Severe community-acquired pneumonia: assessment of microbial aetiology as mortality factor - PubMed (original) (raw)
Severe community-acquired pneumonia: assessment of microbial aetiology as mortality factor
F Paganin et al. Eur Respir J. 2004 Nov.
Free article
Abstract
Community-acquired pneumonia (CAP) remains a major cause of mortality. The aetiology of CAP has rarely been identified as a mortality risk factor. A prospective study was conducted to assess the prognostic factors of CAP patients admitted to the intensive care unit (Centre Hospitalier Departmental Felix Guyon, St Denis de la Reunion, France), with a special emphasis on microbial aetiology. All variables assessing severity were collected, with a special emphasis on microbial investigations. Among 112 immunocompetent patients (mean+/-SD age 54.7+/-15.1 yrs), 84% were male. Severity of CAP was demonstrated by mortality rate (43%), shock (48%), simplified acute physiology score (SAPS; 46.4+/-21.6) and mechanical ventilation support (82%). Mean risk factor score was 2.2+/-1.2. Microbiological identification was obtained in 78.6% of cases, with positive blood culture in 33%. Most frequently, microbial agents were Streptococcus pneumoniae and Klebsiella pneumoniae (42% and 22%, respectively). The univariate analysis recorded the usual mortality variables: age, alcohol consumption, SAPS, shock, mechanical ventilation, positive end expiratory pressure level, positive blood culture, multilobar infiltrates on chest radiograph, neutropenia, and acidosis, and found K. pneumoniae (versus S. pneumoniae, and all CAP) as a mortality factor. The multivariate analysis demonstrated that septic shock (relative risk (RR) 141), K. pneumoniae CAP (RR 27), SAPS (RR 10.7) and positive blood culture (RR 2.7) were independent factors related to death. In conclusion, the present study found that the microbial aetiology, Klebsiella pneumoniae, was an independent risk factor for mortality in severe community-acquired pneumonia.
Similar articles
- Severity scoring in community-acquired pneumonia caused by Streptococcus pneumoniae: a 5-year experience.
Ioachimescu OC, Ioachimescu AG, Iannini PB. Ioachimescu OC, et al. Int J Antimicrob Agents. 2004 Nov;24(5):485-90. doi: 10.1016/j.ijantimicag.2004.05.006. Int J Antimicrob Agents. 2004. PMID: 15519482 - Clinical features of healthcare-associated pneumonia (HCAP) in a Japanese community hospital: comparisons among nursing home-acquired pneumonia (NHAP), HCAP other than NHAP, and community-acquired pneumonia.
Umeki K, Tokimatsu I, Yasuda C, Iwata A, Yoshioka D, Ishii H, Shirai R, Kishi K, Hiramatsu K, Matsumoto B, Kadota J. Umeki K, et al. Respirology. 2011 Jul;16(5):856-61. doi: 10.1111/j.1440-1843.2011.01983.x. Respirology. 2011. PMID: 21545370 - Severe community-acquired pneumonia: an Australian perspective.
Wilson PA, Ferguson J. Wilson PA, et al. Intern Med J. 2005 Dec;35(12):699-705. doi: 10.1111/j.1445-5994.2005.00962.x. Intern Med J. 2005. PMID: 16313544 - Assessment of severity of community-acquired pneumonia.
Boersma WG. Boersma WG. Semin Respir Infect. 1999 Jun;14(2):103-14. Semin Respir Infect. 1999. PMID: 10391405 Review.
Cited by
- Predictors of mortality in severe pneumonia patients: a systematic review and meta-analysis.
Xie K, Guan S, Kong X, Ji W, Du C, Jia M, Wang H. Xie K, et al. Syst Rev. 2024 Aug 5;13(1):210. doi: 10.1186/s13643-024-02621-1. Syst Rev. 2024. PMID: 39103964 Free PMC article. Review. - Community-acquired Klebsiella pneumoniae pneumonia in ICU: a multicenter retrospective study.
Grosjean V, Gressens SB, Pham T, Gaudry S, Ait-Oufella H, De Prost N, Mayaux J, Guerot E, Leflon-Guibout V, Mayer N, Bert F, Gault N, Massonnaud CR, Roux D. Grosjean V, et al. Ann Intensive Care. 2024 Apr 30;14(1):69. doi: 10.1186/s13613-024-01269-3. Ann Intensive Care. 2024. PMID: 38687409 Free PMC article. - Development and validation of a rabbit model of Pseudomonas aeruginosa non-ventilated pneumonia for preclinical drug development.
Gras E, Vu TTT, Nguyen NTQ, Tran VG, Mao Y, Tran ND, Mai NH, Dong OX, Jung DH, Iorio NLPP, Povoa HCC, Pinheiro MG, Aguiar-Alves F, Weiss WJ, Zheng B, Cheng LI, Stover CK, Sellman BR, DiGiandomenico A, Gibault L, Valour F, Diep BA. Gras E, et al. Front Cell Infect Microbiol. 2023 Dec 11;13:1297281. doi: 10.3389/fcimb.2023.1297281. eCollection 2023. Front Cell Infect Microbiol. 2023. PMID: 38149013 Free PMC article. - Machine learning-based prediction of in-ICU mortality in pneumonia patients.
Jeon ET, Lee HJ, Park TY, Jin KN, Ryu B, Lee HW, Kim DH. Jeon ET, et al. Sci Rep. 2023 Jul 17;13(1):11527. doi: 10.1038/s41598-023-38765-8. Sci Rep. 2023. PMID: 37460837 Free PMC article. - Hypervirulence and Multiresistance to Antibiotics in Klebsiella pneumoniae Strains Isolated from Patients with Hospital- and Community-Acquired Infections in a Mexican Medical Center.
Bautista-Cerón A, Monroy-Pérez E, García-Cortés LR, Rojas-Jiménez EA, Vaca-Paniagua F, Paniagua-Contreras GL. Bautista-Cerón A, et al. Microorganisms. 2022 Oct 16;10(10):2043. doi: 10.3390/microorganisms10102043. Microorganisms. 2022. PMID: 36296319 Free PMC article.
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical
Miscellaneous