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1. Bacterial Patterns and Empiric Antibiotic Use in COPD Patients With Community-Acquired Pneumonia.

Author

Pascual-Guardia S, Amati F, Marin-Corral J, Aliberti S, Gea J, Soni NJ, Rodriguez A, Sibila O, Sanz F, Sotgiu G, Marcos PJ, Uranga A, Milenkovic B, Meyer CN, Kolditz M, Anzueto AR, and Restrepo MI

Subjects
Humans, Anti-Bacterial Agents therapeutic use, Streptococcus pneumoniae, Pseudomonas aeruginosa, Pneumonia epidemiology, Pulmonary Disease, Chronic Obstructive complications, Pulmonary Disease, Chronic Obstructive drug therapy, Pulmonary Disease, Chronic Obstructive epidemiology, Community-Acquired Infections drug therapy, Community-Acquired Infections epidemiology
Abstract

Introduction: Chronic obstructive pulmonary disease (COPD) is strongly associated with the development of community-acquired pneumonia (CAP). Limited data are available on risk factors for difficult to manage bacteria such as Pseudomonas aeruginosa in COPD patients with CAP. Our objective was to assess the microbiological patterns associated with risk factors that determine empiric antibiotic therapy in hospitalized COPD patients with CAP., Methods: We performed a secondary data analysis of an international, multicenter, observational, point-prevalence study involving hospitalized COPD patients with CAP from March to June 2015. After identifying the risk factors associated with different microorganisms, we developed a scoring system to guide decision-making about empiric anti-pseudomonal antibiotic therapy in this population., Results: We enrolled 689 hospitalized COPD patients with CAP with documented microbiological testing. The most frequent microorganisms isolated were Streptococcus pneumoniae (8%) and Gram-negative bacteria (8%), P. aeruginosa (7%) and Haemophilus influenzae (3%). We developed a scoring system incorporating the variables independently associated with P. aeruginosa that include a previous P. aeruginosa isolation or infection (OR 14.2 [95%CI 5.7-35.2]), hospitalization in the past 12 months (OR 3.7 [1.5-9.2]), and bronchiectasis (OR 3.2 [1.4-7.2]). Empiric anti-pseudomonal antibiotics were overutilized in COPD patients with CAP. The new scoring system has the potential to reduce empiric anti-pseudomonal antibiotic use from 54.1% to 6.2%., Conclusions: COPD patients with CAP present different microbiological profiles associated with unique risk factors. Anti-pseudomonal treatment is a critical decision when selecting empiric antibiotic therapy. We developed a COPD scoring system to guide decision-making about empiric anti-pseudomonal antibiotic therapy., (Published by Elsevier España, S.L.U.)

Published
2023
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2. Correction to: Bacterial etiology of community-acquired pneumonia in immunocompetent hospitalized patients and appropriateness of empirical treatment recommendations: an international point-prevalence study (European Journal of Clinical Microbiology & Infectious Diseases, (2020), 39, 8, (1513-1525), 10.1007/s10096-020-03870-3)

