology, diagnostic strategies and treatment modalities for nosocomial pneumonia in contemporary ICU settings across multiple countries around the world. Design, setting and patients: PneumoINSPIRE is a large, multinational, prospective cohort study of adult ICU patients diagnosed with nosocomial pneumonia. Participating ICUs from at least 20 countries will collect data on 10 or more consecutive ICU patients with nosocomial pneumonia. Site-specific information, including hospital policies on antibiotic therapy, will be recorded along with patient-specific data. Variables that will be explored include: aetiology and antimicrobial resistance patterns, treatment-related parameters (including time to initiation of antibiotic therapy, and empirical antibiotic choice, dose and escalation or de-escalation), pneumonia resolution, ICU and hospital mortality, and risk factors for unfavourable outcomes. The concordance of ventilator-associated pneumonia diagnosis with accepted definitions will also be assessed. Results and conclusions: PneumoINSPIRE will provide valuable information on current diagnostic and management practices relating to ICU nosocomial pneumonia, and identify research priorities in the field. Trial registration: ClinicalTrials.gov identifier NCT02793141. © 2021, College of Intensive Care Medicine. All rights reserved.

Published
2021

30. An international perspective on hospitalized patients with viral community-acquired pneumonia

Author

Radovanovic, D., Sotgiu, G., Jankovic, M., Mahesh, P.A., Marcos, P.J., Abdalla, M.I., Di Pasquale, M.F., Gramegna, A., Terraneo, S., Blasi, F., Santus, P., Aliberti, S., Reyes, L.F., Restrepo, M.I., Aruj, P.K., Attorri, S., Barimboim, E., Caeiro, J.P., Garzón, M.I., Cambursano, V.H., Ceccato, A., Chertcoff, J., Cordon Díaz, A., de Vedia, L., Ganaha, M.C., Lambert, S., Lopardo, G., Luna, C.M., Malberti, A.G., Morcillo, N., Tartara, S., Pensotti, C., Pereyra, B., Scapellato, P.G., Stagnaro, J.P., Shah, S., Lötsch, F., Thalhammer, F., Anseeuw, K., Francois, C.A., Van Braeckel, E., Vincent, J.L., Djimon, M.Z., Aranha Nouér, S., Chipev, P., Encheva, M., Miteva, D., Petkova, D., Balkissou, A.D., Pefura Yone, E.W., Mbatchou Ngahane, B.H., Shen, N., Xu, J.F., Bustamante Rico, C.A., Buitrago, R., Pereira Paternina, F.J., Kayembe Ntumba, J.M., Vladic-Carevic, V., Jakopovic, M., Matkovic, Z., Mitrecic, I., Bouchy Jacobsson, M.L., Bro Christensen, A., Heitmann Bødtger, U.C., Meyer, C.N., Vestergaard Jensen, A., El-Said Abd El-Wahhab, I., Elsayed Morsy, N., Shafiek, H., Sobh, E., Abdulsemed, K.A., Bertrand, F., Brun-Buisson, C., de Montmollin, E., Fartoukh, M., Messika, J., Tattevin, P., Khoury, A., Ebruke, B., Dreher, M., Kolditz, M., Meisinger, M., Pletz, M.W., Hagel, S., Rupp, J., Schaberg, T., Spielmanns, M., Creutz, P., Suttorp, N., Siaw-Lartey, B., Dimakou, K., Papapetrou, D., Tsigou, E., Ampazis, D., Kaimakamis, E., Bhatia, M., Dhar, R., D'Souza, G., Garg, R., Koul, P.A., Jayaraj, B.S., Narayan, K.V., Udnur, H.B., Krishnamurthy, S.B., Kant, S., Swarnakar, R., Salvi, S., Limaye, S., Golshani, K., Keatings, V.M., Martin-Loeches, I., Maor, Y., Strahilevitz, J., Battaglia, S., Carrabba, M., Ceriana, P., Confalonieri, M., d'Arminio Monforte, A., Del Prato, B., De Rosa, M., Fantini, R., Fiorentino, G., Gammino, M.A., Menzella, F., Milani, G., Nava, S., Palmiero, G., Petrino, R., Gabrielli, B., Rossi, P., Sorino, C., Steinhilber, G., Zanforlin, A., Franzetti, F., Carone, M., Patella, V., Scarlata, S., Comel, A., Kurahashi, K., Aoun Bacha, Z., Barajas Ugalde, D., Ceballos Zuñiga, O., Villegas, J.F., Medenica, M., van de Garde, E.M.W., Raj Mihsra, D., Shrestha, P., Ridgeon, E., Ishola Awokola, B., Nwankwo, O.N.O., Olufunlola, A.B., Olumide, S., Ukwaja, K.N., Irfan, M., Minarowski, L., Szymon, S., Froes, F., Leuschner, P., Meireles, M., Ferrão, C., Neves, J., Ravara, S.B., Brocovschii, V., Ion, C., Rusu, D., Toma, C., Chirita, D., Dorobat, C.M., Birkun, A., Kaluzhenina, A., Almotairi, A., Bukhary, Z.A.A., Edathodu, J., Fathy, A., Mushira Abdulaziz Enani, A., Eltayeb Mohamed, N., Ulhadi Memon, J., Bella, A., Bogdanovic, N., Milenkovic, B., Pesut, D., Borderìas, L., Bordon Garcia, N.M., Cabello Alarcón, H., Cilloniz, C., Torres, A., Diaz-Brito, V., Casas, X., Encabo González, A., Fernández-Almira, M.L., Gallego, M., Gaspar-GarcÍa, I., González Del Castillo, J., Javaloyes Victoria, P., Laserna Martínez, E., Malo de Molina, R., and Menéndez, R.

Subjects
viruses
Abstract

Background: Who should be tested for viruses in patients with community acquired pneumonia (CAP), prevalence and risk factors for viral CAP are still debated. We evaluated the frequency of viral testing, virus prevalence, risk factors and treatment coverage with oseltamivir in patients admitted for CAP. Methods: Secondary analysis of GLIMP, an international, multicenter, point-prevalence study of hospitalized adults with CAP. Testing frequency, prevalence of viral CAP and treatment with oseltamivir were assessed among patients who underwent a viral swab. Univariate and multivariate analysis was used to evaluate risk factors. Results: 553 (14.9%) patients with CAP underwent nasal swab. Viral CAP was diagnosed in 157 (28.4%) patients. Influenza virus was isolated in 80.9% of cases. Testing frequency and viral CAP prevalence were inhomogeneous across the participating centers. Obesity (OR 1.59, 95%CI: 1.01–2.48; p = 0.043) and need for invasive mechanical ventilation (OR 1.62, 95%CI: 1.02–2.56; p = 0.040) were independently associated with viral CAP. Prevalence of empirical treatment with oseltamivir was 5.1%. Conclusion: In an international scenario, testing frequency for viruses in CAP is very low. The most common cause of viral CAP is Influenza virus. Obesity and need for invasive ventilation represent independent risk factors for viral CAP. Adherence to recommendations for treatment with oseltamivir is poor.

Published
2019

36. Reply

Author

Sibila E.F., Mateus E.F., Restrepo M.I., Chalmers J.D., and Vidal S.

Subjects
Mucin-2, mucin 5B, Letter, bacterial colonization, Respiratory System, asthma, mucin 2, enzyme linked immunosorbent assay, cross reacting antibody, cystic fibrosis, Pulmonary Disease, Chronic Obstructive, airway, ELISA kit, protein secretion, protein degradation, Humans, disease severity, optical density, human, measurement accuracy, mucin 5AC, chronic obstructive lung disease
Abstract

[No abstract available]

Published
2016

37. Risk factors and antibiotic therapy in P. aeruginosa community-acquired pneumonia

Author

Sibila O., Laserna E., Maselli D.J., Fernandez J.F., Mortensen E.M., Anzueto A., Waterer G., and Restrepo M.I.

