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2. Chronic rhinosinusitis with nasal polyposis and biological agents: the ARIA-ITALY Survey

Author

Lombardi, C., primary, Passalacqua, G., additional, Menzella, F., additional, Mauritz Canevari, R.F, additional, Danesi, G., additional, Pusateri, A.M., additional, Carone, M., additional, Vancheri, C., additional, Di Marco, F., additional, Micheletto, C., additional, Manzotti, G., additional, Di Gioacchino, M, additional, Bilò, M.B, additional, Gelardi, M, additional, Senna, G, additional, Canonica, G.W, additional, and Italy Panel, ARIA, additional

Published
2024
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3. EPH200 Healthcare Resource Consumption of Patients with Chronic Obstructive Pulmonary Disease Treated with Triple and Dual Therapy and Experiencing an Acute Exacerbation

Author

Calabria, S., primary, Ronconi, G., additional, Dondi, L., additional, Piccinni, C., additional, Dell'Anno, I., additional, Pedrini, A., additional, Esposito, I., additional, Brignoli, O., additional, Canonica, G.W., additional, Carone, M., additional, Di Marco, F., additional, Micheletto, C., additional, Vancheri, C., additional, and Martini, N., additional

Published
2023
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4. Inhaled Corticosteroids And Risk Of Tuberculosis In Patients With Obstructive Lung Diseases: A Systematic Review And Meta-Analysis Of Non-randomized Studies

Author

Castellana G, Castellana M, Castellana C, Resta E, Carone M, and Resta O

Subjects
Tuberculosis, Inhaled corticosteroids, Obstructive Lung Disease, Infection Control, Meta-analysis., Diseases of the respiratory system, RC705-779
Abstract

Giorgio Castellana,1,* Marco Castellana,2,* Carlo Castellana,3 Giuseppe Castellana,4 Emanuela Resta,5 Mauro Carone,1 Onofrio Resta6 1Pulmonary Division, Istituti Clinici Scientifici Maugeri SpA SB Pavia, IRCCS Cassano Murge, Bari, Italy; 2Department of Emergency and Organ Transplantation, Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, University of Bari Aldo Moro, Bari, Italy; 3University of Bari Aldo Moro, Bari, Italy; 4Pulmonary Division, District Health Center ASL Bari, Conversano, Italy; 5University of Italian Switzerland, Lugano, Switzerland; 6Cardio-Thoracic Department, Institute of Respiratory Diseases, University of Bari “Aldo Moro”, Bari, Italy*These authors contributed equally to this workCorrespondence: Giorgio CastellanaPulmonary Division, Istituti Clinici Scientifici Maugeri SpA SB Pavia, IRCCS Cassano Murge, Cassano Murge, Bari, ItalyTel +39 80 781 4379Fax +39 80 781 4308Email giorgio.castellana@icsmaugeri.itBackground: An association between systemic corticosteroids and tuberculosis (TB) is reported in the literature. Here within, we conducted a systematic review and meta-analysis to evaluate the effects of inhaled corticosteroids (ICS) on the risk of TB in patients with obstructive lung diseases.Methods: The review was registered on PROSPERO (CRD42018095874). PubMed, CENTRAL, Scopus and Web of Science were searched from inception to September 2018. Papers reporting cases of incident TB in patients with obstructive lung diseases were included; studies without data on ICS use were excluded. Simultaneous use of oral corticosteroids (OCS) and population attributable fraction (PAF) for TB from ICS exposure were also assessed. Data were analyzed using a generic inverse variance method with a random-effects model. ORs with 95% CI were estimated.Results: Out of 4044 retrieved papers, 9 articles evaluating adult patients only were included in the review. 36,351 patients were prescribed ICS, while 147,171 were not. Any ICS use was associated with an increased risk of TB versus no ICS use (OR=1.46; 95% CI 1.06 to 2.01; p=0.02; I2=96%). A similar result was also found for current ICS use versus prior/no ICS use, as well as for high, moderate and low ICS dose versus no ICS. When simultaneous OCS use was evaluated, the independent contribution of ICS was confirmed only in patients not on OCS (OR=1.63; 95% CI 1.05 to 2.52; p=0.03; I2=94%). Only 0.49% of all TB cases could be attributable to ICS exposure.Conclusions: Despite the association between ICS and TB, the contribution of this risk factor to the epidemiology of TB seems to be limited. As a consequence, no population-based interventions are warranted. Rather, this risk should be taken into account on an individual basis, particularly in those patients with a high risk of progression from LTBI to TB.Keywords: tuberculosis, inhaled corticosteroids, obstructive lung disease, infection control, meta-analysis

Published
2019

5. Bacterial load and inflammatory response in sputum of alpha-1 antitrypsin deficiency patients with COPD

Author

Balbi B, Sangiorgi C, Gnemmi I, Ferrarotti I, Vallese D, Paracchini E, Delle Donne L, Corda L, Baderna P, Corsico A, Carone M, Brun P, Cappello F, Ricciardolo FLM, Ruggeri P, Mumby S, Adcock IM, Caramori G, and Di Stefano A