Author

Carugati M., Aliberti S., Sotgiu G., Blasi F., Gori A., Menendez R., Encheva M., Gallego M., Leuschner P., Ruiz-Buitrago S., Battaglia S., Fantini R., Pascual-Guardia S., Marin-Corral J., Restrepo M. I., Aruj P. K., Attorri S., Barimboim E., Caeiro J. P., Garzon M. I., Cambursano V. H., Ceccato A., Chertcoff J., Lascar F., Tulio F. D., Diaz A. C., de Vedia L., Ganaha M. C., Lambert S., Lopardo G., Luna C. M., Malberti A. G., Morcillo N., Tartara S., Pensotti C., Pereyra B., Scapellato P. G., Stagnaro J. P., Shah S., Lotsch F., Thalhammer F., Vincent J. L., Anseeuw K., Francois C. A., Van Braeckel E., Djimon M. Z., Bashi J., Roger D., Nouer S. A., Chipev P., Miteva D., Petkova D., Dodo B. A., Ngahane M., Hugo B., Shen N., Xu J. -F., Rico C. A. B., Buitrago R., Paternina F. J. P., Jean-Marie K. N., Carevic V. V., Jakopovic M., Jankovic M., Matkovic Z., Mitrecic I., Jacobsson M. -L. B., Christensen A. B., HeitmannBodtger U. C., Meyer C. N., Jensen A. V., Baunbaek-knudsen G., Petersen P. T., Andersen S., El-Wahhab I. E. -S. A., Morsy N. E., Shafiek H., Sobh E., Bertrand F., Brun-Buisson C., de Montmollin E., Fartoukh M., Messika J., Tattevin P., Dreher M., Kolditz M., Meisinger M., Pletz M. W., Hagel S., Rupp J., Schaberg T., Spielmanns M., Siaw-Lartey B., Dimakou K., Papapetrou D., Tsigou E., Ampazis D., Bhatia M., Dhar R., D'Souza G., Garg R., Koul P. A., Mahesh P. A., Jayaraj B. S., Narayan K. V., Udnur H. B., Krishnamurthy S. B., Golshani K., Keatings V. M., Martin-Loeches I., Maor Y., Strahilevitz J., Carrabba M., Ceriana P., Confalonieri M., d'Arminio Monforte A., Del Prato B., De Rosa M., Fiorentino G., Gammino M. A., Menzella F., Milani G., Nava S., Palmiero G., Petrino R., Gabrielli B., Rossi P., Sorino C., Steinhilber G., Zanforlin A., Kurahashi K., Bacha Z. A., Ugalde D. B., Zuniga O. C., Villegas J. F., Medenica M., van de Garde E. M. W., Mihsra D. R., Shrestha P., Ridgeon E., Awokola B. I., Nwankwo O. N. O., Olufunlola A. B., Olumide S., Ukwaja K. N., Irfan M., Minarowski L., Szymon S., Froes F., Meireles M., Ferrao C., Neves J., Ravara S. B., da Beira C., Brocovschii V., Ion C., Rusu D., Toma C., Chirita D., Birkun A., Kaluzhenina A., Almotairi A., Abdulbaqi Z., Bukhary A., Edathodu J., Fathy A., Enani A. M. A., Mohamed N. E., Memon J. U., Bogdanovic N., Milenkovic B., Pesut D., Borderias L., Garcia N. M. B., Alarcon H. C., Cilloniz C., Torres A., Diaz-Brito V., Casas X., Gonzalez A. E., Fernandez-Almira M. L., Gaspar-GarcIa I., del Castillo J. G., Victoria P. J., Martinez E. L., de Molina R. M., Marcos P. J., PandoSandova A., Aymerich C. P., del la Torre A. L., Garcia-Olive I., Rello J., Moyano S., Sanz F., Sibila O., Rodrigo-Troyano A., Sole-Violan J., Uranga A., van Boven J. F., Torra E. V., Pujol J. A., Feldman C., Yum H. K., Fiogbe A. A., Yangui F., Bilaceroglu S., Dalar L., Yilmaz U., Bogomolov A., Elahi N., Dhasmana D. J., Ions R., Skeemer J., Woltmann G., Hancock C., Hill A. T., Rudran B., Campbell M., Whitaker P., Allen K. S., Brito V., Dietz J., Dysart C. E., Kellie S. M., Franco-Sadud R. A., Meier G., Gaga M., Holland T. L., Bergin S. P., Kheir F., Landmeier M., Lois M., Nair G. B., Patel H., Reyes K., Rodriguez-Cintron W., Saito S., Soni N. J., Noda J., Hinojosa C. I., Levine S. M., Angel L. F., Anzueto A., Whitlow K. S., Hipskind J., Sukhija