Subjects
retrospective study, heart failure, ICD-9-CM, meropenem, amikacin, piperacillin, antibiotic therapy, antibiotic agent, ceftazidime, artificial ventilation, clinical trial, cohort analysis, hypertensive factor, cerebrovascular disease, health survey, Anti-Bacterial Agents, antiinfective agent, Community-Acquired Infections, aged, female, priority journal, risk factor, peripheral vascular disease, diabetes mellitus, Pseudomonas aeruginosa, Charlson Comorbidity Index, heart infarction, tobramycin, gentamicin, Article, length of stay, male, ciprofloxacin, cefepime, metastasis, pneumonia, controlled study, Pseudomonas Infections, human, levofloxacin, treatment duration, isolation and purification, practice guideline, microbiology, community acquired pneumonia, major clinical study, mortality, United States, multicenter study, incidence, disease duration, chronic obstructive lung disease, Huma, aztreonam, imipenem, dementia
Abstract

Background and objective Current guidelines recommend empirical treatment against Pseudomonas aeruginosa in community-acquired pneumonia (CAP) patients with specific risk factors. However, evidence to support these recommendations is limited. We evaluate the risk factors and the impact of antimicrobial therapy in patients hospitalized with CAP due to P. aeruginosa. Methods We performed a retrospective population-based study of >150 hospitals. Patients were included if they had a diagnosis of CAP and P. aeruginosa was identified as the causative pathogen. Univariate and multivariate analyses were performed using the presence of risk factors and 30-day mortality as the dependent measures. Results Seven hundred eighty-one patients with P. aeruginosa pneumonia were identified in a cohort of 62 689 patients with pneumonia (1.1%). Of these, 402 patients (0.6%) were included in the study and 379 (0.5%) were excluded due to health care-associated pneumonia or immunosuppression. In patients with CAP due to P. aeruginosa, 272 (67.8%) had no documented risk factors. These patients had higher rates of dementia and cerebrovascular disease. Empirical antibiotic therapy against P. aeruginosa within the first 48 h of presentation was independently associated with lower 30-day mortality in patients with CAP due to P. aeruginosa (hazard ratio (HR) 0.42, 95% confidence interval (CI): 0.23-0.76) and in patients without risk factors for P. aeruginosa CAP (HR 0.40, 95% CI: 0.21-0.76). Conclusions Risk factor recommended by current guidelines only detect one third of the patients admitted with CAP due to P. aeruginosa. Risk factors did not define the whole benefit observed due to empirical therapy covering P. aeruginosa. Risk factors recommended by current guidelines only detect one third of the patients admitted with CAP due to P. aeruginosa. Not administrating antibiotics active against P. aeruginosa in the first 48 h increases 30-day mortality. © Published 2015. This article is a U.S. Government work and is in the public domain in the USA.

Published
2015

38. Diferencias entre la neumonía de origen nosocomial y asociada a la ventilación por Staphylococcus aureus (susceptible a la meticilina y resistente a la meticilina) en Europa y Latinoamérica: comparación de las cohortes de estudio EUVAP y LATINVAP

Author

Rello, J., Molano, D., Villabón, Mario, Rita-Quispe, R., Previgliano, I., Afonso, E., and Restrepo, M.I.

Subjects
Staphylococcus aureus, Neumonía, Staphylococcus aureus resistente a meticilina, Ventilator-associated pneumonia, Respiratory infections, Infecciones del sistema respiratorio, Pneumonia, Neumonía asociada al ventilador, Methicillin resistant Staphylococcus aureus
Abstract

Purpose: A comparison is made of epidemiological variables (demographic and clinical characteristics) and outcomes in patients with hospital-acquired pneumonia (HAP) or ventilatorassociated pneumonia (VAP) caused by methicillin-susceptible and methicillin-resistant Staphylococcus aureus (MSSA and MRSA) in the Latin American VAP (LATINVAP) vs. the European Union VAP (EUVAP) cohorts of patients admitted to intensive care units (ICUs). Methods: The EUVAP project was a prospective, multicenter observational study reporting 827 patients with HAP/VAP in 27 ICUs from 9 European countries. The LATINVAP project was a multicenter prospective observational study, with an identical design, performed in 17 ICUs from 4 Latin American countries involving 99 patients who developed HAP/VAP. Episodes of VAP/HAP caused by S. aureus, MSSA, and MRSA were compared in both cohorts. Results: Forty-five patients had S. aureus HAP/VAP in the EUVAP cohort vs. 11 patients in the LATINVAP cohort. More patients had MRSA in the LATINVAP study than in the EUVAP (45% vs. 33%). ICU mortality among patients with MSSA HAP/VAP in EUVAP was 10% vs. 50% for LATINVAP (OR = 9.75, p = 0.01). Fifteen patients in the EUVAP cohort developed MRSA HAP/VAP as opposed to 5 in LATINVAP. In the EUVAP study there was an ICU mortality rate of 33.3%. In the LATINVAP cohort, the ICU mortality rate was 60% (OR for death = 3.0; 95%CI 0.24---44.7). Conclusion:MRSApneumoniawasassociatedwithpooreroutcomesincomparisonwithMSSA.OurstudysuggestssignificantvariabilityamongEuropeanandLatinAmericanICUpracticesthatmayinfluenceclinicaloutcomes.Furthermore,patientswithpneumoniainLatinAmericahavedifferentoutcomes. Objetivo:compararlas variables epidemiológicas(características demográficas y clínicas) y los efectos en pacientes con neumonía intrahospitalaria (NIH) o neumonía asociada a la ventilación(NAV)causada por Staphylococcus aureus susceptible a la meticilina(SASM) y resistente a la meticilina(SARM) en las cohortes LATINVAP y EUVAP de pacientes admitidos en unidades de cuidados intensivos (UCI). Métodos:El proyecto EUVAP fue un estudio prospectivo,multicéntrico y observacional sobre 827 pacientes con NIH/NAV de 27 UCI de 9 países europeos. El proyecto LATINVAP fue un estudio pospectivo, multicéntrico y observacional de idéntico diseño que se llevó acabo en 17 UCI de 4 países latinoamericanos y en el que se evaluaron 99 pacientes que habían desarrollado HAP/VAP. Se compararon entre las cohortes los episodios de VAP/HAP causados por S.aureus (SASMySARM). Resultados :Cuarenta y cinco pacientes presentaron NIH/NAV por S.aureus en la cohorte EUVAP frente a 11pacientes en la cohorte LATINVAP. El número de pacientes con SAR Men el estudio LATINVAP fue superior al del estudio EUVAP(45%frenteal33%).La mortalidad en la UCI entre los pacientes con NIH/NAV por SASM del estudio EUVAP fue del 10% frente al 50% en el caso del estudio LATINVAP (OR=9,75,p=0,01).Quince pacientes de la cohorte EUVAP desarrollaron NIH/NAV porSARM frente a 5 de la cohorte LATINVAP. En el estudio EUVAP se registró una tasa de mortalidad del 33,3%.En la cohorte LATINVAP la tasa de mortalidad en la UCI fue del 60%(ORdemuerte=3,0;ICdel95%de0,24a44,7).Conclusiones:LaneumoníaporSARMseasoció a unos peores resultados en comparación con la neumonía por SASM.Nuestro estudio sugiere una variabilidad importante entre las prácticas de las UCI europeas y latinoamericanas que podría influir sobre los resultados clínicos. Además, los pacientes con neumonía de Latinoamérica presentaron resultados diferentes.

