Risk factors and severity scores in hospitalized patients with community-acquired pneumonia: prediction of severity and mortality

2011 ◽  
Vol 31 (1) ◽  
pp. 33-47 ◽  
Author(s):  
T. Welte
Keyword(s):  
Risk Factors ◽  
Community Acquired Pneumonia ◽  
Hospitalized Patients ◽  
Severity Scores

scholarly journals Risk factors for Clostridium difficile infection in hospitalized patients with community-acquired pneumonia

2016 ◽  
Vol 73 (1) ◽  
pp. 45-53 ◽  
Author(s):  
James D. Chalmers ◽  
Ahsan R. Akram ◽  
Aran Singanayagam ◽  
Mark H. Wilcox ◽  
Adam T. Hill
Keyword(s):  
Risk Factors ◽  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Community Acquired Pneumonia ◽  
Hospitalized Patients

Incidence, Etiology, Timing, and Risk Factors for Clinical Failure in Hospitalized Patients With Community-Acquired Pneumonia

CHEST Journal ◽  
2008 ◽  
Vol 134 (5) ◽  
pp. 955-962 ◽  
Author(s):  
Stefano Aliberti ◽  
Asad Amir ◽  
Paula Peyrani ◽  
Mehdi Mirsaeidi ◽  
Marty Allen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Community Acquired Pneumonia ◽  
Hospitalized Patients ◽  
Clinical Failure

scholarly journals Community-acquired pneumonia in hospitalized patients: clinical guidelines

2019 ◽  
pp. 79-88
Author(s):  
A. A. Zaytsev ◽  
A. I. Sinopal’nikov
Keyword(s):  
Risk Factors ◽  
Antimicrobial Therapy ◽  
Alternative Therapy ◽  
Community Acquired Pneumonia ◽  
Hospitalized Patients ◽  
Public Health Care ◽  
High Morbidity ◽  
Wide Range ◽  
Amoxicillin Clavulanate ◽  
Severe Community Acquired Pneumonia

Community-acquired pneumonia is still the cornerstone of practical public health care due to high morbidity and mortality. Streptococcus pneumoniae (30-50%), Haemophilus influenzae, Staphylococcus aureus and Klebsiella pneumoniae remain the main cause of community-acquired pneumonia (3-5%). In recent years, the spread of strains resistant to macrolide antibiotics (~30:) and isolates with reduced sensitivity to β-lactams among pneumococci has been a topical problem. On the pages of international recommendations, biological markers of inflammatory response are of great importance in the diagnosis of community-acquired pneumonia. Thus, in patients with an uncertain diagnosis of «community-acquired pneumonia» in case of concentration of C-reactive protein ≥ 100 mg/l its specificity in confirming the diagnosis exceeds 90%, at a concentration of < 20 mg/l the diagnosis of pneumonia is unlikely. All hospitalized patients with community-acquired pneumonia should use the IDSA/ATS criteria or SMART-COP scale to assess severity, predict and determine admission to intensive  care  unit. When planning antimicrobial therapy tactics in hospitalized patients, it is advisable to categorize patients taking into account risk factors for ineffective therapy. In the absence of such, choice of antibiotics are inhibitor-proof aminopenicillins (amoxicillin/clavulanate, etc.), ampicillin; the alternative therapy mode involves the use of respiratory fluoroquinolones.In patients with comorbidities and other risk factors for infection with resistant microorganisms, the drugs of choice are inhibitorproof aminopenicillins (amoxicillin/clavulanate, etc.), III generation cephalosporins (cefotaxime, ceftriaxone), respiratory fluoroquinolones, and ceftaroline and ertapenem may be used in certain categories of patients. With regard to ceftaroline, it is worth noting that its use is currently an attractive strategy due to its wide range of activities, including resistant strains of pneumococcus and S. aureus. Special attention in the publication is paid to antimicrobial therapy modes in case of severe community-acquired pneumonia, the criteria of efficacy assessment and duration of antibiotics application are reflected. 

scholarly journals 803. Risk factors associated with Clostridioides difficile infection in hospitalized patients with community-acquired pneumonia

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S445-S445
Author(s):  
William Justin Moore ◽  
Caroline C Jozefczyk ◽  
Paul R Yarnold ◽  
Karolina Harkabuz ◽  
Valerie Widmaier ◽  
...  
Keyword(s):  
Risk Factors ◽  
Decomposition Analysis ◽  
Antibiotic Use ◽  
Community Acquired Pneumonia ◽  
Hospitalized Patients ◽  
Structural Decomposition Analysis ◽  
Clostridioides Difficile ◽  
Clostridioides Difficile Infection ◽  
Pre Treatment ◽  
Healthcare Associated