K., Wunderink R. G., Shah R. D., Mateyo K. J., Carugati M., Aliberti S., Sotgiu G., Blasi F., Gori A., Menendez R., Encheva M., Gallego M., Leuschner P., Ruiz-Buitrago S., Battaglia S., Fantini R., Pascual-Guardia S., Marin-Corral J., Restrepo M.I., Aruj P.K., Attorri S., Barimboim E., Caeiro J.P., Garzon M.I., Cambursano V.H., Ceccato A., Chertcoff J., Lascar F., Tulio F.D., Diaz A.C., de Vedia L., Ganaha M.C., Lambert S., Lopardo G., Luna C.M., Malberti A.G., Morcillo N., Tartara S., Pensotti C., Pereyra B., Scapellato P.G., Stagnaro J.P., Shah S., Lotsch F., Thalhammer F., Vincent J.L., Anseeuw K., Francois C.A., Van Braeckel E., Djimon M.Z., Bashi J., Roger D., Nouer S.A., Chipev P., Miteva D., Petkova D., Dodo B.A., Ngahane M., Hugo B., Shen N., Xu J.-F., Rico C.A.B., Buitrago R., Paternina F.J.P., Jean-Marie K.N., Carevic V.V., Jakopovic M., Jankovic M., Matkovic Z., Mitrecic I., Jacobsson M.-L.B., Christensen A.B., HeitmannBodtger U.C., Meyer C.N., Jensen A.V., Baunbaek-knudsen G., Petersen P.T., Andersen S., El-Wahhab I.E.-S.A., Morsy N.E., Shafiek H., Sobh E., Bertrand F., Brun-Buisson C., de Montmollin E., Fartoukh M., Messika J., Tattevin P., Dreher M., Kolditz M., Meisinger M., Pletz M.W., Hagel S., Rupp J., Schaberg T., Spielmanns M., Siaw-Lartey B., Dimakou K., Papapetrou D., Tsigou E., Ampazis D., Bhatia M., Dhar R., D'Souza G., Garg R., Koul P.A., Mahesh P.A., Jayaraj B.S., Narayan K.V., Udnur H.B., Krishnamurthy S.B., Golshani K., Keatings V.M., Martin-Loeches I., Maor Y., Strahilevitz J., Carrabba M., Ceriana P., Confalonieri M., d'Arminio Monforte A., Del Prato B., De Rosa M., Fiorentino G., Gammino M.A., Menzella F., Milani G., Nava S., Palmiero G., Petrino R., Gabrielli B., Rossi P., Sorino C., Steinhilber G., Zanforlin A., Kurahashi K., Bacha Z.A., Ugalde D.B., Zuniga O.C., Villegas J.F., Medenica M., van de Garde E.M.W., Mihsra D.R., Shrestha P., Ridgeon E., Awokola B.I., Nwankwo O.N.O., Olufunlola A.B., Olumide S., Ukwaja K.N., Irfan M., Minarowski L., Szymon S., Froes F., Meireles M., Ferrao C., Neves J., Ravara S.B., da Beira C., Brocovschii V., Ion C., Rusu D., Toma C., Chirita D., Birkun A., Kaluzhenina A., Almotairi A., Abdulbaqi Z., Bukhary A., Edathodu J., Fathy A., Enani A.M.A., Mohamed N.E., Memon J.U., Bogdanovic N., Milenkovic B., Pesut D., Borderias L., Garcia N.M.B., Alarcon H.C., Cilloniz C., Torres A., Diaz-Brito V., Casas X., Gonzalez A.E., Fernandez-Almira M.L., Gaspar-GarcIa I., del Castillo J.G., Victoria P.J., Martinez E.L., de Molina R.M., Marcos P.J., PandoSandova A., Aymerich C.P., del la Torre A.L., Garcia-Olive I., Rello J., Moyano S., Sanz F., Sibila O., Rodrigo-Troyano A., Sole-Violan J., Uranga A., van Boven J.F., Torra E.V., Pujol J.A., Feldman C., Yum H.K., Fiogbe A.A., Yangui F., Bilaceroglu S., Dalar L., Yilmaz U., Bogomolov A., Elahi N., Dhasmana D.J., Ions R., Skeemer J., Woltmann G., Hancock C., Hill A.T., Rudran B., Campbell M., Whitaker P., Allen K.S., Brito V., Dietz J., Dysart C.E., Kellie S.M., Franco-Sadud R.A., Meier G., Gaga M., Holland T.L., Bergin S.P., Kheir F., Landmeier M., Lois M., Nair G.B., Patel H., Reyes K., Rodriguez-Cintron W., Saito S., Soni N.J., Noda J., Hinojosa C.I., Levine S.M., Angel L.F., Anzueto A., Whitlow K.S., Hipskind J., Sukhija K., Wunderink R.G., Shah R.D., and Mateyo K.J.