Published
2012

40. Outcome of tracheotomized patients following reintubation

Author

Peñuelas, O., primary, Frutos-Vivar, F., additional, Gordo, F., additional, Apezteguía, C., additional, Restrepo, M.I., additional, González, M., additional, Arabi, Y., additional, Santos, C., additional, Alhashemi, J.A., additional, Pérez, F., additional, Esteban, A., additional, and Anzueto, A., additional

Published
2013
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41. Desenlace de los enfermos traqueotomizados después de la reintubación

Author

Peñuelas, O., primary, Frutos-Vivar, F., additional, Gordo, F., additional, Apezteguía, C., additional, Restrepo, M.I., additional, González, M., additional, Arabi, Y., additional, Santos, C., additional, Alhashemi, J.A., additional, Pérez, F., additional, Esteban, A., additional, and Anzueto, A., additional

Published
2013
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45. Performance of a hybrid central venous catheter utilized for both peripheral blood stem cell harvest and transplant support of patients undergoing autologous peripheral blood stem cell transplantation.

Author

Restrepo, A., Devore, P., Encarnacion, C.E., Wholey, M.H., Schneider, D., Callander, N.S., Ferral, H., Postoak, D., Anderson, J.E., Walsh, T., Padayao, G., Gokmen, E., Ehsan, A., Ochoa, L., Neumon, B., West, G., Restrepo, M.I., Przykucki, J., and Patterson, J.

Subjects
CATHETERS, LEUKAPHERESIS, INFECTION, OCCLUSIVE surgical dressings
Abstract

Presents a study which evaluated the performance of the Pheres-Flow hybrid catheter when utilized for both leukapheresis and transplant support, with particular emphasis on the incidence of infectious and occlusive complications. Information on the patients and methods; Results of the study; Discussion of findings.

Published
2002
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48. Prevalence and Etiology of Community-acquired Pneumonia in Immunocompromised Patients

