Risk Factors Associated with Potentially Antibiotic-Resistant Pathogens in Community-Acquired Pneumonia

2015 ◽  
Vol 12 (2) ◽  
pp. 153-160 ◽  
Author(s):  
Elena Prina ◽  
Otavio T. Ranzani ◽  
Eva Polverino ◽  
Catia Cillóniz ◽  
Miquel Ferrer ◽  
...  
Keyword(s):  
Risk Factors ◽  
Community Acquired Pneumonia ◽  
Antibiotic Resistant ◽  
Factors Associated

scholarly journals 2193. Factors Impacting the Duration of Antimicrobial Therapy for Community-Acquired Pneumonia

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S746-S747
Author(s):  
Avnish Sandhu ◽  
Erin Goldman ◽  
Jordan Polistico ◽  
Sarah Polistico ◽  
Ahmed Oudeif ◽  
...  
Keyword(s):  
Risk Factors ◽  
Medical Center ◽  
Clinical Signs ◽  
Retrospective Chart Review ◽  
Signs And Symptoms ◽  
Community Acquired Pneumonia ◽  
Prescribing Patterns ◽  
Antibiotic Prescribing ◽  
Factors Associated ◽  
Specific Risk

Abstract Background Pneumonia is a common cause of infection associated with hospitalization. Treatment durations for community-acquired pneumonia (CAP) often exceed guideline recommended durations of 5–7 days without a clear explanation. The objective of this study was to determine factors that may lead to durations exceeding this recommendation. Methods A retrospective chart review of 89 patients admitted to the Detroit Medical Center (DMC) for the treatment of pneumonia was conducted. Demographics, clinical signs and symptoms, antibiotic data, pneumonia severity score (CURB 65), risk factors for resistance, microbiology results, and outcomes were recorded and analyzed for factors associated with increased durations of antibiotics. Average durations of antibiotics and durations of antibiotics greater that 7 days were assessed for each risk factor. Results Average durations of antibiotics was 9 days (SD 3.8) for the cohort, and 55 (61%) received durations of > 7 days. Average durations of antibiotics for risk factors are shown in Table 1. Factors associated with durations of antibiotics longer than 7 days are shown in Table 2. There was a trend toward longer average durations of antibiotics for persons with risk factors for resistance [Drug Resistance in Pneumonia (DRIP) score ≥ 4 (increased duration of antibiotics by 1.7 days, P = 0.07] and those with a positive legionella antigen [increased durations of antibiotics by 6.6 days, P = 0.07]. Conclusion Specific risk factors could not be associated with increased durations of antibiotics, although there was a trend toward longer durations for persons with markers for resistance and positive legionella testing. Efforts to reduce durations of antibiotics must target global clinician antibiotic prescribing patterns and not specific risk factors. Disclosures All authors: No reported disclosures.

Incidence, timing and risk factors associated with 1-year mortality after hospitalization for community-acquired pneumonia

2014 ◽  
Vol 68 (6) ◽  
pp. 534-541 ◽  
Author(s):  
Jordi Adamuz ◽  
Diego Viasus ◽  
Emilio Jiménez-Martínez ◽  
Pilar Isla ◽  
Carolina Garcia-Vidal ◽  
...  
Keyword(s):  
Risk Factors ◽  
Community Acquired Pneumonia ◽  
Factors Associated

scholarly journals Bacteraemia and antibiotic-resistant pathogens in community acquired pneumonia: risk and prognosis

2015 ◽  
Vol 45 (5) ◽  
pp. 1353-1363 ◽  
Author(s):  
Antoni Torres ◽  
Catia Cillóniz ◽  
Miquel Ferrer ◽  
Albert Gabarrús ◽  
Eva Polverino ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Multivariate Analysis ◽  
Intensive Care ◽  
Community Acquired Pneumonia ◽  
Blood Cultures ◽  
Arterial Oxygen ◽  
C Reactive Protein ◽  
Antibiotic Resistant ◽  
Reactive Protein