Subjects
pneumonia, Settore MED/10 - Malattie Dell'Apparato Respiratorio
Abstract

In the originally published article, the individual collaborator names were not captured under the group name “GLIMP Collaborators”. The names are now captured correctly under this group accordingly. The original article has been corrected.

Published
2021

3. Bacterial etiology of community-acquired pneumonia in immunocompetent hospitalized patients and appropriateness of empirical treatment recommendations: an international point-prevalence study

Author

Carugati, Manuela, Aliberti, S., Sotgiu, G., Blasi, F., Gori, A., Menendez, R., Encheva, M., Gallego, M., Leuschner, P., Ruiz-Buitrago, S., Battaglia, S., Fantini, R., Pascual-Guardia, S., Marin-Corral, J., Restrepo, M. I., Aruj, Patricia Karina, Attorri, Silvia, Barimboim, Enrique, Caeiro, Juan Pablo, Garzón, María I, Cambursano, Victor Hugo, Ceccato, Adrian, Chertcoff, Julio, Lascar, Florencia, Tulio, Fernando Di, Díaz, Ariel Cordon, de Vedia, Lautaro, Ganaha, Maria Cristina, Lambert, Sandra, Lopardo, Gustavo, Luna, Carlos M, Malberti, Alessio Gerardo, Morcillo, Nora, Tartara, Silvina, Pensotti, Claudia, Pereyra, Betiana, Scapellato, Pablo Gustavo, Stagnaro, Juan Pablo, Shah, Sonali, Lötsch, Felix, Thalhammer, Florian, Vincent, Jean Louis, Anseeuw, Kurt, Francois, Camille A, Van Braeckel, Eva, Djimon, Marcel Zannou, Bashi, Jules, Roger, Dodo, Nouér, Simone Aranha, Chipev, Peter, Encheva, Milena, Miteva, Darina, Petkova, Diana, Dodo, Balkissou Adamou, Ngahane, Mbatchou, Hugo, Bertrand, Shen, Ning, Xu, Jin-fu, Rico, Carlos Andres Bustamante, Buitrago, Ricardo, Paternina, Fernando Jose Pereira, Jean-Marie, Kayembe Ntumba, Carevic, Vesna Vladic, Jakopovic, Marko, Jankovic, Mateja, Matkovic, Zinka, Mitrecic, Ivan, Jacobsson, Marie-Laure Bouchy, Christensen, Anette Bro, HeitmannBødtger, Uff e Christian, Meyer, Christian Niels, Jensen, Andreas Vestergaard, Baunbæk-knudsen, Gertrud, Petersen, Pelle Trier, Andersen, Stine, El-Wahhab, Ibrahim El-Said Abd, Morsy, Nesreen Elsayed, Shafiek, Hanaa, Sobh, Eman, Bertrand, Fabrice, Brun-Buisson, Christian, de Montmollin, Etienne, Fartoukh, Muriel, Messika, Jonathan, Tattevin, Pierre, Dreher, Michael, Kolditz, Martin, Meisinger, Matthias, Pletz, Mathias W, Hagel, Stefan, Rupp, Jan, Schaberg, Tom, Spielmanns, Marc, Siaw-Lartey, Beatrice, Dimakou, Katerina, Papapetrou, Dimosthenis, Tsigou, Evdoxia, Ampazis, Dimitrios, Bhatia, Mohit, Dhar, Raja, D’Souza, George, Garg, Rajiv, Koul, Parvaiz A, Mahesh, P A, Jayaraj, B S, Narayan, Kiran Vishnu, Udnur, Hirennappa B, Krishnamurthy, Shashi Bhaskara, Golshani, Keihan, Keatings, Vera M, Martin-Loeches, Ignacio, Maor, Yasmin, Strahilevitz, Jacob, Battaglia, Salvatore, Carrabba, Maria, Ceriana, Piero, Confalonieri, Marco, d’Arminio Monforte, Antonella, Del Prato, Bruno, De Rosa, Marino, Fantini, Riccardo, Fiorentino, Giuseppe, Gammino, Maria Antonia, Menzella, Francesco, Milani, Giuseppe, Nava, Stefano, Palmiero, Gerardo, Petrino, Roberta, Gabrielli, Barbra, Rossi, Paolo, Sorino, Claudio, Steinhilber, Gundi, Zanforlin, Alessandro, Kurahashi, Kiyoyasu, Bacha, Zeina Aoun, Ugalde, Daniel Barajas, Zuñiga, Omar Ceballos, Villegas, José F, Medenica, Milic, van de Garde, E M W, Mihsra, Deebya Raj, Shrestha, Poojan, Ridgeon, Elliott, Awokola, Babatunde Ishola, Nwankwo, Ogonna N O, Olufunlola, Adefuye Bolanle, Olumide, Segaolu, Ukwaja, Kingsley N, Irfan, Muhammad, Minarowski, Lukasz, Szymon, Skoczyński, Froes, Felipe, Leuschner, Pedro, Meireles, Mariana, Ferrão, Cláudia, Neves, João, Ravara, Sofia B, da Beira, Cova, Brocovschii, Victoria, Ion, Chesov, Rusu, Doina, Toma, Cristina, Chirita, Daniela, Birkun, Alexei, Kaluzhenina, Anna, Almotairi, Abdullah, Abdulbaqi, Zakeya, Bukhary, Ali, Edathodu, Jameela, Fathy, Amal, Enani, Abdullah Mushira Abdulaziz, Mohamed, Nazik Eltayeb, Memon, Jawed Ulhadi, Bogdanović, Nada, Milenkovic, Branislava, Pesut, Dragica, Borderìas, Luis, Garcia, Noel Manuel Bordon, Alarcón, Hugo Cabello, Cilloniz, Catia, Torres, Antoni, Diaz-Brito, Vicens, Casas, Xavier, González, Alicia Encabo, Fernández-Almira, Maria Luisa, Gallego, Miguel, Gaspar-GarcÍa, Inmaculada, del Castillo, Juan González, Victoria, Patricia Javaloyes, Martínez, Elena Laserna, de Molina, Rosa Malo, Marcos, Pedro J, Menéndez, Rosario, PandoSandova, Ana, Aymerich, Cristina Prat, del la Torre, Alicia Lacoma, García-Olivé, Ignasi, Rello, Jordi, Moyano, Silvia, Sanz, Francisco, Sibila, Oriol, Rodrigo-Troyano, Ana, Solé-Violán, Jordi, Uranga, Ane, van Boven, Job FM, Torra, Ester Vendrell, Pujol, Jordi Almirall, Feldman, Charles, Yum, Ho Kee, Fiogbe, Arnauld Attannon, Yangui, Ferdaous, Bilaceroglu, Semra, Dalar, Levent, Yilmaz, Ufuk, Bogomolov, Artemii, Elahi, Naheed, Dhasmana, Devesh J, Ions, Rhiannon, Skeemer, Julie, Woltmann, Gerrit, Hancock, Carole, Hill, Adam T, Rudran, Banu, Ruiz-Buitrago, Silvia, Campbell, Marion, Whitaker, Paul, Allen, Karen S, Brito, Veronica, Dietz, Jessica, Dysart, Claire E, Kellie, Susan M, Franco-Sadud, Ricardo A, Meier, Garnet, Gaga, Mina, Holland, Thomas L, Bergin, Stephen P, Kheir, Fayez, Landmeier, Mark, Lois, Manuel, Nair, Girish B, Patel, Hemali, Reyes, Katherine, Rodriguez-Cintron, William, Saito, Shigeki, Soni, Nilam J, Noda, Julio, Hinojosa, Cecilia I, Levine, Stephanie M, Angel, Luis F, Anzueto, Antonio, Whitlow, K Scott, Hipskind, John, Sukhija, Kunal, Wunderink, Richard G., Shah, Ray D, Mateyo, Kondwelani John, Carugati, Manuela, Aliberti, S, Sotgiu, G, Blasi, F, Gori, A, Menendez, R, Encheva, M, Gallego, M, Leuschner, P, Ruiz-Buitrago, S, Battaglia, S, Fantini, R, Pascual-Guardia, S, Marin-Corral, J, and Restrepo, M I

