Pseudomonas aeruginosa pneumonia in the community (original) (raw)

Abstract

Introduction: The P. aeruginosa pneumonia acquired in a non-hospital environment (Community-Acquired Pneumonia [CAP] and Healthcare-Associated Pneumonia [HCAP]) is a growing threat whose correct diagnosis can lead to a better outcome and prognosis. Purpose: Assessment of the epidemiological, clinical, radiological and therapeutic approach of patients with Pseudomonas pneumonia acquired in a non-hospital environment. Methods: Retrospective analysis of patients admitted with of P. aeruginosa CAP and HCAP according to ATS/IDSA 2005 criteria. Results: Sixty eight patients were included: 10 (14.7%) with CAP and 58 (86.3%) with HCAP. Mean age was 75.4 years and 58,8% were males. Sixty patients (88.2%) were partially or totally care dependent. Comorbidity index ( Charlson comorbidity index adjusted for age) was ≥ 6 in half of the sample. At hospital admission, patients presented a CURB-65 score ≥ 3 in 42 patients (61.7%) and a Pneumonia Severity Index IV/V in 63 patients (92.6%).Chest radiography showed alveolar infiltrates in 66 patients: lower lung lobes predominance (68,2%) and focal pattern (59.1%). Identification of the infectious agent was mostly performed in microbiological examination of sputum (58 patients, 85.3%); in blood cultures and BAL/bronchial aspirate, respectively, in 8 (11.8%) and 7 (10.3%) patients. Initial antibiotic regimen was changed in 37 patients (54.4%) and had Pseudomonas coverage in 41 patiens (60.3%), with Piperacillin/Tazobactam being the first choice in 22 patients (53.6%). The mortality rate was 13.2%. Conclusion: P. aeruginosa pneumonia acquired in a non-hospital environment, is associated to patients with high level of dependency and comorbidities and usually presents with clinically severe disease.

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