Author

Di Pasquale, Marta Francesca, Sotgiu, Giovanni, Gramegna, Andrea, Radovanovic, Dejan, Terraneo, Silvia, Reyes, Luis F, Rupp, Jan, González del Castillo, Juan, Blasi, Francesco, Aliberti, Stefano, Restrepo, Marcos I, Aruj, Patricia Karina, Attorri, Silvia, Barimboim, Enrique, Caeiro, Juan Pablo, Garzón, María I, Cambursano, Victor Hugo, Cazaux, A, Ceccato, Adrian, Chertcoff, Julio, Lascar, Florencia, Tulio, Fernando Di, Díaz, Ariel Cordon, de Vedia, Lautaro, Ganaha, Maria Cristina, Lambert, Sandra, Lopardo, Gustavo, Luna, Carlos M, Malberti, Alessio Gerardo, Morcillo, Nora, Tartara, Silvina, Cetrangolo, Antonio A, Pensotti, Claudia, Pereyra, Betiana, Scapellato, Pablo Gustavo, Stagnaro, Juan Pablo, Shah, Sonali, Lötsch, Felix, Thalhammer, Florian, Anseeuw, Kurt, Francois, Camille A, Van Braeckel, Eva, Vincent, Jean Louis, Djimon, Marcel Zannou, Bashi, Jules, Dodo, Roger, Nouér, Simone Aranha, Chipev, Peter, Encheva, Milena, Miteva, Darina, Petkova, Diana, Balkissou, Adamou Dodo, Yone, Eric Walter Pefura, Ngahane, Bertrand Hugo Mbatchou, Shen, Ning, Xu, Jin-fu, Rico, Carlos Andres Bustamante, Buitrago, Ricardo, Paternina, Fernando Jose Pereira, Ntumba, Jean-Marie Kayembe, Carevic, Vesna Vladic, Jakopovic, Marko, Jankovic, Mateja, Matkovic, Zinka, Mitrecic, Ivan, Jacobsson, Marie-Laure Bouchy, Christensen, Anette Bro, Bødtger, Uffe Christian Heitmann, Meyer, Christian Niels, Jensen, Andreas Vestergaard, Baunbæk-Knudsen, Gertrud, Petersen, Pelle Trier, Andersen, Stine, El-Wahhab, Ibrahim El-Said Abd, Morsy, Nesreen Elsayed, Shafiek, Hanaa, Sobh, Eman, Abdulsemed, Kedir Abdella, Bertrand, Fabrice, Brun-Buisson, Christian, de Montmollin, Etienne, Fartoukh, Muriel, Messika, Jonathan, Tattevin, Pierre, Khoury, Abdo, Ebruke, Bernard, Dreher, Michael, Kolditz, Martin, Meisinger, Matthias, Niederlausitz, Klinikum, Pletz, Mathias W, Hagel, Stefan, Schaberg, Tom, Spielmanns, Marc, Creutz, Petra, Suttorp, Norton, Siaw-Lartey, Beatrice, Dimakou, Katerina, Papapetrou, Dimosthenis, Tsigou, Evdoxia, Ampazis, Dimitrios, Kaimakamis, Evangelos, Bhatia, Mohit, Dhar, Raja, D’Souza, George, Garg, Rajiv, Koul, Parvaiz A, Mahesh, P A, Jayaraj, B S, Narayan, Kiran Vishnu, Udnur, Hirennappa B, Krishnamurthy, Shashi Bhaskara, Kant, Surya, Swarnakar, Rajesh, Limaye, Sneha, Salvi, Sundeep, Golshani, Keihan, Keatings, Vera M, Martin-Loeches, Ignacio, Maor, Yasmin, Strahilevitz, Jacob, Battaglia, Salvatore, Carrabba, Maria, Ceriana, Piero, Confalonieri, Marco, Monforte, Antonella d’Arminio, Prato, Bruno Del, Rosa, Marino De, Fantini, Riccardo, Fiorentino, Giuseppe, Gammino, Maria Antonia, Menzella, Francesco, Milani, Giuseppe, Nava, Stefano, Palmiero, Gerardo, Petrino, Roberta, Gabrielli, Barbra, Rossi, Paolo, Sorino, Claudio, Steinhilber, Gundi, Zanforlin, Alessandro, Franzetti, Fabio, Carugati, Manuela, Morosi, Manuela, Monge, Elisa, Carone, Mauro, Patella, Vincenzo, Scarlata, Simone, Comel, Andrea, Kurahashi, Kiyoyasu, Bacha, Zeina Aoun, Ugalde, Daniel Barajas, Zuñiga, Omar Ceballos, Villegas, José F, Medenica, Milic, van de Garde, E M W, Mihsra, Deebya Raj, Shrestha, Poojan, Ridgeon, Elliott, Awokola, Babatunde Ishola, Nwankwo, Ogonna N O, Olufunlola, Adefuye Bolanle, Olumide, Segaolu, Ukwaja, Kingsley N, Irfan, Muhammad, Minarowski, Lukasz, Szymon, Skoczyński, Froes, Felipe, Leuschner, Pedro, Meireles, Mariana, Ferrão, Cláudia, Neves, João, Ravara, Sofia B, Brocovschii, Victoria, Ion, Chesov, Rusu, Doina, Toma, Cristina, Chirita, Daniela, Dorobat, Carmen Mihaela, Birkun, Alexei, Kaluzhenina, Anna, Almotairi, Abdullah, Bukhary, Zakeya Abdulbaqi Ali, Edathodu, Jameela, Fathy, Amal, Enani, Abdullah Mushira Abdulaziz, Mohamed, Nazik Eltayeb, Memon, Jawed Ulhadi, Bella, Abdelhaleem, Bogdanović, Nada, Milenkovic, Branislava, Pesut, Dragica, Borderìas, Luis, Garcia, Noel Manuel Bordon, Alarcón, Hugo Cabello, Cilloniz, Catia, Torres, Antoni, Diaz-Brito, Vicens, Casas, Xavier, González, Alicia Encabo, Fernández-Almira, Maria Luisa, Gallego, Miguel, Gaspar-GarcÍa, Inmaculada, del Castillo, Juan González, Victoria, Patricia Javaloyes, Martínez, Elena Laserna, de Molina, Rosa Malo, Marcos, Pedro J, Menéndez, Rosario, Pando-Sandoval, Ana, Aymerich, Cristina Prat, de la Torre, Alicia Lacoma, García-Olivé, Ignasi, Rello, Jordi, Moyano, Silvia, Sanz, Francisco, Sibila, Oriol, Rodrigo-Troyano, Ana, Solé-Violán, Jordi, Uranga, Ane, van Boven, Job F M, Torra, Ester Vendrell, Pujol, Jordi Almirall, Feldman, Charles, Yum, Ho Kee, Fiogbe, Arnauld Attannon, Yangui, Ferdaous, Bilaceroglu, Semra, Dalar, Levent, Yilmaz, Ufuk, Bogomolov, Artemii, Elahi, Naheed, Dhasmana, Devesh J, Feneley, Andrew, Ions, Rhiannon, Skeemer, Julie, Woltmann, Gerrit, Hancock, Carole, Hill, Adam T, Rudran, Banu, Ruiz-Buitrago, Silvia, Campbell, Marion, Whitaker, Paul, Youzguin, Alexander, Singanayagam, Anika, Allen, Karen S, Brito, Veronica, Dietz, Jessica, Dysart, Claire E, Kellie, Susan M, Franco-Sadud, Ricardo A, Meier, Garnet, Gaga, Mina, Holland, Thomas L, Bergin, Stephen P, Kheir, Fayez, Landmeier, Mark, Lois, Manuel, Nair, Girish B, Patel, Hemali, Reyes, Katherine, Rodriguez-Cintron, William, Saito, Shigeki, Soni, Nilam J, Noda, Julio, Hinojosa, Cecilia I, Levine, Stephanie M, Angel, Luis F, Anzueto, Antonio, Whitlow, K Scott, Hipskind, John, Sukhija, Kunal, Totten, Vicken, Wunderink, Richard G, Shah, Ray D, Mateyo, Kondwelani John, Noriega, Lorena, Alvarado, Ezequiel, Aman, Mohamed, Labra, Lucía, Value, Affordability and Sustainability (VALUE), Groningen Research Institute for Asthma and COPD (GRIAC), Di Pasquale, M. F., Sotgiu, G., Gramegna, A., Radovanovic, D., Terraneo, S., Reyes, L. F., Rupp, J., Gonzalez Del Castillo, J., Blasi, F., Aliberti, S., Restrepo, M. I., Aruj, P. K., Attorri, S., Barimboim, E., Caeiro, J. P., Garzon, M. I., Cambursano, V. H., Cazaux, A., Ceccato, A., Chertcoff, J., Lascar, F., Tulio, F. D., Diaz, A. C., de Vedia, L., Ganaha, M. C., Lambert, S., Lopardo, G., Luna, C. M., Malberti, A. G., Morcillo, N., Tartara, S., Cetrangolo, A. A., Pensotti, C., Pereyra, B., Scapellato, P. G., Stagnaro, J. P., Shah, S., Lotsch, F., Thalhammer, F., Anseeuw, K., Francois, C. A., Van Braeckel, E., Vincent, J. L., Djimon, M. Z., Bashi, J., Dodo, R., Nouer, S. A., Chipev, P., Encheva, M., Miteva, D., Petkova, D., Balkissou, A. D., Yone, E. W. P., Ngahane, B. H. M., Shen, N., Xu, J. F., Rico, C. A. B., Buitrago, R., Paternina, F. J. P., Ntumba, J. K., Carevic, V. V., Jakopovic, M., Jankovic, M., Matkovic, Z., Mitrecic, I., Jacobsson, M. B., Christensen, A. B., Bodtger, U. C. H., Meyer, C. N., Jensen, A. V., Baunbaek-Knudsen, G., Petersen, P. T., Andersen, S., El-Wahhab, I. E. A., Morsy, N. E., Shafiek, H., Sobh, E., Abdulsemed, K. A., Bertrand, F., Brun-Buisson, C., de