Abstract Background Patients with community-acquired pneumonia (CAP) who are hospitalized and treated with antibiotics may carry an increased risk for developing Clostridioides difficile infection (CDI). Accurate risk estimation tools are needed to guide monitoring and CDI mitigation efforts. We aimed to identify patient-specific risk factors associated with CDI among hospitalized patients with CAP. Methods Design: retrospective case-control study of hospitalized patients who received CAP-directed antibiotic therapy between 1/1/2014 and 5/29/2018. Cases were hospitalized CAP patients who developed CDI post-admission. Control patients did not develop CDI and were selected at random from CAP patients hospitalized during this period. Variables: comorbidities, laboratory results, vital signs, severity of illness, prior hospitalization, and past antibiotic use. Propensity-score weights: identified via structural decomposition analysis of pre-treatment variables. Analysis: weighted classification tree models that predicted any CDI, hospital-onset CDI, and any healthcare-associated CDI according to CAP antibiotic treatment. Performance: percent accuracy in classification (PAC) and weighted positive (PPV) and negative predictive values (NPV). Modeling: completed using the ODA package (v1.0.1.3) for R (v3.5.1). Results A total of 32 cases and 232 controls were identified. Sixty pre-treatment variables were screened. Structural decomposition analysis, completed in two stages, identified prior hospitalization (OR 6.56, 95% CI: 3.01-14.31; PAC: 80.3%) and BUN greater than 29 mg/dL (OR 11.67, 95% CI: 2.41-56.5; PAC: 80.8%) as propensity-score weights. With respect to CDI, receipt of broad-spectrum anti-pseudomonal antibiotics was significantly (all P’s&lt; 0.05) associated with any CDI (NPV: 90.29%, PPV: 27.94%), hospital-onset CDI (NPV: 97.53%, PPV: 26.86%), and healthcare-associated CDI (NPV: 92.89%, PPV: 27.94%). Conclusion We identified risk factors available at hospital admission and empiric use of broad-spectrum Gram-negative antibiotics as being associated with the development of CDI. Model PPVs were over two-fold greater than our sample base rate. Increased monitoring and avoidance of overly broad antibiotic use in high-risk patients appears warranted. Disclosures All Authors: No reported disclosures

Aetiology and risk factors of community-acquired pneumonia in hospitalized patients in Norway

2015 ◽  
Vol 10 (6) ◽  
pp. 756-764 ◽  
Author(s):  
Wenche Røysted ◽  
Øystein Simonsen ◽  
Andrew Jenkins ◽  
Marjut Sarjomaa ◽  
Martin Veel Svendsen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Community Acquired Pneumonia ◽  
Hospitalized Patients

scholarly journals Tigecycline Versus Levofloxacin in Hospitalized Patients With Community-Acquired Pneumonia: An Analysis of Risk Factors

2013 ◽  
Vol 7 (1) ◽  
pp. 13-20 ◽  
Author(s):  
Nathalie Dartois ◽  
C Angel Cooper ◽  
Nathalie Castaing ◽  
Hassan Gandjini ◽  
Denise Sarkozy
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Altered Mental Status ◽  
Community Acquired Pneumonia ◽  
Hospitalized Patients ◽  
Individual Risk ◽  
Chronic Obstructive ◽  
Intention To Treat ◽  
Clinical Instability ◽  
Cure Rates

Introduction: This study was conducted to evaluate the efficacy of tigecycline (TGC) versus levofloxacin (LEV) in hospitalized patients with community-acquired pneumonia (CAP) using pooled data and to perform exploratory analyses of risk factors associated with poor outcome. Materials and Methodology: Pooled analyses of 2 phase 3 studies in patients randomized to intravenous (IV) TGC (100 mg, then 50 mg q12h) or IV LEV (500 mg q24h or q12h). Clinical responses at test of cure visit for the clinically evaluable (CE) and clinical modified intention to treat populations were assessed for patients with risk factors including aged ≥65 years, prior antibiotic failure, bacteremia, multilobar disease, chronic obstructive pulmonary disease, alcohol abuse, altered mental status, hypoxemia, renal insufficiency, diabetes mellitus, white blood cell count >30 x 109/L or <4 x 109/L, CURB-65 score ≥2, Fine score category of III to V and at least 2 clinical instability criteria on physical examination. Results: In the CE population of 574 patients, overall cure rates were similar: TGC (253/282, 89.7%); LEV (252/292, 86.3%). For all but one risk factor, cure rates for TGC were similar to or higher than those for LEV. For individual risk factors, the greatest difference between treatment groups was observed in patients with diabetes mellitus (difference of 22.9 for TGC versus LEV; 95% confidence interval, 4.8 - 39.9). Conclusions: TGC achieved cure rates similar to those of LEV in hospitalized patients with CAP. For patients with risk factors, TGC provided generally favorable clinical outcomes.

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