6533b851fe1ef96bd12a9079

RESEARCH PRODUCT

Prevalence and Etiology of Community-acquired Pneumonia in Immunocompromised Patients

Marta Francesca Di PasqualeGiovanni SotgiuAndrea GramegnaDejan RadovanovicSilvia TerraneoLuis F ReyesJan RuppJuan González Del CastilloFrancesco BlasiStefano AlibertiMarcos I RestrepoPatricia Karina ArujSilvia AttorriEnrique BarimboimJuan Pablo CaeiroMaría I GarzónVictor Hugo CambursanoA CazauxAdrian CeccatoJulio ChertcoffFlorencia LascarFernando Di TulioAriel Cordon DíazLautaro De VediaMaria Cristina GanahaSandra LambertGustavo LopardoCarlos M LunaAlessio Gerardo MalbertiNora MorcilloSilvina TartaraAntonio A CetrangoloClaudia PensottiBetiana PereyraPablo Gustavo ScapellatoJuan Pablo StagnaroSonali ShahFelix LötschFlorian ThalhammerKurt AnseeuwCamille A FrancoisEva Van BraeckelJean Louis VincentMarcel Zannou DjimonJules BashiRoger DodoSimone Aranha NouérPeter ChipevMilena EnchevaDarina MitevaDiana PetkovaAdamou Dodo BalkissouEric Walter Pefura YoneBertrand Hugo Mbatchou NgahaneNing ShenJin-fu XuCarlos Andres Bustamante RicoRicardo BuitragoFernando Jose Pereira PaterninaJean-marie Kayembe NtumbaVesna Vladic CarevicMarko JakopovicMateja JankovicZinka MatkovicIvan MitrecicMarie-laure Bouchy JacobssonAnette Bro ChristensenUffe Christian Heitmann BødtgerChristian Niels MeyerAndreas Vestergaard JensenGertrud Baunbæk-knudsenPelle Trier PetersenStine AndersenIbrahim El-said Abd El-wahhabNesreen Elsayed MorsyHanaa ShafiekEman SobhKedir Abdella AbdulsemedFabrice BertrandChristian Brun-buissonEtienne De MontmollinMuriel FartoukhJonathan MessikaPierre TattevinAbdo KhouryBernard EbrukeMichael DreherMartin KolditzMatthias MeisingerKlinikum NiederlausitzMathias W PletzStefan HagelJan RuppTom SchabergMarc SpielmannsPetra CreutzNorton SuttorpBeatrice Siaw-larteyKaterina DimakouDimosthenis PapapetrouEvdoxia TsigouDimitrios AmpazisEvaggelos KaimakamisMohit BhatiaRaja DharGeorge D’souzaRajiv GargParvaiz A KoulP A MaheshB S JayarajKiran Vishnu NarayanHirennappa B UdnurShashi Bhaskara KrishnamurthySurya KantRajesh SwarnakarSneha LimayeSundeep SalviKeihan GolshaniVera M KeatingsIgnacio Martin-loechesYasmin MaorJacob StrahilevitzSalvatore BattagliaMaria CarrabbaPiero CerianaMarco ConfalonieriAntonella D’arminio MonforteBruno Del PratoMarino De RosaRiccardo FantiniGiuseppe FiorentinoMaria Antonia GamminoFrancesco MenzellaGiuseppe MilaniStefano NavaGerardo PalmieroRoberta PetrinoBarbra GabrielliPaolo RossiClaudio SorinoGundi SteinhilberAlessandro ZanforlinFabio FranzettiManuela CarugatiManuela MorosiElisa MongeMauro CaroneVincenzo PatellaSimone ScarlataAndrea ComelKiyoyasu KurahashiZeina Aoun BachaDaniel Barajas UgaldeOmar Ceballos ZuñigaJosé F VillegasMilic MedenicaE M W Van De GardeDeebya Raj MihsraPoojan ShresthaElliott RidgeonBabatunde Ishola AwokolaOgonna N O NwankwoAdefuye Bolanle OlufunlolaSegaolu OlumideKingsley N UkwajaMuhammad IrfanŁUkasz MinarowskiSkoczyński SzymonFelipe FroesPedro LeuschnerMariana MeirelesCláudia FerrãoPedro LeuschnerJoão NevesSofia B RavaraVictoria BrocovschiiChesov IonDoina RusuCristina TomaDaniela ChiritaCarmen Mihaela DorobatAlexei BirkunAnna KaluzheninaAbdullah AlmotairiZakeya Abdulbaqi Ali BukharyJameela EdathoduAmal FathyAbdullah Mushira Abdulaziz EnaniNazik Eltayeb MohamedJawed Ulhadi MemonAbdelhaleem BellaNada BogdanovićBranislava MilenkovicDragica PesutLuis BorderìasNoel Manuel Bordon GarciaHugo Cabello AlarcónCatia CillonizAntoni TorresVicens Diaz-britoXavier CasasAlicia Encabo GonzálezMaria Luisa Fernández-almiraMiguel GallegoInmaculada Gaspar-garcíaJuan González Del CastilloPatricia Javaloyes VictoriaElena Laserna MartínezRosa Malo De MolinaPedro J MarcosRosario MenéndezAna Pando-sandovalCristina Prat AymerichAlicia Lacoma De La TorreIgnasi García-olivéJordi RelloSilvia MoyanoFrancisco SanzOriol SibilaAna Rodrigo-troyanoJordi Solé-violánAne UrangaJob F M Van BovenEster Vendrell TorraJordi Almirall PujolCharles FeldmanHo Kee YumArnauld Attannon FiogbeFerdaous YanguiSemra BilacerogluLevent DalarUfuk YilmazArtemii BogomolovNaheed ElahiDevesh J DhasmanaAndrew FeneleyRhiannon IonsJulie SkeemerGerrit WoltmannCarole HancockAdam T HillBanu RudranSilvia Ruiz-buitragoMarion CampbellPaul WhitakerAlexander YouzguinAnika SinganayagamKaren S AllenVeronica BritoJessica DietzClaire E DysartSusan M KellieRicardo A Franco-sadudGarnet MeierMina GagaThomas L HollandStephen P BerginFayez KheirMark LandmeierManuel LoisGirish B NairHemali PatelKatherine ReyesWilliam Rodriguez-cintronShigeki SaitoNilam SoniJulio NodaCecilia I HinojosaStephanie M LevineLuis F AngelAntonio AnzuetoK Scott WhitlowJohn HipskindKunal SukhijaVicken TottenRichard G WunderinkRay D ShahKondwelani John MateyoLorena NoriegaEzequiel AlvaradoMohamed AmanLucía Labra