Subjects
Alpha-1 antitrypsin deficiency, COPD, chronic airway inflammation, respiratory disability, sputum, Diseases of the respiratory system, RC705-779
Abstract

Bruno Balbi,1 Claudia Sangiorgi,1 Isabella Gnemmi,1 Ilaria Ferrarotti,2 Davide Vallese,1 Elena Paracchini,1 Lorena Delle Donne,1 Luciano Corda,3 Paolo Baderna,4 Angelo Corsico,2 Mauro Carone,1 Paola Brun,5 Francesco Cappello,6,7 Fabio LM Ricciardolo,8 Paolo Ruggeri,9 Sharon Mumby,10 Ian M Adcock,10 Gaetano Caramori,9 Antonino Di Stefano11Istituti Clinici Scientifici Maugeri, IRCCS, Division of Pneumology and Laboratory of Cytoimmunopathology of the Heart and Lung, Veruno, Italy; 2Department of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy; 3Medicina Respiratoria, Seconda Medicina Interna, Spedali Civili, Brescia, Italy; 4Division of Pneumology, Aosta Hospital, Aosta, Italy; 5Department of Molecular Medicine, University of Padova, Padova, Italy; 6Dipartimento di Biomedicina Sperimentale e Neuroscienze Cliniche, Sezione di Anatomia Umana, Università di Palermo, Palermo, Italy; 7Euro-mediterranean Institute of Science and Technology (IEMEST), Palermo, Italy; 8Department of Clinical and Biological Sciences, A.O.U., San Luigi Gonzaga, Orbassano, University of Turin, Turin, Italy; 9UOC Di Pneumologia, Dipartimento di Scienze Biomediche, Odontoiatriche e Delle Immagini Morfologiche e Funzionali (BIOMORF), Università di Messina, Messina, Italy; 10Airways Disease Section, National Heart and Lung Institute, Imperial College London, UKCorrespondence: Antonino Di StefanoIstituti Clinici Scientifici Maugeri Irccs, Via Maugeri, 4, Pavia 27100, ItalyTel +39 032 288 4711Fax +39 032 288 4776Email antonino.distefano@icsmaugeri.itBackground: Airway inflammation may drive the progression of chronic obstructive pulmonary disease (COPD) associated with alpha-1 antitrypsin deficiency (AATD), but the relationship between airway microbiota and inflammation has not been investigated.Methods: We studied 21 non-treated AATD (AATD-noT) patients, 20 AATD-COPD patients under augmentation therapy (AATD-AT), 20 cigarette smoke-associated COPD patients, 20 control healthy smokers (CS) and 21 non-smokers (CON) with normal lung function. We quantified sputum inflammatory cells and inflammatory markers (IL-27, CCL3, CCL5, CXCL8, LTB4, MPO) by ELISA, total bacterial load (16S) and pathogenic bacteria by qRT-PCR.Results: AATD-AT patients were younger but had similar spirometric and DLCO values compared to cigarette smoke-associated COPD, despite a lower burden of smoking history. Compared to cigarette smoke-associated COPD, AATD-noT and AATD-AT patients had lower sputum neutrophil levels (p=0.0446, p=0.0135), total bacterial load (16S) (p=0.0081, p=0.0223), M. catarrhalis (p=0.0115, p=0.0127) and S. pneumoniae (p=0.0013, p=0.0001). Sputum IL-27 was significantly elevated in CS and cigarette smoke-associated COPD. AATD-AT, but not AATD-noT patients, had IL-27 sputum levels (pg/ml) significantly lower than COPD (p=0.0297) and these positively correlated with FEV1% predicted values (r=0.578, p=0.0307).Conclusions: Compared to cigarette smoke-associated COPD, AATD-AT (COPD) patients have a distinct airway inflammatory and microbiological profile. The decreased sputum bacterial load and IL-27 levels in AATD-AT patients suggests that augmentation therapy play a role in these changes.Keywords: alpha-1 antitrypsin deficiency, COPD, chronic airway inflammation, respiratory disability, sputum

Published
2019

6. Early management of COPD: where are we now and where do we go from here? A Delphi consensus project

Author

Di Marco F, Balbo P, de Blasio F, Cardaci V, Crimi N, Girbino G, Pelaia G, Pirina P, Roversi P, Santus P, Scichilone N, Vatrella A, Pasqualetti P, and Carone M

Subjects
Italy, bronchodilator therapy, respiratory symptoms, dyspnoea, Diseases of the respiratory system, RC705-779
Abstract