The sensitivity of blood cultures in the diagnosis of bacteraemia for community-acquired pneumonia is low. Recommendations, by guidelines, to perform blood cultures are discordant. We aimed to determine the incidence, microbial aetiology, risk factors and outcomes of bacteraemic patients with community-acquired pneumonia, including cases with antibiotic-resistant pathogens (ARP).A prospective, observational study was undertaken on consecutive adult patients admitted to the Hospital Clinic of Barcelona (Barcelona, Spain) with community-acquired pneumonia and blood cultures were obtained.Of the 2892 patients included, bacteraemia was present in 297 (10%) patients; 30 (10%) of whom had ARP (multidrug-resistantStreptococcus pneumoniae, methicillin-resistantStaphylococcus aureus,Pseudomonas aeruginosa, and an extended spectrum of beta-lactamase producingEnterobacteriaceae). In multivariate analyses, pleuritic pain, C-reactive protein ≥21.6 mg·dL−1and intensive care unit admissions were independently associated with bacteraemia, while prior antibiotic treatment and pneumococcal vaccine were protective factors. The risk factors for ARP bacteraemia were previous antibiotics and C-reactive protein <22.2 mg·dL−1, while pleuritic pain was the only protective factor in the multivariate analysis. Bacteraemia (excluding ARP), appropriate empiric treatment, neurological disease, arterial oxygen tension/inspiratory oxygen fraction <250, pneumonia severity index risk classes IV and V, and intensive care unit admission were independently associated with a 30-day hospital mortality in the multivariate analysis. Inappropriate therapy was more frequent in ARP bacteraemia, compared with other bacteraemias (27%versus3%, respectively, p<0.001).Antibiotic therapy protected against bacteraemia, but increased specifically the risk of bacteraemia from ARP due to the inappropriate coverage of these pathogens. Identifying patients at risk of ARP bacteraemia would help in deciding appropriate empiric antimicrobial therapy. The results from this study provide evidence concerning community-acquired pneumonia patients in whom blood cultures should not be performed.

Analysis of Risk Factors Associated with Antibiotic-Resistant Escherichia coli

2012 ◽  
Vol 18 (2) ◽  
pp. 161-168 ◽  
Author(s):  
Mohamed O. Ahmed ◽  
Nicola J. Williams ◽  
Peter D. Clegg ◽  
Jennifer C. van Velkinburgh ◽  
Keith E. Baptiste ◽  
...  
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Antibiotic Resistant ◽  
Factors Associated

scholarly journals Risk Factors Associated With 30-Day Readmission in Patients With Community-Acquired Pneumonia

2015 ◽  
Vol 2 (suppl_1) ◽  
Author(s):  
Yuan Xin ◽  
Rebecca Bajoka ◽  
Ruchira Sengupta ◽  
Daniela Moreno ◽  
Anthony D. Harris ◽  
...  
Keyword(s):  
Risk Factors ◽  
Community Acquired Pneumonia ◽  
Factors Associated

scholarly journals Factors associated with hospitalization due to streptococcal infection in Houston, Texas 2015-2016

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Razina Khayat ◽  
Sudipa Biswas ◽  
Sudipa Biswas ◽  
Najmus Abdullah ◽  
Najmus Abdullah ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Disease Surveillance ◽  
Streptococcal Infection ◽  
Kidney Diseases ◽  
Community Acquired Pneumonia ◽  
Chi Square ◽  
Streptococcal Disease ◽  
Factors Associated ◽  
Disease Surveillance System

ObjectiveTo study the factors associated with streptococcal infection that led to hospitalization in Houston, Texas for years 2015-2016IntroductionDifferent studies have shown that Streptococcal infections in adults are more common among older age, blacks, and underlying chronic medical conditions like diabetes, cardiovascular and kidney diseases.In specific, other studies have demonstrated that streptococcal pyogenes can cause severe illnesses and dramatic hospital outbreaks.Furthermore, community-acquired pneumonia studies had also suggested that cardiovascular disease, severe renal disease, chronic lung disease and diabetes were associated with increased odds of hospitalization.MethodsData were extracted from Houston Electronic Disease Surveillance System (HEDSS) beginning January 1, 2015 to December 31, 2016. A total of 512 confirmed cases were investigated and analyzed during the study period. Frequencies and percentages were calculated and chi square test was used to examine the association between hospitalization and other risk factors. Odds ratio was calculated using unconditional logistic regression to determine the association of risk factors with hospitalization in streptococcal patients.ResultsA total of 414 patients (81 %) of the confirmed cases were hospitalized.Age, race, fever, sepsis, diabetes, cardiovascular and kidney diseases were significantly associated with hospitalization in the bivariate analysis.Logistic regression analysis adjusted for confounding factors demonstrated that among clinical characteristics, fever (OR 2.9; 95% CI 1.66-5.38) was three times more prevalent among hospitalized patients with streptococcal infection.Patients with diabetes (OR 7.92; 95% CI 3.08-20.36) were almost eight times more likely to be hospitalized than patients without diabetes among streptococcal patients, followed by cardiovascular disease (OR 2.84; CI 1.32-6.10) which was three times more likely to be present.ConclusionsCommon clinical sign like fever was associated with hospitalization among streptococcal patient. Similarly, risk factors like diabetes and cardiovascular diseases were significantly associated with hospitalization in streptococcal patients.Prevention strategies need to be focused on streptococcal patients with chronic risk factors like diabetes, and cardiovascular disease.ReferencesParks t, Barret L, Jones N. Invasive streptococcal disease: a review for clinicians. British Med Bulletin, 2015; 115 (7): 77-89.Skoff TH, Farley MM, Petit S, et al. Increasing Burden of Invasive Group B Streptococcal Disease in Nonpregnant Adults, 1990-2007. CID 2009; 49 (7): 85-92.

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