Montmollin, E., Fartoukh, M., Messika, J., Tattevin, P., Khoury, A., Ebruke, B., Dreher, M., Kolditz, M., Meisinger, M., Niederlausitz, K., Pletz, M. W., Hagel, S., Schaberg, T., Spielmanns, M., Creutz, P., Suttorp, N., Siaw-Lartey, B., Dimakou, K., Papapetrou, D., Tsigou, E., Ampazis, D., Kaimakamis, E., Bhatia, M., Dhar, R., D'Souza, G., Garg, R., Koul, P. A., Mahesh, P. A., Jayaraj, B. S., Narayan, K. V., Udnur, H. B., Krishnamurthy, S. B., Kant, S., Swarnakar, R., Limaye, S., Salvi, S., Golshani, K., Keatings, V. M., Martin-Loeches, I., Maor, Y., Strahilevitz, J., Battaglia, S., Carrabba, M., Ceriana, P., Confalonieri, M., Monforte, A. D., Prato, B. D., Rosa, M., Fantini, R., Fiorentino, G., Gammino, M. A., Menzella, F., Milani, G., Nava, S., Palmiero, G., Petrino, R., Gabrielli, B., Rossi, P., Sorino, C., Steinhilber, G., Zanforlin, A., Franzetti, F., Carugati, M., Morosi, M., Monge, E., Carone, M., Patella, V., Scarlata, S., Comel, A., Kurahashi, K., Bacha, Z. A., Ugalde, D. B., Zuniga, O. C., Villegas, J. F., Medenica, M., van de Garde, E. M. W., Mihsra, D. R., Shrestha, P., Ridgeon, E., Awokola, B. I., Nwankwo, O. N. O., Olufunlola, A. B., Olumide, S., Ukwaja, K. N., Irfan, M., Minarowski, L., Szymon, S., Froes, F., Leuschner, P., Meireles, M., Ferrao, C., Neves, J., Ravara, S. B., Brocovschii, V., Ion, C., Rusu, D., Toma, C., Chirita, D., Dorobat, C. M., Birkun, A., Kaluzhenina, A., Almotairi, A., Bukhary, Z. A. A., Edathodu, J., Fathy, A., Enani, A. M. A., Mohamed, N. E., Memon, J. U., Bella, A., Bogdanovic, N., Milenkovic, B., Pesut, D., Borderias, L., Garcia, N. M. B., Alarcon, H. C., Cilloniz, C., Torres, A., Diaz-Brito, V., Casas, X., Gonzalez, A. E., Fernandez-Almira, Ml., Gallego, M., Gaspar-GarcIa, I., Victoria, P. J., Martinez, E. L., de Molina, R. M., Marcos, P. J., Menendez, R., Pando-Sandoval, A., Aymerich, C. P., de la Torre, A. L., Garcia-Olive, I., Rello, J., Moyano, S., Sanz, F., Sibila, O., Rodrigo-Troyano, A., Sole-Violan, J., Uranga, A., van Boven, J. F. M., Torra, E. V., Pujol, J. A., Feldman, C., Yum, H. K., Fiogbe, A. A., Yangui, F., Bilaceroglu, S., Dalar, L., Yilmaz, U., Bogomolov, A., Elahi, N., Dhasmana, D. J., Feneley, A., Ions, R., Skeemer, J., Woltmann, G., Hancock, C., Hill, A. T., Rudran, B., Ruiz-Buitrago, S., Campbell, M., Whitaker, P., Youzguin, A., Singanayagam, A., Allen, K. S., Brito, V., Dietz, J., Dysart, C. E., Kellie, S. M., Franco-Sadud, R. A., Meier, G., Gaga, M., Holland, T. L., Bergin, S. P., Kheir, F., Landmeier, M., Lois, M., Nair, G. B., Patel, H., Reyes, K., Rodriguez-Cintron, W., Saito, S., Soni, N. J., Noda, J., Hinojosa, C. I., Levine, S. M., Angel, L. F., Anzueto, A., Whitlow, K. S., Hipskind, J., Sukhija, K., Totten, V., Wunderink, R. G., Shah, R. D., Mateyo, K. J., Noriega, L., Alvarado, E., Aman, M., Labra, L., Di Pasquale M.F., Sotgiu G., Gramegna A., Radovanovic D., Terraneo S., Reyes L.F., Rupp J., Gonzalez Del Castillo J., Blasi F., Aliberti S., Restrepo M.I., Aruj P.K., Attorri S., Barimboim E., Caeiro J.P., Garzon M.I., Cambursano V.H., Cazaux A., Ceccato A., Chertcoff J., Lascar F., Tulio F.D., Diaz A.C., de Vedia L., Ganaha M.C., Lambert S., Lopardo G., Luna C.M., Malberti A.G., Morcillo N., Tartara S., Cetrangolo A.A., Pensotti C., Pereyra B., Scapellato P.G., Stagnaro J.P., Shah S., Lotsch F., Thalhammer F., Anseeuw K., Francois C.A., Van Braeckel E., Vincent J.L., Djimon M.Z., Bashi J., Dodo R., Nouer S.A., Chipev P., Encheva M., Miteva D., Petkova D., Balkissou A.D., Yone E.W.P., Ngahane B.H.M., Shen N., Xu J.F., Rico C.A.B., Buitrago R., Paternina F.J.P., Ntumba J.K., Carevic V.V., Jakopovic M., Jankovic M., Matkovic Z., Mitrecic I., Jacobsson M.B., Christensen A.B., Bodtger U.C.H., Meyer C.N., Jensen A.V., Baunbaek-Knudsen G., Petersen P.T., Andersen S., El-Wahhab I.E.A., Morsy N.E., Shafiek H., Sobh E., Abdulsemed K.A., Bertrand F., Brun-Buisson C., de Montmollin E., Fartoukh M., Messika J., Tattevin P., Khoury A., Ebruke B., Dreher M., Kolditz M., Meisinger M., Niederlausitz K., Pletz M.W., Hagel S., Schaberg T., Spielmanns M., Creutz P., Suttorp N., Siaw-Lartey B., Dimakou K., Papapetrou D., Tsigou E., Ampazis D., Kaimakamis E., Bhatia M., Dhar R., D'Souza G., Garg R., Koul P.A., Mahesh P.A., Jayaraj B.S., Narayan K.V., Udnur H.B., Krishnamurthy S.B., Kant S., Swarnakar R., Limaye S., Salvi S., Golshani K., Keatings V.M., Martin-Loeches I., Maor Y., Strahilevitz J., Battaglia S., Carrabba M., Ceriana P., Confalonieri M., Monforte A.D., Prato B.D., Rosa M., Fantini R., Fiorentino G., Gammino M.A., Menzella F., Milani G., Nava S., Palmiero G., Petrino R., Gabrielli B., Rossi P., Sorino C., Steinhilber G., Zanforlin A., Franzetti F., Carugati M., Morosi M., Monge E., Carone M., Patella V., Scarlata S., Comel A., Kurahashi K., Bacha Z.A., Ugalde D.B., Zuniga O.C., Villegas J.F., Medenica M., van de Garde E.M.W., Mihsra D.R., Shrestha P., Ridgeon E., Awokola B.I., Nwankwo O.N.O., Olufunlola A.B., Olumide S., Ukwaja K.N., Irfan M., Minarowski L., Szymon S., Froes F., Leuschner P., Meireles M., Ferrao C., Neves J., Ravara S.B., Brocovschii V., Ion C., Rusu D., Toma C., Chirita D., Dorobat C.M., Birkun A., Kaluzhenina A., Almotairi A., Bukhary Z.A.A., Edathodu J., Fathy A., Enani A.M.A., Mohamed N.E., Memon J.U., Bella A., Bogdanovic N., Milenkovic B., Pesut D., Borderias L., Garcia N.M.B., Alarcon H.C., Cilloniz C., Torres A., Diaz-Brito V., Casas X., Gonzalez A.E., Fernandez-Almira ML., Gallego M., Gaspar-GarcIa I., Victoria P.J., Martinez E.L., de Molina R.M., Marcos P.J., Menendez R., Pando-Sandoval A., Aymerich C.P., de la Torre A.L., Garcia-Olive I., Rello J., Moyano S., Sanz F., Sibila O., Rodrigo-Troyano A., Sole-Violan J., Uranga A., van Boven J.F.M., Torra E.V., Pujol J.A., Feldman C., Yum H.K., Fiogbe A.A., Yangui F., Bilaceroglu S., Dalar L., Yilmaz U., Bogomolov A., Elahi N., Dhasmana D.J., Feneley A., Ions R., Skeemer J., Woltmann G., Hancock C., Hill A.T., Rudran B., Ruiz-Buitrago S., Campbell M., Whitaker P., Youzguin A., Singanayagam A., Allen K.S., Brito V., Dietz J., Dysart C.E., Kellie S.M., Franco-Sadud R.A., Meier G., Gaga M., Holland T.L., Bergin S.P., Kheir F., Landmeier M., Lois M., Nair G.B., Patel H., Reyes K., Rodriguez-Cintron W., Saito S., Soni N.J., Noda J., Hinojosa C.I., Levine S.M., Angel L.F., Anzueto A., Whitlow K.S., Hipskind J., Sukhija K., Totten V., Wunderink R.G., Shah R.D., Mateyo K.J., Noriega L., Alvarado E., Aman M., and Labra L.