Fabiano Di Marco,1 Piero Balbo,2 Francesco de Blasio,3 Vittorio Cardaci,4 Nunzio Crimi,5 Giuseppe Girbino,6 Girolamo Pelaia,7 Pietro Pirina,8 Pietro Roversi,9 Pierachille Santus,10,11 Nicola Scichilone,12 Alessandro Vatrella,13 Patrizio Pasqualetti,14 Mauro Carone15 1Department of Health Sciences, University of Milan, Respiratory Unit, Papa Giovanni XXIII Hospital, Bergamo, Italy; 2SC Malattie dell’Apparato Respiratorio, AOU Maggiore della Carità, Novara, Italy; 3Respiratory Medicine and Pulmonary Rehabilitation Section, Clinic Center S.p.A. Private Hospital, Department of Medicine and Health Sciences “V Tiberio”, University of Molise, Campobasso, Italy; 4Unit of Pulmonary Rehabilitation, IRCCS “San Raffaele Pisana”, Rome, Italy; 5Unità Operativa Complessa di Pneumologia e Allergologia, Policlinico Rodolico Vittorio Emanuele, Università di Catania, Catania, Italy; 6Dipartimento di Scienze Biomediche, Odontoiatriche e delle Immagini Morfologiche e Funzionali (BIOMORF), Università degli Studi di Messina, Messina, Italy; 7Department of Medical and Surgical Sciences, Unit of Respiratory Diseases, University Magna Graecia of Catanzaro, Catanzaro, Italy; 8Respiratory Unit, AOU Sassari, Sassari, Italy; 9Azienda Ospedaliera Universitaria, Policlinico di Modena, Modena, Italy; 10Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy; 11Division of Respiratory Diseases “L. Sacco” Hospital, ASST Fatebenefratelli Sacco, Milan, Italy; 12Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), University of Palermo, Palermo, Italy; 13Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Salerno, Italy; 14Fondazione Fatebenefratelli per la Ricerca e la Formazione Sanitaria e Sociale, Rome, Italy; 15Istituti Clinici Scientifici Maugeri, IRCCS di Cassano delle Murge, Cassano delle Murge (BA), Italy Purpose: There is a lack of consensus on the most appropriate early diagnostic strategy, criteria for early access to treatment and follow-up approach for patients with COPD. Materials and methods: A Delphi consensus project investigated the early management of COPD. We formulated two questionnaires for completion by pneumologists in Italy. Results: A total of 207 specialists completed questionnaire 1 and 184 of them questionnaire 2, between November 2016 and October 2017. Early diagnosis of COPD was considered uncommon for 93.2% of the expert panel. Regardless of the definition of “early diagnosis” – a diagnosis made before the clinical manifestation of the disease for most responders (60.4%) – experts were confident of the positive effects of early disease management, which they consider is effective in modifying the natural history of the disease. Lack of awareness of the disease was considered the first limiting factor to early COPD management for 78% of respondents. The most effective steps to reduce functional decline were considered to be smoking cessation, followed by long-acting β2-agonist (LABA)/long-acting muscarinic antagonist (LAMA), LAMA, LABA, and finally inhaled corticosteroid/LABA (P

Published
2019

7. Disease awareness in patients with COPD: measurement and extent

Author

Baiardini I, Rogliani P, Santus P, Corsico AG, Contoli M, Scichilone N, Di Marco F, Lessi P, Scognamillo C, Molinengo G, Ferri F, Patella V, Fiorentino G, Carone M, and Braido F

Subjects
COPD, awareness, questionnaire, patient satisfaction, Diseases of the respiratory system, RC705-779
Abstract

Ilaria Baiardini,1 Paola Rogliani,2 Pierachille Santus,3 Angelo G Corsico,4 Marco Contoli,5 Nicola Scichilone,6 Fabiano Di Marco,7 Patrizia Lessi,8 Carla Scognamillo,8 Giorgia Molinengo,9 Fabio Ferri,10 Vincenzo Patella,11 Giuseppe Fiorentino,12 Mauro Carone,13 Fulvio Braido14 1Department of Biomedical Sciences, Humanitas University, Milan, Italy; 2Respiratory Unit, Department of Experimental Medicine, University of Rome “Tor Vergata”, Rome, Italy; 3Department of Biomedical and Clinical Sciences (DIBIC), University of Milan, Milan, Italy; 4Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy; 5Department of Medical Sciences, University of Ferrara, Ferrara, Italy; 6Department of Biomedicine and Internal and Specialistic Medicine (DIBIMIS), University of Palermo, Palermo, Italy; 7Department of Health Sciences, University of Milan, Milan, Italy; 8Boehringer Ingelheim, Milan, Italy; 9Department of Psychology, University of Turin, Turin, Italy; 10MediNeos Observational Research, Modena, Italy; 11U.O. di Allergologia e Immunologia Clinica del Dipartimento delle Discipline Mediche, Battipaglia, Italy; 12U.O.C. Malattie, Fisiopatologia e Riabilitazione Respiratoria A.O. dei Colli, Naples, Italy; 13UOC Pneumologia, ICS Maugeri, IRCCS Cassano Murge, Murge, Italy; 14Department of Internal Medicine, Respiratory Diseases and Allergy Clinic, University of Genova, Azienda Policlinico IRCCS San Martino, Genoa, Italy Background: Patient awareness of COPD refers to knowledge and acceptance of the disease and its treatment. Although it is relevant to management and outcomes, the disease awareness of patients is poorly investigated, and no validated questionnaires are currently available. We aimed to develop the novel Disease Awareness in COPD Questionnaire (DACQ), which was validated in relation to demographic and clinical features, in patients participating in the SATisfaction and Adherence to COPD Treatment (SAT) study.Methods: DACQ was developed according to a list of items regarding the patient’s knowledge, acceptance, and perception of COPD as well as of treatment needs. The questionnaire was validated by assessing internal structure and consistency, correlations with other patient-reported outcomes, and stability over time. Furthermore, the extent of disease awareness of patients enrolled in the SAT study was assessed by using DACQ, and correlations with demographic and clinical features were evaluated.Results: DACQ was composed of four domains. Overall reliability and stability over time were adequate; correlations between DACQ and other tools measuring different constructs (ie, treatment satisfaction, illness perception, impact of COPD symptoms on daily life, and dyspnea severity) were, as expected, more limited. In the enrolled patient sample, a suboptimal level of disease awareness (