Subjects
Male, 0301 basic medicine, Microbiology (medical), medicine.medical_specialty, Community-acquired pneumonia, 030106 microbiology, Antimicrobial treatment, Prevalence, Guideline, Settore MED/10 - Malattie Dell'Apparato Respiratorio, Guidelines, Global Health, medicine.disease_cause, Immunocompromised Host, 03 medical and health sciences, 0302 clinical medicine, Medical microbiology, Internal medicine, Epidemiology, Streptococcus pneumoniae, Pneumonia, Bacterial, Humans, Medicine, 030212 general & internal medicine, Practice Patterns, Physicians', Aged, Aged, 80 and over, business.industry, Correction, General Medicine, Middle Aged, medicine.disease, Anti-Bacterial Agents, Community-Acquired Infections, Hospitalization, Pneumonia, Infectious Diseases, Practice Guidelines as Topic, Pseudomonas aeruginosa, Etiology, Original Article, Female, Guideline Adherence, business
Abstract

An accurate knowledge of the epidemiology of community-acquired pneumonia (CAP) is key for selecting appropriate antimicrobial treatments. Very few etiological studies assessed the appropriateness of empiric guideline recommendations at a multinational level. This study aims at the following: (i) describing the bacterial etiologic distribution of CAP and (ii) assessing the appropriateness of the empirical treatment recommendations by clinical practice guidelines (CPGs) for CAP in light of the bacterial pathogens diagnosed as causative agents of CAP. Secondary analysis of the GLIMP, a point-prevalence international study which enrolled adults hospitalized with CAP in 2015. The analysis was limited to immunocompetent patients tested for bacterial CAP agents within 24 h of admission. The CAP CPGs evaluated included the following: the 2007 and 2019 American Thoracic Society/Infectious Diseases Society of America (ATS/IDSA), the European Respiratory Society (ERS), and selected country-specific CPGs. Among 2564 patients enrolled, 35.3% had an identifiable pathogen. Streptococcus pneumoniae (8.2%) was the most frequently identified pathogen, followed by Pseudomonas aeruginosa (4.1%) and Klebsiella pneumoniae (3.4%). CPGs appropriately recommend covering more than 90% of all the potential pathogens causing CAP, with the exception of patients enrolled from Germany, Pakistan, and Croatia. The 2019 ATS/IDSA CPGs appropriately recommend covering 93.6% of the cases compared with 90.3% of the ERS CPGs (p

Published
2020

4. Aspiration Risk Factors, Microbiology, and Empiric Antibiotics for Patients Hospitalized With Community-Acquired Pneumonia

