Risk Factors for Development of Pulmonary and Extra-Pulmonary Complications in Severe Community-Acquired Pneumonia

2019 ◽  
Author(s):  
A.S. Sadigov ◽  
S. Huseynova ◽  
F. Abdullayev
Keyword(s):  
Risk Factors ◽  
Community Acquired Pneumonia ◽  
Pulmonary Complications ◽  
Extra Pulmonary ◽  
Severe Community Acquired Pneumonia

scholarly journals PES Pathogens in Severe Community-Acquired Pneumonia

2019 ◽  
Vol 7 (2) ◽  
pp. 49 ◽  
Author(s):  
Catia Cillóniz ◽  
Cristina Dominedò ◽  
Antonello Nicolini ◽  
Antoni Torres
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Distress Syndrome ◽  
Community Acquired Pneumonia ◽  
Pulmonary Complications ◽  
Cardiac Events ◽  
Intensive Care Admission ◽  
Methicillin Resistant ◽  
Admission Rates ◽  
Severe Community Acquired Pneumonia

Worldwide, there is growing concern about the burden of pneumonia. Severe community-acquired pneumonia (CAP) is frequently complicated by pulmonary and extra-pulmonary complications, including sepsis, septic shock, acute respiratory distress syndrome, and acute cardiac events, resulting in significantly increased intensive care admission rates and mortality rates. Streptococcus pneumoniae (Pneumococcus) remains the most common causative pathogen in CAP. However, several bacteria and respiratory viruses are responsible, and approximately 6% of cases are due to the so-called PES (Pseudomonas aeruginosa, extended-spectrum β-lactamase Enterobacteriaceae, and methicillin-resistant Staphylococcus aureus) pathogens. Of these, P. aeruginosa and methicillin-resistant Staphylococcus aureus are the most frequently reported and require different antibiotic therapy to that for typical CAP. It is therefore important to recognize the risk factors for these pathogens to improve the outcomes in patients with CAP.

Diagnosis and management of community-acquired pneumonia

2016 ◽  
Author(s):  
Antoni Torres ◽  
Adamantia Liapikou
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Community Acquired Pneumonia ◽  
Atypical Pathogens ◽  
High Prevalence ◽  
Refractory Septic Shock ◽  
Pneumococcal Bacteraemia ◽  
Severe Community Acquired Pneumonia ◽  
Reason For Admission ◽  
Selection Of

Severe community-acquired pneumonia (SCAP) remains the most common infectious reason for admission to the intensive care unit (ICU), reaching a mortality rate of 30–40%. The microbial pattern of the SCAP has changed with S. pneumoniae still the leading pathogen, but a decrease of atypical pathogens, especially Legionella and an increase of viral and polymicrobial pneumonias. IDSA/ATS issued guidelines on the management of CAP including specific criteria to identify patients for ICU admission with good predictive value. The first selection of antimicrobial therapy should be started early covering all likely pathogens, depending on the presence of the risk factors for Pseudomonas aeruginosa infection. Combination therapy may be useful in patients with non-refractory septic shock and severe sepsis pneumococcal bacteraemia as well. The challenges include the emergence of new pathogens as community-acquired methicillin-resistant Staphylococcus aureus, new influenza virus subtypes and the high prevalence of multidrug resistance, mainly from institutionalizing patients.

Risk factors for early onset severe community-acquired pneumonia complications

2018 ◽  
Author(s):  
Vaida Averjanovaitė ◽  
Rūta Saikalytė ◽  
Giedrė Cincilevičiūtė ◽  
Gabrielė Kučinskaitė ◽  
Domantė Mačiulytė ◽  
...  
Keyword(s):  
Risk Factors ◽  
Early Onset ◽  
Community Acquired Pneumonia ◽  
Severe Community Acquired Pneumonia

scholarly journals Severe Community-Acquired Pneumonia due to Acinetobacter baumannii in North America: Case Report and Review of the Literature

2018 ◽  
Vol 5 (3) ◽  
Author(s):  
David P Serota ◽  
Mary Elizabeth Sexton ◽  
Colleen S Kraft ◽  
Federico Palacio
Keyword(s):  
Risk Factors ◽  
Septic Shock ◽  
Acute Respiratory Distress Syndrome ◽  
Case Report ◽  
North America ◽  
Acinetobacter Baumannii ◽  
Distress Syndrome ◽  
Community Acquired Pneumonia ◽  
Review Of The Literature ◽  
Severe Community Acquired Pneumonia

Abstract Acinetobacter baumannii is a rare but emerging cause of fulminant community-acquired pneumonia (CAP-AB). We describe a patient from a rural area who developed acute respiratory distress syndrome and septic shock. We describe risk factors and characteristics of this syndrome and review published cases of CAP-AB from North America.

scholarly journals Severe Community-acquired Pneumonia in an Intensive Care Unit: Risk Factors for Mortality

2005 ◽  
Vol 44 (7) ◽  
pp. 710-716 ◽  
Author(s):  
Akihiro YOSHIMOTO ◽  
Hiroyuki NAKAMURA ◽  
Masaki FUJIMURA ◽  
Shinji NAKAO
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Community Acquired Pneumonia ◽  
Unit Risk ◽  
Severe Community Acquired Pneumonia

scholarly journals Fluoroquinolone treatment as a protective factor for 10-day mortality in Streptococcus pneumoniae bacteremia in cancer patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Naihma Salum Fontana ◽  
K. I. Ibrahim ◽  
P. R. Bonazzi ◽  
F. Rossi ◽  
S. C. G. Almeida ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cancer Patients ◽  
Protective Factor ◽  
Pneumococcal Vaccination ◽  
Community Acquired Pneumonia ◽  
Cancer Type ◽  
Karnofsky Score ◽  
Pneumococcal Bacteremia ◽  
Severe Community Acquired Pneumonia ◽  
Associated Risk Factors

AbstractTo evaluate the prognostic factors in adult cancer patients with pneumococcal bacteremia, describe episode features and the phenotypic characteristics of the isolated strains. We evaluated the episodes in patients admitted to a cancer hospital between 2009 and 2015. The outcomes were defined as 48 h mortality and mortality within 10 days after the episode. The variables evaluated were: age, sex, ethnicity, ECOG, Karnofsky score, SOFA, cancer type, metastasis, chemotherapy, radiotherapy, neutropenia, previous antibiotic therapy, community or healthcare-acquired infection, comorbidities, smoking, pneumococcal vaccination, infection site, presence of fever, polymicrobial infection, antimicrobial susceptibility, serotype and treatment. 165 episodes were detected in 161 patients. The mean age was 61.3 years; solid tumors were the most prevalent (75%). 48 h and 10-day mortality were 21% (34/161) and 43% (70/161) respectively. The 48 h mortality- associated risk factors were SOFA and polymicrobial bacteremia; 10-day mortality-associated risk factors were fever, neutropenia, ECOG 3/4, SOFA and fluoroquinolones as a protective factor. Pneumococcal bacteremia presented high mortality in cancer patients, with prognosis related to intrinsic host factors and infection episodes features. Fluoroquinolone treatment, a protective factor in 10-day mortality, has potential use for IPDs and severe community-acquired pneumonia in cancer patients.

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. 

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