Subjects
0301 basic medicine, Male, Pediatrics, Etiology, Multidrug-resistant pathogen, MRSA, Pneumocystis pneumonia, Pneumònia adquirida a la comunitat, HOSPITALIZED-PATIENTS, 0302 clinical medicine, Community-acquired pneumonia, Risk Factors, Prevalence, Medicine, 030212 general & internal medicine, PNEUMOCYSTIS PNEUMONIA, Articles and Commentaries, Aged, 80 and over, Respiratory tract infections, Anemia, Aplastic, Middle Aged, 3. Good health, Community-Acquired Infections, Europe, Infectious Diseases, Immunocompromise, Microbiology, Multidrug-resistant pathogens, Pneumonia, Etiologia, Hematologic Neoplasms, Female, BLOOD-STREAM INFECTIONS, Lung Transplantation, Microbiology (medical), medicine.medical_specialty, Asia, Neutropenia, 030106 microbiology, RESPIRATORY-TRACT INFECTIONS, Settore MED/10 - Malattie Dell'Apparato Respiratorio, TRANSPLANT RECIPIENTS, DISEASES-SOCIETY, 03 medical and health sciences, Immunocompromised Host, Pneumonia, Bacterial, MANAGEMENT, Humans, pneumonia, BACTERIAL PNEUMONIA, Aged, Acquired Immunodeficiency Syndrome, business.industry, microbiology, Bacterial pneumonia, Australia, medicine.disease, multidrug-resistant pathogens, Mycoses, Bacteremia, Africa, RISK-FACTORS, immunocompromise, Americas, business
Abstract