Published
2018

9. Adherence to GOLD guidelines in real-life COPD management in the Puglia region of Italy

Author

Palmiotti GA, Lacedonia D, Liotino V, Schino P, Satriano F, Di Napoli PL, Sabato E, Mastrosimone V, Scoditti A, Carone M, Costantino E, Resta E, Attolini E, and Foschino Barbaro MP

Subjects
COPD, appropriateness, web-platform, Health care spending, online survey, Diseases of the respiratory system, RC705-779
Abstract

Giuseppe Antonio Palmiotti,1 Donato Lacedonia,1 Vito Liotino,2 Pietro Schino,3 Francesco Satriano,4 Pier Luigi Di Napoli,3 Eugenio Sabato,5 Vincenzo Mastrosimone,6 Alfredo Scoditti,7 Mauro Carone,8 Elio Costantino,9 Emanuela Resta,2 Ettore Attolini,10 Maria Pia Foschino Barbaro1 1Department of Medical and Surgical Sciences, Institute of Respiratory Diseases, University of Foggia, Foggia, Italy; 2Department of Cardiac, Thoracic, and Vascular Science, Institute of Respiratory Diseases, School of Medicine, University of Bari, Bari, Italy; 3Physiopathology Respiratory Unit, F Miulli General Hospital, Acquaviva delle Fonti, Bari, Italy; 4Pneumology Clinic, Vito Fazzi Hospital, Lecce, Italy; 5UOC of Pneumology, “N Melli” Hospital, San Pietro Vernotico, Italy; 6Division of Pulmonary Disease, Medical Center of Rehabilitation, Foundation Salvatore Maugeri, IRCCS, Marina di Ginosa, Italy; 7Department of Respiratory Diseases, San Camillo Clinic, Taranto, Italy; 8Division of Pulmonary Disease, Medical Center of Rehabilitation, Foundation Salvatore Maugeri, IRCCS, Cassano delle Murge, Italy; 9UOC of Pneumology, Hospital “Madonna delle Grazie”, Matera, Italy; 10Regional Health Agency (ARES), Bari, Italy Background: COPD is a disease associated with significant economic burden. It was reported that Global initiative for chronic Obstructive Lung Disease (GOLD) guideline-oriented pharmacotherapy improves airflow limitation and reduces health care costs. However, several studies showed a significant dissociation between international recommendations and clinicians’ practices. The consequent reduced diagnostic and therapeutic inappropriateness has proved to be associated with an increase in costs and a waste of economic resources in the health sector. The aim of the study was to evaluate COPD management in the Puglia region. The study was performed in collaboration with the pulmonology centers and the Regional Health Agency (AReS Puglia). Methods: An IT platform allowed the pulmonologists to enter data via the Internet. All COPD patients who visited a pneumological outpatient clinic for the first time or for regular follow-ups or were admitted to a pneumological department for an exacerbation were considered eligible for the study. COPD’s diagnosis was confirmed by a pulmonologist at the moment of the visit. The project lasted 18 months and involved 17 centers located in the Puglia region. Results: Six hundred ninety-three patients were enrolled, evenly distributed throughout the region. The mean age was 71±9 years, and 85% of them were males. Approximately 23% were current smokers, 63% former smokers and 13.5% never smokers. The mean post-bronchodilator forced expiratory volume in 1 second was 59%±20% predicted. The platform allowed the classification of patients according to the GOLD guidelines (Group A: 20.6%, Group B: 32.3%, Group C: 5.9% and Group D: 39.2%), assessed the presence and severity of exacerbations (20% of the patients had an exacerbation defined as mild [13%], moderate [37%] and severe [49%]) and evaluated the appropriateness of inhalation therapy at the time of the visit. Forty-nine percent of Group A patients were following inappropriate therapy; in Group B, 45.8% were following a therapy in contrast with the guidelines. Among Group C patients, 41.46% resulted in triple combination therapy, while ~14% of Group D patients did not have a therapy or were following an inappropriate therapy. In conclusion, 30% of all patients evaluated had been following an inadequate therapy. Subsequently, an online survey was developed to inquire about the reasons for the results obtained. In particular, we investigated the reasons why 30% of our population did not follow the therapy suggested by the GOLD guidelines: 1) why was there an excessive use of inhaled corticosteroids, 2) why a significantly high percentage was inappropriately treated with triple therapy and 3) why a consistent percentage (11%) of Group D patients were not treated at all. Conclusion: The data provides an overview on the management of COPD in the region of Puglia (Italy) and represents a resource in order to improve appropriateness and reduce the waste of health resources. Keywords: COPD, appropriateness, web platform, health care spending, online survey

