scholarly journals Community-acquired pneumonia in HIV patients

2021 ◽  
Vol 99 (4) ◽  
pp. 22-28
Author(s):  
I. B. Viktorova ◽  
V. N. Zimina ◽  
I. V. Dadyka ◽  
I. V. Аndreeva ◽  
I. A. Golovina ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Respiratory Diseases ◽  
Community Acquired Pneumonia ◽  
Polymicrobial Infection ◽  
Cd4 Count ◽  
Empiric Antibiotic Therapy ◽  
Patient Treatment ◽  
Hiv Patients ◽  
Empiric Antibiotic ◽  
Therapy Department

The objective: to study the frequency and nature of community-acquired pneumonia (CAP) in HIV patients.Subjects and methods: The continuous longitudinal retrospective study of all cases of respiratory diseases among HIV patients (n = 185), who received in-patient treatment in the therapy department.Results. CAP was diagnosed in 38.4% (n = 71) of patients and it was the most frequent respiratory disease among HIV patients. The median CD4 count in CAP made 197.5 cells/μL, 9.1% of patients received antiretroviral therapy before hospital admission. 74.7% of CAP patients (n = 53) had lesions disseminated to several lobes. Laboratory parameters revealed in severe CAP (leukocytosis > 12 × 109/L, leukopenia < 4.0 × 109/L and thrombocytopenia < 100 × 1012/L) were associated with the degree of immunodeficiency and did not depend on the infiltration dissemination (p > 0.05). Bacteremia in CAP was detected in 20.8% of patients and it was associated with the failure of standard empiric antibiotic therapy (p < 0.05). 9.9% of CAP patients (n = 7) were diagnosed with polymicrobial infection. Lethal outcomes of CAP were recorded in 5.6% of cases (n = 4), all with severe immunosuppression (the median of CD4 count was 5 cells/μL), 2 cases had bilateral subtotal CAP and 2 suffered from polymicrobial infection.

scholarly journals Air bronchogram integrated lung ultrasound score to monitor community-acquired pneumonia in a pilot pediatric population

2021 ◽  
Author(s):  
Riccardo Inchingolo ◽  
Roberto Copetti ◽  
Andrea Smargiassi ◽  
Rafael Emanuele Gerardi ◽  
Emanuele Giovanni Conte ◽  
...  
Keyword(s):  
Pediatric Population ◽  
Community Acquired Pneumonia ◽  
Empiric Antibiotic Therapy ◽  
Non Invasive ◽  
Lung Consolidation ◽  
Therapy Relationship ◽  
Increased Risk ◽  
Empiric Antibiotic ◽  
Registration Number ◽  
Invasive Method

Abstract Aims Chest ultrasound is a non-invasive method for evaluating children with suspected community-acquired pneumonia (CAP). We evaluated the prognostic role of change of ultrasonographic (US) air bronchogram in management of CAP in terms of: rate of complicated CAP, change of empiric antibiotic therapy, relationship to defervescence time, and length of hospitalization. Methods Patients with CAP and radiographic evidence of lung consolidation were prospectively enrolled. Chest US examinations were performed within 12 h from admission and after 48 h. A new grading system (USINCHILD score) based on presence and features of air bronchogram was adopted. Results Thirty six patients were stratified into two groups according to the presence of an increase of at least 1 grade of US score (Δ US grade), expression of an improvement of lung consolidation. Δ US grade after 48 h ≥ 1 was associated with an increased risk of complicated CAP (p value 0.027) and a longer defervescence time (p value 0.036). Moreover, Δ US grade ≥ 1 was predictive of a short hospitalization (p value 0.008). Conclusions USINCHILD score could be an innovative biotechnology tool for the management of pediatric CAP. Trial registration number and date of registration NCT03556488, June 14, 2018. Graphic abstract

scholarly journals CAPPRIC Study—Characterization of Community-Acquired Pneumonia in Spanish Adults Managed in Primary Care Settings

2021 ◽  
Vol 9 (3) ◽  
pp. 508
Author(s):  
Jesús Molina ◽  
Amelia González-Gamarra ◽  
Leovigildo Ginel ◽  
Mª Peláez ◽  
Juan Juez ◽  
...  
Keyword(s):  
Primary Care ◽  
Prospective Observational Study ◽  
Community Acquired Pneumonia ◽  
Hospitalization Rate ◽  
Empiric Antibiotic Therapy ◽  
Radiographic Findings ◽  
Primary Care Settings ◽  
Significant Burden ◽  
Empiric Antibiotic