Author

Judith Marin-Corral, Sergi Pascual-Guardia, Francesco Amati, Stefano Aliberti, Joan R Masclans, Nilam Soni, Alejandro Rodriguez, Oriol Sibila, Francisco Sanz, Giovanni Sotgiu, Antonio Anzueto, Katerina Dimakou, Roberta Petrino, Ewoudt van de Garde, Marcos I Restrepo, GLIMP investigators, Patricia Karina Aruj, Silvia Attorri, Enrique Barimboim, Juan Pablo Caeiro, María I Garzón, Victor Hugo Cambursano, V H Dr Cazaux A Adrian Ceccato, Julio Chertcoff, Florencia Lascar, Fernando Di Tulio, Ariel Cordon Díaz, Lautaro de Vedia, Maria Cristina Ganaha, Sandra Lambert, Gustavo Lopardo, Carlos M Luna, Alessio Gerardo Malberti, Nora Morcillo, Silvina Tartara, Claudia Pensotti, Betiana Pereyra, Pablo Gustavo Scapellato, Juan Pablo Stagnaro, Sonali Shah, Felix Lötsch, Florian Thalhammer, Kurt Anseeuw, Camille A Francois, Eva Van Braeckel, Jean Louis Vincent, Marcel Zannou Djimon, Jules Bashi, Roger Dodo, Simone Aranha Nouér, Peter Chipev, Milena Encheva, Darina Miteva, Diana Petkova, Adamou Dodo Balkissou, Eric Walter Pefura Yone, Bertrand Hugo Mbatchou Ngahane, Ning Shen, Jin-Fu Xu, Carlos Andres Bustamante Rico, Ricardo Buitrago, Fernando Jose Pereira Paternina, Jean-Marie Kayembe Ntumba, Vesna Vladic Carevic, Marko Jakopovic, Mateja Jankovic, Zinka Matkovic, Ivan Mitrecic, Marie-Laure Bouchy Jacobsson, Anette Bro Christensen, Uffe Christian Heitmann Bødtger, Christian Niels Meyer, Andreas Vestergaard Jensen, Gertrud Baunbæk-Knudsen, Pelle Trier Petersen, Stine Andersen, Ibrahim El-Said Abd El-Wahhab, Nesreen Elsayed Morsy, Hanaa Shafiek, Eman Sobh, Kedir Abdella Abdulsemed, Fabrice Bertrand, Christian Brun-Buisson, Etienne de Montmollin, Muriel Fartoukh, Jonathan Messika, Pierre Tattevin, Abdo Khoury, Bernard Ebruke, Michael Dreher, Martin Kolditz, Matthias Meisinger, Mathias W Pletz, Stefan Hagel, Jan Rupp, Tom Schaberg, Marc Spielmanns, Petra Creutz, Norton Suttorp, Beatrice Siaw-Lartey, Dimosthenis Papapetrou, Evdoxia Tsigou, Dimitrios Ampazis, Evangelos Kaimakamis, Mohit Bhatia, Raja Dhar, George D'Souza, Rajiv Garg, Parvaiz A Koul, P A Mahesh, B S Jayaraj, Kiran Vishnu Narayan, Hirennappa B Udnur, Shashi Bhaskara Krishnamurthy, Surya Kant, Rajesh Swarnakar, Sneha Limaye, Sundeep Salvi, Keihan Golshani, Vera M Keatings, Ignacio Martin-Loeches, Yasmin Maor, Jacob Strahilevitz, Paola Faverio, Salvatore Battaglia, Maria Carrabba, Piero Ceriana, Marco Confalonieri, Antonella d'Arminio Monforte, Bruno Del Prato, Marino De Rosa, Riccardo Fantini, Giuseppe Fiorentino, Maria Antonia Gammino, Francesco Menzella, Giuseppe Milani, Stefano Nava, Gerardo Palmiero, Barbra Gabrielli, Paolo Rossi, Claudio Sorino, Gundi Steinhilber, Alessandro Zanforlin, Ospedale San Luca, Fabio Franzetti, Manuela Carugati, Manuela Morosi, Elisa Monge, Mauro Carone, Vincenzo Patella, Simone Scarlata, Andrea Comel, Kiyoyasu Kurahashi, Zeina Aoun Bacha, Daniel Barajas Ugalde, Omar Ceballos Zuñiga, José F Villegas, Milic Medenica, Deebya Raj Mihsra, Poojan Shrestha, Elliott Ridgeon, Babatunde Ishola Awokola, Ogonna N O Adefuye Bolanle Olufunlola, Segaolu Olumide, Kingsley N Ukwaja, Muhammad Irfan, Lukasz Minarowski, Skoczyński Szymon, Felipe Froes, Pedro Leuschner, Mariana Meireles, Cláudia Ferrão, João Neves, Abel Salazar, Sofia B Ravara, Victoria Brocovschii, Doina Rusu, Cristina Toma, Daniela Chirita, Carmen Mihaela Dorobat, Alexei Birkun, Anna Kaluzhenina, Abdullah Almotairi, Zakeya Abdulbaqi Ali Bukhary, Jameela Edathodu, Amal Fathy, Abdullah