Published
2018

11. Development of a Barthel Index based on dyspnea for patients with respiratory diseases

Author

Vitacca M, Paneroni M, Baiardi P, De Carolis V, Zampogna E, Belli S, Carone M, Spanevello A, Balbi B, and Bertolotti G

Subjects
ADLs, psychometric tests, COPD, pulmonary rehabilitation, Diseases of the respiratory system, RC705-779
Abstract

Michele Vitacca,1 Mara Paneroni,1 Paola Baiardi,2 Vito De Carolis,3 Elisabetta Zampogna,4 Stefano Belli,5 Mauro Carone,3 Antonio Spanevello,4,6 Bruno Balbi,5 Giorgio Bertolotti7 1Respiratory Rehabilitation Division, Salvatore Maugeri Foundation, IRCCS, Institute of Lumezzane, Brescia, 2Scientific Direction, Salvatore Maugeri Foundation, IRCCS, Institute of Pavia, Pavia, 3Respiratory Division, Salvatore Maugeri Foundation, IRCCS, Institute of Cassano delle Murge, Bari, 4Respiratory Division, Salvatore Maugeri Foundation, IRCCS, Institute of Tradate, Varese, 5Respiratory Division, Salvatore Maugeri Foundation, IRCCS, Institute of Veruno, Novara, 6Respiratory Diseases Unit, University of Insubria, Varese, 7Psychology Unit, Salvatore Maugeri Foundation, IRCCS, Institute of Tradate, Varese, Italy Background: As Barthel Index (BI) quantifies motor impairment but not breathlessness, the use of only this index could underestimate disability in chronic respiratory disease (CRD). To our knowledge, no study evaluates both motor and respiratory disability in CRD during activities of daily living (ADLs) simultaneously and with a unique tool. The objective of this study was to propose for patients with CRD an additional tool for dyspnea assessment during ADLs based on BI items named Barthel Index dyspnea.Methods: Comprehensibility, reliability, internal consistency, validity, responsiveness, and ability to differentiate between disease groups were assessed on 219 subjects through an observational study performed in an in-hospital rehabilitation setting.Results: Good comprehensibility, high reliability (interrater intraclass correlation coefficient was 0.93 [95% confidence interval 0.892–0.964] and test–retest intraclass correlation coefficient was 0.99 [95% confidence interval 0.983–0.994]), good internal consistency (Cronbach’s alpha 0.89), strong concurrent validity with 6 minute walking distance (Pearson r=–0.538, P

Published
2016

12. Bacterial–viral load and the immune response in stable and exacerbated COPD: significance and therapeutic prospects

Author

D’Anna SE, Balbi B, Cappello F, Carone M, and Di Stefano A

Subjects
COPD Phenotype, Biomarkers, Exacerbations, Severity of COPD, microbiome, Diseases of the respiratory system, RC705-779
Abstract

Silvestro Ennio D’Anna,1 Bruno Balbi,2 Francesco Cappello,3,4 Mauro Carone,2 Antonino Di Stefano21Department of Rehabilitation, Cardiorespiratory Unit, Fondazione Istituto G. Giglio di Cefalù, 2Pneumology Unit and Laboratory of Cytoimmunopathology of Heart and Lung, Fondazione Salvatore Maugeri, IRCCS, Veruno (NO) and Cassano delle Murge (BA), 3Human Anatomy Section, Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Palermo, Italy; 4Euro-Mediterranean Institute of Science and Technology, Palermo, ItalyAbstract: Chronic obstructive pulmonary disease (COPD) is characterized by persistent airflow limitation and an abnormal inflammatory response of the lung. Bacteria and viruses are a major cause of COPD exacerbations and may contribute to COPD progression by perpetuating the inflammatory response in the airways. Bacterial variety diminishes with increasing COPD severity. Respiratory viruses can colonize the lower respiratory tract in stable COPD, altering the respiratory microbiome and facilitating secondary bacterial infections. In this review, we present the most updated information about the role of bacteria and viruses in stable and exacerbated COPD. In our opinion, to optimize therapeutic strategies, the dynamic events involving bacterial–viral infections and related immune response in COPD phenotypes need to be better clarified. Our paper would address these points that we consider of great importance for the clinical management of COPD.Keywords: COPD phenotype, biomarkers, exacerbations, severity of COPD, microbiome

Published
2016

13. The Barthel index-dyspnea a tool for respiratory rehabilitation: reply to the letter by Chuang [Letter of clarification]

Author

Carone M, Vitacca M, Paneroni M, Baiardi P, Spanevello A, and Bertolotti G

Subjects
Barthel, COPD, Respiratory Rehabilitation, Diseases of the respiratory system, RC705-779
Abstract