Background The correct management of immunocompromised patients with pneumonia is debated. We evaluated the prevalence, risk factors, and characteristics of immunocompromised patients coming from the community with pneumonia. Methods We conducted a secondary analysis of an international, multicenter study enrolling adult patients coming from the community with pneumonia and hospitalized in 222 hospitals in 54 countries worldwide. Risk factors for immunocompromise included AIDS, aplastic anemia, asplenia, hematological cancer, chemotherapy, neutropenia, biological drug use, lung transplantation, chronic steroid use, and solid tumor. Results At least 1 risk factor for immunocompromise was recorded in 18% of the 3702 patients enrolled. The prevalences of risk factors significantly differed across continents and countries, with chronic steroid use (45%), hematological cancer (25%), and chemotherapy (22%) the most common. Among immunocompromised patients, community-acquired pneumonia (CAP) pathogens were the most frequently identified, and prevalences did not differ from those in immunocompetent patients. Risk factors for immunocompromise were independently associated with neither Pseudomonas aeruginosa nor non–community-acquired bacteria. Specific risk factors were independently associated with fungal infections (odds ratio for AIDS and hematological cancer, 15.10 and 4.65, respectively; both P = .001), mycobacterial infections (AIDS; P = .006), and viral infections other than influenza (hematological cancer, 5.49; P < .001). Conclusions Our findings could be considered by clinicians in prescribing empiric antibiotic therapy for CAP in immunocompromised patients. Patients with AIDS and hematological cancer admitted with CAP may have higher prevalences of fungi, mycobacteria, and noninfluenza viruses.

Published
2019

49. Correction to: Bacterial etiology of community-acquired pneumonia in immunocompetent hospitalized patients and appropriateness of empirical treatment recommendations: an international point-prevalence study (European Journal of Clinical Microbiology & Infectious Diseases, (2020), 39, 8, (1513-1525), 10.1007/s10096-020-03870-3)

Author

Carugati M., Aliberti S., Sotgiu G., Blasi F., Gori A., Menendez R., Encheva M., Gallego M., Leuschner P., Ruiz-Buitrago S., Battaglia S., Fantini R., Pascual-Guardia S., Marin-Corral J., Restrepo M. I., Aruj P. K., Attorri S., Barimboim E., Caeiro J. P., Garzon M. I., Cambursano V. H., Ceccato A., Chertcoff J., Lascar F., Tulio F. D., Diaz A. C., de Vedia L., Ganaha M. C., Lambert S., Lopardo G., Luna C. M., Malberti A. G., Morcillo N., Tartara S., Pensotti C., Pereyra B., Scapellato P. G., Stagnaro J. P., Shah S., Lotsch F., Thalhammer F., Vincent J. L., Anseeuw K., Francois C. A., Van Braeckel E., Djimon M. Z., Bashi J., Roger D., Nouer S. A., Chipev P., Miteva D., Petkova D., Dodo B. A., Ngahane M., Hugo B., Shen N., Xu J. -F., Rico C. A. B., Buitrago R., Paternina F. J. P., Jean-Marie K. N., Carevic V. V., Jakopovic M., Jankovic M., Matkovic Z., Mitrecic I., Jacobsson M. -L. B., Christensen A. B., HeitmannBodtger U. C., Meyer C. N., Jensen A. V., Baunbaek-knudsen G., Petersen P. T., Andersen S., El-Wahhab I. E. -S. A., Morsy N. E., Shafiek H., Sobh E., Bertrand F., Brun-Buisson C., de Montmollin E., Fartoukh M., Messika J., Tattevin P., Dreher M., Kolditz M., Meisinger M., Pletz M. W., Hagel S., Rupp J., Schaberg T., Spielmanns M., Siaw-Lartey B., Dimakou K., Papapetrou D., Tsigou E., Ampazis D., Bhatia M., Dhar R., D'Souza G., Garg R., Koul P. A., Mahesh P. A., Jayaraj B. S., Narayan K. V., Udnur H. B., Krishnamurthy S. B., Golshani K., Keatings V. M., Martin-Loeches I., Maor Y., Strahilevitz J., Carrabba M., Ceriana P., Confalonieri M., d'Arminio Monforte A., Del Prato B., De Rosa M., Fiorentino G., Gammino M. A., Menzella F., Milani G., Nava S., Palmiero G., Petrino R., Gabrielli B., Rossi P., Sorino C., Steinhilber G., Zanforlin A., Kurahashi K., Bacha Z. A., Ugalde D. B., Zuniga O. C., Villegas J. F., Medenica M., van de Garde E. M. W., Mihsra D. R., Shrestha P., Ridgeon E., Awokola B. I., Nwankwo O. N. O., Olufunlola A. B., Olumide S., Ukwaja K. N., Irfan M., Minarowski L., Szymon S., Froes F., Meireles M., Ferrao C., Neves J., Ravara S. B., da Beira C., Brocovschii V., Ion C., Rusu D., Toma C., Chirita D., Birkun A., Kaluzhenina A., Almotairi A., Abdulbaqi Z., Bukhary A., Edathodu J., Fathy A., Enani A. M. A., Mohamed N. E., Memon J. U., Bogdanovic N., Milenkovic B., Pesut D., Borderias L., Garcia N. M. B., Alarcon H. C., Cilloniz C., Torres A., Diaz-Brito V., Casas X., Gonzalez A. E., Fernandez-Almira M. L., Gaspar-GarcIa I., del Castillo J. G., Victoria P. J., Martinez E. L., de Molina R. M., Marcos P. J., PandoSandova A., Aymerich C. P., del la Torre A. L., Garcia-Olive I., Rello J., Moyano S., Sanz F., Sibila O., Rodrigo-Troyano A., Sole-Violan J., Uranga A., van Boven J. F., Torra E. V., Pujol J. A., Feldman C., Yum H. K., Fiogbe A. A., Yangui F., Bilaceroglu S., Dalar L., Yilmaz U., Bogomolov A., Elahi N., Dhasmana D. J., Ions R., Skeemer J., Woltmann G., Hancock C., Hill A. T., Rudran B., Campbell M., Whitaker P., Allen K. S., Brito V., Dietz J., Dysart C. E., Kellie S. M., Franco-Sadud R. A., Meier G., Gaga M., Holland T. L., Bergin S. P., Kheir F., Landmeier M., Lois M., Nair G. B., Patel H., Reyes K., Rodriguez-Cintron W., Saito S., Soni N. J., Noda J., Hinojosa C. I., Levine S. M., Angel L. F., Anzueto A., Whitlow K. S., Hipskind J., Sukhija K., Wunderink R. G., Shah R. D., Mateyo K. J., Carugati M., Aliberti S., Sotgiu G., Blasi F., Gori A., Menendez R., Encheva M., Gallego M., Leuschner P., Ruiz-Buitrago S., Battaglia S., Fantini R., Pascual-Guardia S., Marin-Corral J., Restrepo M.I., Aruj P.K., Attorri S., Barimboim E., Caeiro J.P., Garzon M.I., Cambursano V.H., Ceccato A., Chertcoff J., Lascar F., Tulio F.D., Diaz A.C., de Vedia L., Ganaha M.C., Lambert S., Lopardo G., Luna C.M., Malberti A.G., Morcillo N., Tartara S., Pensotti C., Pereyra B., Scapellato P.G., Stagnaro J.P., Shah S., Lotsch F., Thalhammer F., Vincent J.L., Anseeuw K., Francois C.A., Van Braeckel E., Djimon M.Z., Bashi J., Roger D., Nouer S.A., Chipev P., Miteva D., Petkova D., Dodo B.A., Ngahane M., Hugo B., Shen N., Xu J.-F., Rico C.A.B., Buitrago R., Paternina F.J.P., Jean-Marie K.N., Carevic V.V., Jakopovic M., Jankovic M., Matkovic Z., Mitrecic I., Jacobsson M.-L.B., Christensen A.B., HeitmannBodtger U.C., Meyer C.N., Jensen A.V., Baunbaek-knudsen G., Petersen P.T., Andersen S., El-Wahhab I.E.-S.A., Morsy N.E., Shafiek H., Sobh E., Bertrand F., Brun-Buisson C., de Montmollin E., Fartoukh M., Messika J., Tattevin P., Dreher M., Kolditz M., Meisinger M., Pletz M.W., Hagel S., Rupp J., Schaberg T., Spielmanns M., Siaw-Lartey B., Dimakou K., Papapetrou D., Tsigou E., Ampazis D., Bhatia M., Dhar R., D'Souza G., Garg R., Koul P.A., Mahesh P.A., Jayaraj B.S., Narayan K.V., Udnur H.B., Krishnamurthy S.B., Golshani K., Keatings V.M., Martin-Loeches I., Maor Y., Strahilevitz J., Carrabba M., Ceriana P., Confalonieri M., d'Arminio Monforte A., Del Prato B., De Rosa M., Fiorentino G., Gammino M.A., Menzella F., Milani G., Nava S., Palmiero G., Petrino R., Gabrielli B., Rossi P., Sorino C., Steinhilber G., Zanforlin A., Kurahashi K., Bacha Z.A., Ugalde D.B., Zuniga O.C., Villegas J.F., Medenica M., van de Garde E.M.W., Mihsra D.R., Shrestha P., Ridgeon E., Awokola B.I., Nwankwo O.N.O., Olufunlola A.B., Olumide S., Ukwaja K.N., Irfan M., Minarowski L., Szymon S., Froes F., Meireles M., Ferrao C., Neves J., Ravara S.B., da Beira C., Brocovschii V., Ion C., Rusu D., Toma C., Chirita D., Birkun A., Kaluzhenina A., Almotairi A., Abdulbaqi Z., Bukhary A., Edathodu J., Fathy A., Enani A.M.A., Mohamed N.E., Memon J.U., Bogdanovic N., Milenkovic B., Pesut D., Borderias L., Garcia N.M.B., Alarcon H.C., Cilloniz C., Torres A., Diaz-Brito V., Casas X., Gonzalez A.E., Fernandez-Almira M.L., Gaspar-GarcIa I., del Castillo J.G., Victoria P.J., Martinez E.L., de Molina R.M., Marcos P.J., PandoSandova A., Aymerich C.P., del la Torre A.L., Garcia-Olive I., Rello J., Moyano S., Sanz F., Sibila O., Rodrigo-Troyano A., Sole-Violan J., Uranga A., van Boven J.F., Torra E.V., Pujol J.A., Feldman C., Yum H.K., Fiogbe A.A., Yangui F., Bilaceroglu S., Dalar L., Yilmaz U., Bogomolov A., Elahi N., Dhasmana D.J., Ions R., Skeemer J., Woltmann G., Hancock C., Hill A.T., Rudran B., Campbell M., Whitaker P., Allen K.S., Brito V., Dietz J., Dysart C.E., Kellie S.M., Franco-Sadud R.A., Meier G., Gaga M., Holland T.L., Bergin S.P., Kheir F., Landmeier M., Lois M., Nair G.B., Patel H., Reyes K., Rodriguez-Cintron W., Saito S., Soni N.J., Noda J., Hinojosa C.I., Levine S.M., Angel L.F., Anzueto A., Whitlow K.S., Hipskind J., Sukhija K., Wunderink R.G., Shah R.D., and Mateyo K.J.