subject

0301 basic medicineMalePediatricsEtiologyMultidrug-resistant pathogenMRSAPneumocystis pneumoniaPneumònia adquirida a la comunitatHOSPITALIZED-PATIENTS0302 clinical medicineCommunity-acquired pneumoniaRisk FactorsPrevalenceMedicine030212 general & internal medicinePNEUMOCYSTIS PNEUMONIAArticles and CommentariesAged 80 and overRespiratory tract infectionsAnemia AplasticMiddle Aged3. Good healthCommunity-Acquired InfectionsEuropeInfectious DiseasesImmunocompromise; Microbiology; MRSA; Multidrug-resistant pathogens; PneumoniaEtiologiaHematologic NeoplasmsFemaleBLOOD-STREAM INFECTIONSLung TransplantationMicrobiology (medical)medicine.medical_specialtyAsiaNeutropeniaCommunity-acquired pneumonia030106 microbiologyRESPIRATORY-TRACT INFECTIONSHematologic NeoplasmsSettore MED/10 - Malattie Dell'Apparato RespiratorioTRANSPLANT RECIPIENTSDISEASES-SOCIETYMicrobiology03 medical and health sciencesImmunocompromised HostPneumonia BacterialMANAGEMENTHumanspneumoniaBACTERIAL PNEUMONIAImmunocompromiseAgedAcquired Immunodeficiency Syndromebusiness.industrymicrobiologyBacterial pneumoniaAustraliaPneumoniamedicine.diseaseMultidrug-resistant pathogensPneumoniamultidrug-resistant pathogensMycosesBacteremiaAfricaEtiologyRISK-FACTORSimmunocompromiseAmericasbusiness

description

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.

yearjournalcountryeditionlanguage
2018-08-23Clinical Infectious Diseases
10.1093/cid/ciy723https://doi.org/10.1093/cid/ciy723