The real burden of community-acquired pneumonia (CAP) in non-hospitalized patients is largely unknown. This is a 3-year prospective, observational study of ambulatory CAP in adults, conducted in 24 Spanish primary care centers between 2016–2019. Sociodemographic and clinical variables of patients with radiographically confirmed CAP were collected. Pneumococcal etiology was assessed using the Binax Now® test. Patients were followed up for 10 ± 3 days. A total of 456 CAP patients were included in the study. Mean age was 56.6 (±17.5) years, 53.5% were female, and 53.9% had ≥1 comorbidity. Average incidence of CAP was 1.2–3.5 cases per 1000 persons per year. Eighteen patients (3.9%) were classified as pneumococcal CAP. Cough was present in 88.1% of patients at diagnosis and fever in 70.8%. Increased pulmonary density (63.3%) and alveolar infiltrates with air bronchogram (16.6%) were the most common radiographic findings. After 14.6 ± 6.0 days (95% CI = 13.9–15.3), 65.4% of patients had recovered. Hospitalization rate was 2.8%. The most frequently prescribed antibiotics were quinolones (58.7%) and β-lactams (31.1%). In conclusion, one-third of CAP patients did not fully recover after two weeks of empiric antibiotic therapy and 2.8% required hospitalization, highlighting the significant burden associated with non-hospitalized CAP in Spain.

scholarly journals Epidemiology and antibiotic resistance trends of Pantoea species in a tertiary-care teaching hospital: A 12-year retrospective study

2019 ◽  
Vol 2 (3) ◽  
pp. 72-75 ◽  
Author(s):  
M Gajdács
Keyword(s):  
Retrospective Study ◽  
Antimicrobial Susceptibility ◽  
Susceptibility Testing ◽  
Tertiary Care ◽  
Multidrug Resistant ◽  
Antimicrobial Susceptibility Testing ◽  
Empiric Antibiotic Therapy ◽  
Gram Negative ◽  
Extended Spectrum Beta Lactamase ◽  
Empiric Antibiotic

Purpose Pantoea species are pigmented, Gram-negative rods belonging to the Enterobacterales order. They are considered rare, opportunistic pathogens and are mostly implicated in nosocomial outbreaks affecting neonates and immunocompromised patients. The aim of this study was to describe the prevalence and antibiotic susceptibility of Pantoea species during a 12-year period. Materials and methods This retrospective study was carried out using microbiological data collected between January 1, 2006 and December 31, 2017. Patients’ data such as age, sex, inpatient/outpatient status, and empiric antibiotic therapy were also collected. Antimicrobial susceptibility testing was performed using E-tests; the interpretation was based on European Committee on Antimicrobial Susceptibility Testing breakpoints for Enterobacterales. Results Seventy individual Pantoea spp. isolates were identified; the most frequently isolated species was Pantoea agglomerans. Most isolates were susceptible to relevant antibiotics. In 61 out of 68 patients, ampicillin was the empirically administered antibiotic. The highest levels of resistance were to amoxicillin–clavulanic acid and ampicillin. No extended spectrum beta-lactamase-positive isolate was detected. Conclusions There is a scarcity of data available on the susceptibility patterns of Pantoea species, but our results correspond to what we could find in the literature. The development of multidrug-resistant (MDR) Gram-negative bacteria is a grave concern, and the development of MDR Pantoea spp. may be expected in the future.

scholarly journals Rapid heuristic inference of antibiotic resistance and susceptibility by genomic neighbor typing

2018 ◽  
Author(s):  
Karel Břinda ◽  
Alanna Callendrello ◽  
Kevin C. Ma ◽  
Derek R MacFadden ◽  
Themoula Charalampous ◽  
...  
Keyword(s):  
Healthcare Providers ◽  
Empiric Antibiotic Therapy ◽  
Patient Treatment ◽  
Resistant Bacteria ◽  
Sample Collection ◽  
Drug Resistant Bacteria ◽  
Oxford Nanopore ◽  
Empiric Antibiotic ◽  
Susceptibility And Resistance

AbstractSurveillance of drug-resistant bacteria is essential for healthcare providers to deliver effective empiric antibiotic therapy. However, traditional molecular epidemiology does not typically occur on a timescale that could impact patient treatment and outcomes. Here we present a method called ‘genomic neighbor typing’ for inferring the phenotype of a bacterial sample by identifying its closest relatives in a database of genomes with metadata. We show that this technique can infer antibiotic susceptibility and resistance for both S. pneumoniae and N. gonorrhoeae. We implemented this with rapid k-mer matching, which, when used on Oxford Nanopore MinION data, can run in real time. This resulted in determination of resistance within ten minutes (sens/spec 91%/100% for S. pneumoniae and 81%/100% N. gonorrhoeae from isolates with a representative database) of sequencing starting, and for clinical metagenomic sputum samples (75%/100% for S. pneumoniae), within four hours of sample collection. This flexible approach has wide application to pathogen surveillance and may be used to greatly accelerate appropriate empirical antibiotic treatment.

scholarly journals Initial empiric antibiotic therapy for community-acquired pneumonia in Chinese hospitals

2018 ◽  
Vol 24 (6) ◽  
pp. 658.e1-658.e6 ◽  
Author(s):  
X.M. Nie ◽  
Y.S. Li ◽  
Z.W. Yang ◽  
H. Wang ◽  
S.Y. Jin ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Community Acquired Pneumonia ◽  
Empiric Antibiotic Therapy ◽  
Empiric Antibiotic
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