Subjects
pneumonia, Settore MED/10 - Malattie Dell'Apparato Respiratorio
Abstract

In the originally published article, the individual collaborator names were not captured under the group name “GLIMP Collaborators”. The names are now captured correctly under this group accordingly. The original article has been corrected.

Published
2021

50. Aspiration Risk Factors, Microbiology, and Empiric Antibiotics for Patients Hospitalized With Community-Acquired Pneumonia

Author

Judith Marin-Corral, Sergi Pascual-Guardia, Francesco Amati, Stefano Aliberti, Joan R Masclans, Nilam Soni, Alejandro Rodriguez, Oriol Sibila, Francisco Sanz, Giovanni Sotgiu, Antonio Anzueto, Katerina Dimakou, Roberta Petrino, Ewoudt van de Garde, Marcos I Restrepo, GLIMP investigators, Patricia Karina Aruj, Silvia Attorri, Enrique Barimboim, Juan Pablo Caeiro, María I Garzón, Victor Hugo Cambursano, V H Dr Cazaux A Adrian Ceccato, Julio Chertcoff, Florencia Lascar, Fernando Di Tulio, Ariel Cordon Díaz, Lautaro de Vedia, Maria Cristina Ganaha, Sandra Lambert, Gustavo Lopardo, Carlos M Luna, Alessio Gerardo Malberti, Nora Morcillo, Silvina Tartara, Claudia Pensotti, Betiana Pereyra, Pablo Gustavo Scapellato, Juan Pablo Stagnaro, Sonali Shah, Felix Lötsch, Florian Thalhammer, Kurt Anseeuw, Camille A Francois, Eva Van Braeckel, Jean Louis Vincent, Marcel Zannou Djimon, Jules Bashi, Roger Dodo, Simone Aranha Nouér, Peter Chipev, Milena Encheva, Darina Miteva, Diana Petkova, Adamou Dodo Balkissou, Eric Walter Pefura Yone, Bertrand Hugo Mbatchou Ngahane, Ning Shen, Jin-Fu Xu, Carlos Andres Bustamante Rico, Ricardo Buitrago, Fernando Jose Pereira Paternina, Jean-Marie Kayembe Ntumba, Vesna Vladic Carevic, Marko Jakopovic, Mateja Jankovic, Zinka Matkovic, Ivan Mitrecic, Marie-Laure Bouchy Jacobsson, Anette Bro Christensen, Uffe Christian Heitmann Bødtger, Christian Niels Meyer, Andreas Vestergaard Jensen, Gertrud Baunbæk-Knudsen, Pelle Trier Petersen, Stine Andersen, Ibrahim El-Said Abd El-Wahhab, Nesreen Elsayed Morsy, Hanaa Shafiek, Eman Sobh, Kedir Abdella Abdulsemed, Fabrice Bertrand, Christian Brun-Buisson, Etienne de Montmollin, Muriel Fartoukh, Jonathan Messika, Pierre Tattevin, Abdo Khoury, Bernard Ebruke, Michael Dreher, Martin Kolditz, Matthias Meisinger, Mathias W Pletz, Stefan Hagel, Jan Rupp, Tom Schaberg, Marc Spielmanns, Petra Creutz, Norton Suttorp, Beatrice Siaw-Lartey, Dimosthenis Papapetrou, Evdoxia Tsigou, Dimitrios Ampazis, Evangelos Kaimakamis, Mohit Bhatia, Raja Dhar, George D'Souza, Rajiv Garg, Parvaiz A Koul, P A Mahesh, B S Jayaraj, Kiran Vishnu Narayan, Hirennappa B Udnur, Shashi Bhaskara Krishnamurthy, Surya Kant, Rajesh Swarnakar, Sneha Limaye, Sundeep Salvi, Keihan Golshani, Vera M Keatings, Ignacio Martin-Loeches, Yasmin Maor, Jacob Strahilevitz, Paola Faverio, Salvatore Battaglia, Maria Carrabba, Piero Ceriana, Marco Confalonieri, Antonella d'Arminio Monforte, Bruno Del Prato, Marino De Rosa, Riccardo Fantini, Giuseppe Fiorentino, Maria Antonia Gammino, Francesco Menzella, Giuseppe Milani, Stefano Nava, Gerardo Palmiero, Barbra Gabrielli, Paolo Rossi, Claudio Sorino, Gundi Steinhilber, Alessandro Zanforlin, Ospedale San Luca, Fabio Franzetti, Manuela Carugati, Manuela Morosi, Elisa Monge, Mauro Carone, Vincenzo Patella, Simone Scarlata, Andrea Comel, Kiyoyasu Kurahashi, Zeina Aoun Bacha, Daniel Barajas Ugalde, Omar Ceballos Zuñiga, José F Villegas, Milic Medenica, Deebya Raj Mihsra, Poojan Shrestha, Elliott Ridgeon, Babatunde Ishola Awokola, Ogonna N O Adefuye Bolanle Olufunlola, Segaolu Olumide, Kingsley N Ukwaja, Muhammad Irfan, Lukasz Minarowski, Skoczyński Szymon, Felipe Froes, Pedro Leuschner, Mariana Meireles, Cláudia Ferrão, João Neves, Abel Salazar, Sofia B Ravara, Victoria Brocovschii, Doina Rusu, Cristina Toma, Daniela Chirita, Carmen Mihaela Dorobat, Alexei Birkun, Anna Kaluzhenina, Abdullah Almotairi, Zakeya Abdulbaqi Ali Bukhary, Jameela Edathodu, Amal Fathy, Abdullah Mushira Abdulaziz Enani, Nazik Eltayeb Mohamed, Jawed Ulhadi Memon, Abdelhaleem Bella, Serbia Nada Bogdanović, Branislava Milenkovic, Dragica Pesut, Luis Borderìas, Noel Manuel Bordon Garcia, Hugo Cabello Alarcón, Catia Cilloniz, Antoni Torres, Vicens Diaz-Brito, Xavier Casas, Alicia Encabo González, Maria Luisa Fernández-Almira, Medicina Interna, Miguel Gallego, Inmaculada Gaspar-GarcÍa, Juan González Del Castillo, Patricia Javaloyes Victoria, Elena Laserna Martínez, Rosa Malo de Molina, Pedro J Marcos, Rosario 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Eman, Abdella Abdulsemed, Kedir, Bertrand, Fabrice, Brun-Buisson, Christian, de Montmollin, Etienne, Fartoukh, Muriel, Messika, Jonathan, Tattevin, Pierre, Khoury, Abdo, Ebruke, Bernard, Dreher, Michael, Kolditz, Martin, Meisinger, Matthia, W Pletz, Mathia, Hagel, Stefan, Rupp, Jan, Schaberg, Tom, Spielmanns, Marc, Creutz, Petra, Suttorp, Norton, Siaw-Lartey, Beatrice, Papapetrou, Dimostheni, Tsigou, Evdoxia, Ampazis, Dimitrio, Kaimakamis, Evangelo, Bhatia, Mohit, Dhar, Raja, D'Souza, George, Garg, Rajiv, A Koul, Parvaiz, A Mahesh, P, S Jayaraj, B, Vishnu Narayan, Kiran, B Udnur, Hirennappa, Bhaskara Krishnamurthy, Shashi, Kant, Surya, Swarnakar, Rajesh, Limaye, Sneha, Salvi, Sundeep, Golshani, Keihan, M Keatings, Vera, Martin-Loeches, Ignacio, Maor, Yasmin, Strahilevitz, Jacob, Faverio, Paola, Battaglia, Salvatore, Carrabba, Maria, Ceriana, Piero, Confalonieri, Marco, d'Arminio Monforte, Antonella, Del Prato, Bruno, De Rosa, Marino, Fantini, Riccardo, Fiorentino, Giuseppe, Antonia 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Subjects
Male, Pulmonary and Respiratory Medicine, medicine.drug_class, Aspiration risk, Antibiotics, Nursing home resident, Settore MED/10 - Malattie Dell'Apparato Respiratorio, Critical Care and Intensive Care Medicine, Microbiology, anaerobic, aspiration, bacteria, pneumonia, risk factors, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Community-acquired pneumonia, Taverne, Anti-Bacterial Agent, medicine, Humans, Community-Acquired Infection, 030212 general & internal medicine, Stroke, Aged, Aged, 80 and over, business.industry, Respiratory Aspiration, Middle Aged, medicine.disease, Antibiotic coverage, Anti-Bacterial Agents, Community-Acquired Infections, Hospitalization, Pneumonia, 030228 respiratory system, Risk factors, risk factor, Female, Underweight, medicine.symptom, business, Cardiology and Cardiovascular Medicine
Abstract

Background: Aspiration community-acquired pneumonia (ACAP) and community-acquired pneumonia (CAP) in patients with aspiration risk factors (AspRFs) are infections associated with anaerobes, but limited evidence suggests their pathogenic role. Research Question: What are the aspiration risk factors, microbiology patterns, and empiric anti-anaerobic use in patients hospitalized with CAP? Study Design and Methods: This is a secondary analysis of GLIMP, an international, multicenter, point-prevalence study of adults hospitalized with CAP. Patients were stratified into three groups: (1) ACAP, (2) CAP/AspRF+ (CAP with AspRF), and (3) CAP/AspRF- (CAP without AspRF). Data on demographics, comorbidities, microbiological results, and anti-anaerobic antibiotics were analyzed in all groups. Patients were further stratified in severe and nonsevere CAP groups. Results: We enrolled 2,606 patients with CAP, of which 193 (7.4%) had ACAP. Risk factors independently associated with ACAP were male, bedridden, underweight, a nursing home resident, and having a history of stroke, dementia, mental illness, and enteral tube feeding. Among non-ACAP patients, 1,709 (70.8%) had CAP/AspRF+ and 704 (29.2%) had CAP/AspRF-. Microbiology patterns including anaerobes were similar between CAP/AspRF-, CAP/AspRF+ and ACAP (0.0% vs 1.03% vs 1.64%). Patients with severe ACAP had higher rates of total gram-negative bacteria (64.3% vs 44.3% vs 33.3%, P =.021) and lower rates of total gram-positive bacteria (7.1% vs 38.1% vs 50.0%, P 50% in all groups) independent of AspRFs or ACAP received specific or broad-spectrum anti-anaerobic coverage antibiotics. Interpretation: Hospitalized patients with ACAP or CAP/AspRF+ had similar anaerobic flora compared with patients without aspiration risk factors. Gram-negative bacteria were more prevalent in patients with severe ACAP. Despite having similar microbiological flora between groups, a large proportion of CAP patients received anti-anaerobic antibiotic coverage.

Published
2021

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