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Prevalence and Etiology of Community-acquired Pneumonia in Immunocompromised Patients
- Source :
- Universidad de La Sabana, Intellectum Repositorio Universidad de La Sabana, Repositorio Universidad de la Sabana, Universidad de la Sabana, instacron:Universidad de la Sabana, Clinical Infectious Diseases, Clinical Infectious Diseases, 68(9), 1482-1493. Oxford University Press, Recercat. Dipósit de la Recerca de Catalunya, instname, Di Pasquale, M F, Sotgiu, G, Gramegna, A, Radovanovic, D, Terraneo, S, Reyes, L F, Rupp, J, González Del Castillo, J, Blasi, F, Aliberti, S, Restrepo, M I, GLIMP investigators & Bødtger, U 2019, ' Prevalence and Etiology of Community-acquired Pneumonia in Immunocompromised Patients ', Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, vol. 68, no. 9, pp. 1482-1493 . https://doi.org/10.1093/cid/ciy723, Dipòsit Digital de la UB, Universidad de Barcelona, CLINICAL INFECTIOUS DISEASES, r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau, Clinical Infectious Diseases, 68(9), 1482. Univ. of Chicago Press
- Publication Year :
- 2019
-
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.
- 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
Subjects
Details
- Language :
- English
- ISSN :
- 10584838
- Volume :
- 68
- Issue :
- 9
- Database :
- OpenAIRE
- Journal :
- Clinical Infectious Diseases
- Accession number :
- edsair.doi.dedup.....f430e7269b9ea24ed514aa72bba09d7b