Mushira Abdulaziz Enani, Nazik Eltayeb Mohamed, Jawed Ulhadi Memon, Abdelhaleem Bella, Serbia Nada Bogdanović, Branislava Milenkovic, Dragica Pesut, Luis Borderìas, Noel Manuel Bordon Garcia, Hugo Cabello Alarcón, Catia Cilloniz, Antoni Torres, Vicens Diaz-Brito, Xavier Casas, Alicia Encabo González, Maria Luisa Fernández-Almira, Medicina Interna, Miguel Gallego, Inmaculada Gaspar-GarcÍa, Juan González Del Castillo, Patricia Javaloyes Victoria, Elena Laserna Martínez, Rosa Malo de Molina, Pedro J Marcos, Rosario Menéndez, Ana Pando-Sandoval, Cristina Prat Aymerich, Alicia Lacoma de la Torre, Ignasi García-Olivé, Jordi Rello, Silvia Moyano, Ana Rodrigo-Troyano, Jordi Solé-Violán, Ane Uranga, Job Fm van Boven, Ester Vendrell Torra, Jordi Almirall Pujol, Charles Feldman, Ho Kee Yum, Inje Univ Arnauld Attannon Fiogbe, Ferdaous Yangui, Semra Bilaceroglu, Izmir Dr Levent Dalar, Ufuk Yilmaz, Artemii Bogomolov, Naheed Elahi, Devesh J Dhasmana, Andrew Feneley, Adam T Hill, Banu Rudran, Silvia Ruiz-Buitrago, Marion Campbell, Paul Whitaker, Alexander Youzguin, Anika Singanayagam, C Hancock, David Villafuerte, Karen S Allen, Veronica Brito, Jessica Dietz, Claire E Dysart, Susan M Kellie, Clement J Ricardo A Franco-Sadud, Garnet Meier, Mina Gaga, Thomas L Holland, Stephen P Bergin, Fayez Kheir, Mark Landmeier, Manuel Lois, Girish B Nair, Hemali Patel, Katherine Reyes, William Rodriguez-Cintron, Shigeki Saito, Julio Noda, Cecilia I Hinojosa, Stephanie M Levine, Luis F Reyes, Luis F Angel, K Scott Whitlow, 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Eman, Abdella Abdulsemed, Kedir, Bertrand, Fabrice, Brun-Buisson, Christian, de Montmollin, Etienne, Fartoukh, Muriel, Messika, Jonathan, Tattevin, Pierre, Khoury, Abdo, Ebruke, Bernard, Dreher, Michael, Kolditz, Martin, Meisinger, Matthia, W Pletz, Mathia, Hagel, Stefan, Rupp, Jan, Schaberg, Tom, Spielmanns, Marc, Creutz, Petra, Suttorp, Norton, Siaw-Lartey, Beatrice, Papapetrou, Dimostheni, Tsigou, Evdoxia, Ampazis, Dimitrio, Kaimakamis, Evangelo, Bhatia, Mohit, Dhar, Raja, D'Souza, George, Garg, Rajiv, A Koul, Parvaiz, A Mahesh, P, S Jayaraj, B, Vishnu Narayan, Kiran, B Udnur, Hirennappa, Bhaskara Krishnamurthy, Shashi, Kant, Surya, Swarnakar, Rajesh, Limaye, Sneha, Salvi, Sundeep, Golshani, Keihan, M Keatings, Vera, Martin-Loeches, Ignacio, Maor, Yasmin, Strahilevitz, Jacob, Faverio, Paola, Battaglia, Salvatore, Carrabba, Maria, Ceriana, Piero, Confalonieri, Marco, d'Arminio Monforte, Antonella, Del Prato, Bruno, De Rosa, Marino, Fantini, Riccardo, Fiorentino, Giuseppe, Antonia 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Subjects
Male, Pulmonary and Respiratory Medicine, medicine.drug_class, Aspiration risk, Antibiotics, Nursing home resident, Settore MED/10 - Malattie Dell'Apparato Respiratorio, Critical Care and Intensive Care Medicine, Microbiology, anaerobic, aspiration, bacteria, pneumonia, risk factors, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Community-acquired pneumonia, Taverne, Anti-Bacterial Agent, medicine, Humans, Community-Acquired Infection, 030212 general & internal medicine, Stroke, Aged, Aged, 80 and over, business.industry, Respiratory Aspiration, Middle Aged, medicine.disease, Antibiotic coverage, Anti-Bacterial Agents, Community-Acquired Infections, Hospitalization, Pneumonia, 030228 respiratory system, Risk factors, risk factor, Female, Underweight, medicine.symptom, business, Cardiology and Cardiovascular Medicine
Abstract