Mauro Carone,1 Michele Vitacca,2 Mara Paneroni,2 Paola Baiardi,3 Antonio Spanevello,4,5 Giorgio Bertolotti6 1Respiratory Division, ICS MAUGERI SPA SB, Institute of Cassano Murge (BA) IRCCS, Italy; 2Respiratory Rehabilitation Division, ICS MAUGERI SPA SB, Institute of Lumezzane (BS) IRCCS, Italy; 3Scientific Direction, ICS MAUGERI SPA SB, Institute of Pavia, IRCCS, Italy; 4Respiratory Rehabilitation Division, ICS MAUGERI SPA SB, Institute of Tradate (VA) IRCCS, Italy; 5Respiratory Diseases Unit, University of Insubria, Varese; 6Psychology Unit, ICS MAUGERI SPA SB, Institute of Tradate (VA) IRCCS, Italy We read the remarkable letter by Chuang.1 We thank him for his valid suggestions on our paper. Interestingly, he focused on the two dimensions of the Barthel index-dyspnea (BI-d), which was exactly our goal. As rehabilitators, our goal is to provide patients with physical therapy depending on their health status and to improve their respiratory function. We need to verify and demonstrate the efficacy and the outcomes of respiratory rehabilitation, supported by physical therapy. For these reasons, we need an assessment device that measures respiratory improvement during daily motor activities that should be monitored.The modified Barthel index2 is a well-consolidated and widely used instrument to assess the performance of a person in a predetermined and fixed set of activities of daily living (ADLs). By proposing BI-d,3 we aimed to develop a scale to measure how dyspnea precludes or reduces the same ADLs, with the ultimate goal of globally assessing the effectiveness of rehabilitation. Hence, an assessment method that measures the impact of dyspnea on activities monitored by a rehabilitation program is of utmost importance for rehabilitators. Large part of Chuang’s letter is based on the Chronic Respiratory Questionnaire-dyspnea (CRQ-d). The CRQ-d is a health-related quality of life (health status) questionnaire, with a dyspnea “domain”.4 However, for our purposes, the CRQ-d is too individualized as each subject selects five activity items – “the most important” – out of 26 listed activities. Therefore, each subject may choose different items from other subjects in the same study group. Due to this significant methodology, CRQ was standardized recently into a version that contains a total of only five items with a dyspnea domain, all of which have to be responded.5 View the original paper by Vitacca et alView the original letter by Chuang

