6533b857fe1ef96bd12b4575
RESEARCH PRODUCT
Patógenos atípicos en pacientes hospitalizados con neumonía adquirida en la comunidad: una perspectiva mundial
Gramegna A.Sotgiu G.Di Pasquale M.Radovanovic D.Terraneo S.Reyes L. F.Vendrell E.Neves J.Menzella F.Blasi F.Aliberti S.Restrepo M. I.Aruj P. K.Attorri S.Barimboim E.Caeiro J. P.Cambursano V. H.Ceccato A.Chertcoff J.Lascar F.Di Tulio F.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.Lotsch F.Vincent J. L.Anseeuw K.Francois C. A.Van Braeckel E.Djimon M. Z.Bashi J.Roger D.Nouer S. A.Chipev P.Encheva M.Miteva D.Petkova D.Dodo B. A.Hugo M. N. 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.Shafi Ek 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.Bhatia M.Ampazis D.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.Battaglia S.Carrabba M.Ceriana P.Confalonieri M.D'arminio A.Del Prato B.De Rosa M.Fantini R.Fiorentino G.Gammino M. A.Milani G.Nava S.Palmiero G.Petrino R.Gabrielli B.Rossi P.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.Ridgeon E.Nwankwo O. N. O.Olufunlola A. B.Olumide S.Ukwaja K. N.Irfan M.Minarowski L.Szymo S.Froes F.Meireles M.Ferrao C.Leuschner P.Neves J.Ravara S. B.Brocovschii V.Ion C.Rusu D.Chirita D.Birkun A.Kaluzhenina A.Almotairi A.Bukhary Z. A. A.Edathodu J.Fathy A.Enani A. M. A.Mohamed N. E.Memon J. U.Bogdanovic N.Milenkovic B.Borderias L.Garcia N. M. B.Alarcon H. C.Cilloniz C.Torres A.Diaz-brito V.Casas X.Gonzalez A. E.Fernandezalmira M. L.Gallego M.Gaspar-garcia I.Del Castillo J. G.Victoria P. J.Martinez E. L.De Molina R. M.Marcos P. J.Menendez R.Pando-sandoval 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. 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.Ions R.Skeemer J.Woltmann G.Hancock C.Rudran B.Ruiz-buitrago S.Campbell M.Whitaker P.Allen K. S.Brito V.Dietz J.Dysart C. E.Franco-sadud R. A.Kellie G. M. S. M.Gaga M.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.subject
medicine.medical_specialtyAtypical pathogensEpidemiologyPopulationSettore MED/10 - Malattie Dell'Apparato Respiratoriolcsh:Infectious and parasitic diseases03 medical and health sciences0302 clinical medicineMedical microbiologyCommunity-acquired pneumoniaInternal medicineEpidemiologyRisk Factors.Medicinelcsh:RC109-216030212 general & internal medicineeducationAged 80 and overeducation.field_of_studybusiness.industryIncidence (epidemiology)Atypical pathogenHealthcare-Associated PneumoniaChlamydophila pneumoniaemedicine.diseaseAntibiotic coverageCAPPneumoniaInfectious Diseases030228 respiratory systemLegionnaires' diseasebusinessResearch Articledescription
Abstract Background Empirical antibiotic coverage for atypical pathogens in community-acquired pneumonia (CAP) has long been debated, mainly because of a lack of epidemiological data. We aimed to assess both testing for atypical pathogens and their prevalence in hospitalized patients with CAP worldwide, especially in relation with disease severity. Methods A secondary analysis of the GLIMP database, an international, multicentre, point-prevalence study of adult patients admitted for CAP in 222 hospitals across 6 continents in 2015, was performed. The study evaluated frequency of testing for atypical pathogens, including L. pneumophila, M. pneumoniae, C. pneumoniae, and their prevalence. Risk factors for testing and prevalence for atypical pathogens were assessed through univariate analysis. Results Among 3702 CAP patients 1250 (33.8%) underwent at least one test for atypical pathogens. Testing varies greatly among countries and its frequency was higher in Europe than elsewhere (46.0% vs. 12.7%, respectively, p < 0.0001). Detection of L. pneumophila urinary antigen was the most common test performed worldwide (32.0%). Patients with severe CAP were less likely to be tested for both atypical pathogens considered together (30.5% vs. 35.0%, p = 0.009) and specifically for legionellosis (28.3% vs. 33.5%, p = 0.003) than the rest of the population. Similarly, L. pneumophila testing was lower in ICU patients. At least one atypical pathogen was isolated in 62 patients (4.7%), including M. pneumoniae (26/251 patients, 10.3%), L. pneumophila (30/1186 patients, 2.5%), and C. pneumoniae (8/228 patients, 3.5%). Patients with CAP due to atypical pathogens were significantly younger, showed less cardiovascular, renal, and metabolic comorbidities in comparison to adult patients hospitalized due to non-atypical pathogen CAP. Conclusions Testing for atypical pathogens in patients admitted for CAP in poorly standardized in real life and does not mirror atypical prevalence in different settings. Further evidence on the impact of atypical pathogens, expecially in the low-income countries, is needed to guidelines implementation.
year | journal | country | edition | language |
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2018-12-18 |