Background: Aspiration community-acquired pneumonia (ACAP) and community-acquired pneumonia (CAP) in patients with aspiration risk factors (AspRFs) are infections associated with anaerobes, but limited evidence suggests their pathogenic role. Research Question: What are the aspiration risk factors, microbiology patterns, and empiric anti-anaerobic use in patients hospitalized with CAP? Study Design and Methods: This is a secondary analysis of GLIMP, an international, multicenter, point-prevalence study of adults hospitalized with CAP. Patients were stratified into three groups: (1) ACAP, (2) CAP/AspRF+ (CAP with AspRF), and (3) CAP/AspRF- (CAP without AspRF). Data on demographics, comorbidities, microbiological results, and anti-anaerobic antibiotics were analyzed in all groups. Patients were further stratified in severe and nonsevere CAP groups. Results: We enrolled 2,606 patients with CAP, of which 193 (7.4%) had ACAP. Risk factors independently associated with ACAP were male, bedridden, underweight, a nursing home resident, and having a history of stroke, dementia, mental illness, and enteral tube feeding. Among non-ACAP patients, 1,709 (70.8%) had CAP/AspRF+ and 704 (29.2%) had CAP/AspRF-. Microbiology patterns including anaerobes were similar between CAP/AspRF-, CAP/AspRF+ and ACAP (0.0% vs 1.03% vs 1.64%). Patients with severe ACAP had higher rates of total gram-negative bacteria (64.3% vs 44.3% vs 33.3%, P =.021) and lower rates of total gram-positive bacteria (7.1% vs 38.1% vs 50.0%, P 50% in all groups) independent of AspRFs or ACAP received specific or broad-spectrum anti-anaerobic coverage antibiotics. Interpretation: Hospitalized patients with ACAP or CAP/AspRF+ had similar anaerobic flora compared with patients without aspiration risk factors. Gram-negative bacteria were more prevalent in patients with severe ACAP. Despite having similar microbiological flora between groups, a large proportion of CAP patients received anti-anaerobic antibiotic coverage.

Published
2021

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