Published
2017

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

Author

Marin-Corral, J, Pascual-Guardia, S, Amati, F, Aliberti, S, Masclans, J, Soni, N, Rodriguez, A, Sibila, O, Sanz, F, Sotgiu, G, Anzueto, A, Dimakou, K, Petrino, R, van de Garde, E, Restrepo, M, Aruj, P, Attorri, S, Barimboim, E, Caeiro, J, Garzon, M, Cambursano, V, Adrian Ceccato, V, Chertcoff, J, Lascar, F, Di Tulio, F, Diaz, A, de Vedia, L, Ganaha, M, Lambert, S, Lopardo, G, Luna, C, Malberti, A, Morcillo, N, Tartara, S, Pensotti, C, Pereyra, B, Scapellato, P, Stagnaro, J, Shah, S, Lotsch, F, Thalhammer, F, Anseeuw, K, Francois, C, Van Braeckel, E, Vincent, J, Djimon, M, Bashi, J, Dodo, R, Nouer, S, Chipev, P, Encheva, M, Miteva, D, Petkova, D, Balkissou, A, Pefura Yone, E, Mbatchou Ngahane, B, Shen, N, Xu, J, Bustamante Rico, C, Buitrago, R, Pereira Paternina, F, Kayembe Ntumba, J, Carevic, V, Jakopovic, M, Jankovic, M, Matkovic, Z, Mitrecic, I, Bouchy Jacobsson, M, Christensen, A, Heitmann Bodtger, U, Meyer, C, Jensen, A, Baunbaek-knudsen, G, Petersen, P, Andersen, S, El-Said Abd El-Wahhab, I, Morsy, N, Shafiek, H, Sobh, E, Abdulsemed, K, Bertrand, F, Brun-Buisson, C, de Montmollin, E, Fartoukh, M, Messika, J, Tattevin, P, Khoury, A, Ebruke, B, Dreher, M, Kolditz, M, Meisinger, M, Pletz, M, Hagel, S, Rupp, J, Schaberg, T, Spielmanns, M, Creutz, P, Suttorp, N, Siaw-Lartey, B, Papapetrou, D, Tsigou, E, Ampazis, D, Kaimakamis, E, Bhatia, M, Dhar, R, D'Souza, G, Garg, R, Koul, P, Mahesh, P, Jayaraj, B, Narayan, K, Udnur, H, Krishnamurthy, S, Kant, S, Swarnakar, R, Limaye, S, Salvi, S, Golshani, K, Keatings, V, Martin-Loeches, I, Maor, Y, Strahilevitz, J, Faverio, P, Battaglia, S, Carrabba, M, Ceriana, P, Confalonieri, M, Monforte, A, Del Prato, B, De Rosa, M, Fantini, R, Fiorentino, G, Gammino, M, Menzella, F, Milani, G, Nava, S, Palmiero, G, Gabrielli, B, Rossi, P, Sorino, C, Steinhilber, G, Zanforlin, A, San Luca, O, Franzetti, F, Carugati, M, Morosi, M, Monge, E, Carone, M, Patella, V, Scarlata, S, Comel, A, Kurahashi, K, Bacha, Z, Ugalde, D, Zuniga, O, Villegas, J, Medenica, M, Mihsra, D, Shrestha, P, Ridgeon, E, Awokola, B, Adefuye Bolanle Olufunlola, O, Olumide, S, Ukwaja, K, Irfan, M, Minarowski, L, Szymon, S, Froes, F, Leuschner, P, Meireles, M, Ferrao, C, Neves, J, Abel, S, Ravara, S, Brocovschii, V, Rusu, D, Toma, C, Chirita, D, Dorobat, C, Birkun, A, Kaluzhenina, A, Almotairi, A, Ali Bukhary, Z, Edathodu, J, Fathy, A, Abdulaziz Enani, A, Mohamed, N, Memon, J, Bella, A, Bogdanovic, S, Milenkovic, B, Pesut, D, Borderias, L, Bordon Garcia, N, Alarcon, H, Cilloniz, C, Torres, A, Diaz-Brito, V, Casas, X, Gonzalez, A, Fernandez-Almira, M, Interna, M, Gallego, M, Gaspar-GarcIa, I, Gonzalez del Castillo, J, Victoria, P, Martinez, E, Malo de Molina, R, Marcos, P, Menendez, R, Pando-Sandoval, A, Aymerich, C, Lacoma de la Torre, A, Garcia-Olive, I, Rello, J, Moyano, S, Rodrigo-Troyano, A, Sole-Violan, J, Uranga, A, van Boven, J, Torra, E, Pujol, J, Feldman, C, Yum, H, Arnauld Attannon Fiogbe, I, Yangui, F, Bilaceroglu, S, Levent Dalar, I, Yilmaz, U, Bogomolov, A, Elahi, N, Dhasmana, D, Feneley, A, Hill, A, Rudran, B, Ruiz-Buitrago, S, Campbell, M, Whitaker, P, Youzguin, A, Singanayagam, A, Hancock, C, Villafuerte, D, Allen, K, Brito, V, Dietz, J, Dysart, C, Kellie, S, Ricardo, A, Meier, G, Gaga, M, Holland, T, Bergin, S, Kheir, F, Landmeier, M, Lois, M, Nair, G, Patel, H, Reyes, K, Rodriguez-Cintron, W, Saito, S, Noda, J, Hinojosa, C, Levine, S, Reyes, L, Angel, L, Whitlow, K, Hipskind, J, Sukhija, K, Totten, V, Wunderink, R, Shah, R, Mateyo, K, Noriega, L, Alvarado, E, Aman, M, Labra, L, Marin-Corral J., Pascual-Guardia S., Amati F., Aliberti S., Masclans J. R., Soni N., Rodriguez A., Sibila O., Sanz F., Sotgiu G., Anzueto A., Dimakou K., Petrino R., van de Garde E., Restrepo M. I., Aruj P. K., Attorri S., Barimboim E., Caeiro J. P., Garzon M. I., Cambursano V. H., Adrian Ceccato V. H. D. C. A., Chertcoff J., Lascar F., Di Tulio F., 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., Anseeuw K., Francois C. A., Van Braeckel E., Vincent J. L., Djimon M. Z., Bashi J., Dodo R., Nouer S. A., Chipev P., Encheva M., Miteva D., Petkova D., Balkissou A. D., Pefura Yone E. W., Mbatchou Ngahane B. H., Shen N., Xu J. -F., Bustamante Rico C. A., Buitrago R., Pereira Paternina F. J., Kayembe Ntumba J. -M., Carevic V. V., Jakopovic M., Jankovic M., Matkovic Z., Mitrecic I., Bouchy Jacobsson M. -L., Christensen A. B., Heitmann Bodtger U. C., Meyer C. N., Jensen A. V., Baunbaek-knudsen G., Petersen P. T., Andersen S., El-Said Abd El-Wahhab I., Morsy N. E., Shafiek H., Sobh E., Abdulsemed K. A., Bertrand F., Brun-Buisson C., de Montmollin E., Fartoukh M., Messika J., Tattevin P., Khoury A., Ebruke B., Dreher M., Kolditz M., Meisinger M., Pletz M. W., Hagel S., Rupp J., Schaberg T., Spielmanns M., Creutz P., Suttorp N., Siaw-Lartey B., Papapetrou D., Tsigou E., Ampazis D., Kaimakamis E., 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., Kant S., Swarnakar R., Limaye S., Salvi S., Golshani K., Keatings V. M., Martin-Loeches I., Maor Y., Strahilevitz J., Faverio P., Battaglia S., Carrabba M., Ceriana P., Confalonieri M., Monforte A. D., Del Prato B., De Rosa M., Fantini R., Fiorentino G., Gammino M. A., Menzella F., Milani G., Nava S., Palmiero G., Gabrielli B., Rossi P., Sorino C., Steinhilber G., Zanforlin A., San Luca O., Franzetti F., Carugati M., Morosi M., Monge E., Carone M., Patella V., Scarlata S., Comel A., Kurahashi K., Bacha Z. A., Ugalde D. B., Zuniga O. C., Villegas J. F., Medenica M., Mihsra D. R., Shrestha P., Ridgeon E., Awokola B. I., Adefuye Bolanle Olufunlola O. N. O., Olumide S., Ukwaja K. N., Irfan M., Minarowski L., Szymon S., Froes F., Leuschner P., Meireles M., Ferrao C., Neves J., Abel Salazar, Ravara S. B., Brocovschii V., Rusu D., Toma C., Chirita D., Dorobat C. M., Birkun A., Kaluzhenina A., Almotairi A., Ali Bukhary Z. A., Edathodu J., Fathy A., Abdulaziz Enani A. M., Mohamed N. E., Memon J. U., Bella A., Bogdanovic S. N., Milenkovic B., Pesut D., Borderias L., Bordon Garcia N. M., Alarcon H. C., Cilloniz C., Torres A., Diaz-Brito V., Casas X., Gonzalez A. E., Fernandez-Almira M. L., Interna M., Gallego M., Gaspar-GarcIa I., Gonzalez del Castillo J., Victoria P. J., Martinez E. L., Malo de Molina R., Marcos P. J., Menendez R., Pando-Sandoval A., Aymerich C. P., Lacoma de la Torre A., Garcia-Olive I., Rello J., Moyano S., Rodrigo-Troyano A., Sole-Violan J., Uranga A., van Boven J. F., Torra E. V., Pujol J. A., Feldman C., Yum H. K., Arnauld Attannon Fiogbe I. U., Yangui F., Bilaceroglu S., Levent Dalar I. D., Yilmaz U., Bogomolov A., Elahi N., Dhasmana D. J., Feneley A., Hill A. T., Rudran B., Ruiz-Buitrago S., Campbell M., Whitaker P., Youzguin A., Singanayagam A., Hancock C., Villafuerte D., Allen K. S., Brito V., Dietz J., Dysart C. E., Kellie S. M., Ricardo A. Franco-Sadud C. J., 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., Noda J., Hinojosa C. I., Levine S. M., Reyes L. F., Angel L. F., Whitlow K. S., Hipskind J., Sukhija K., Totten V., Wunderink R. G., Shah R. D., Mateyo K. J., Noriega L., Alvarado E., Aman M., Labra L., Marin-Corral, J, Pascual-Guardia, S, Amati, F, Aliberti, S, Masclans, J, Soni, N, Rodriguez, A, Sibila, O, Sanz, F, Sotgiu, G, Anzueto, A, Dimakou, K, Petrino, R, van de Garde, E, Restrepo, M, Aruj, P, Attorri, S, Barimboim, E, Caeiro, J, Garzon, M, Cambursano, V, Adrian Ceccato, V, Chertcoff, J, Lascar, F, Di Tulio, F, Diaz, A, de Vedia, L, Ganaha, M, Lambert, S, Lopardo, G, Luna, C, Malberti, A, Morcillo, N, Tartara, S, Pensotti, C, Pereyra, B, Scapellato, P, Stagnaro, J, Shah, S, Lotsch, F, Thalhammer, F, Anseeuw, K, Francois, C, Van Braeckel, E, Vincent, J, Djimon, M, Bashi, J, Dodo, R, Nouer, S, Chipev, P, Encheva, M, Miteva, D, Petkova, D, Balkissou, A, Pefura Yone, E, Mbatchou Ngahane, B, Shen, N, Xu, J, Bustamante Rico, C, Buitrago, R, Pereira Paternina, F, Kayembe Ntumba, J, Carevic, V, Jakopovic, M, Jankovic, M, Matkovic, Z, Mitrecic, I, Bouchy Jacobsson, M, Christensen, A, Heitmann Bodtger, U, Meyer, C, Jensen, A, Baunbaek-knudsen, G, Petersen, P, Andersen, S, El-Said Abd El-Wahhab, I, Morsy, N, Shafiek, H, Sobh, E, Abdulsemed, K, Bertrand, F, Brun-Buisson, C, de Montmollin, E, Fartoukh, M, Messika, J, Tattevin, P, Khoury, A, Ebruke, B, Dreher, M, Kolditz, M, Meisinger, M, Pletz, M, Hagel, S, Rupp, J, Schaberg, T, Spielmanns, M, Creutz, P, Suttorp, N, Siaw-Lartey, B, Papapetrou, D, Tsigou, E, Ampazis, D, Kaimakamis, E, Bhatia, M, Dhar, R, D'Souza, G, Garg, R, Koul, P, Mahesh, P, Jayaraj, B, Narayan, K, Udnur, H, Krishnamurthy, S, Kant, S, Swarnakar, R, Limaye, S, Salvi, S, Golshani, K, Keatings, V, Martin-Loeches, I, Maor, Y, Strahilevitz, J, Faverio, P, Battaglia, S, Carrabba, M, Ceriana, P, Confalonieri, M, Monforte, A, Del Prato, B, De Rosa, M, Fantini, R, Fiorentino, G, Gammino, M, Menzella, F, Milani, G, Nava, S, Palmiero, G, Gabrielli, B, Rossi, P, Sorino, C, Steinhilber, G, Zanforlin, A, San Luca, O, Franzetti, F, Carugati, M, Morosi, M, Monge, E, Carone, M, Patella, V, Scarlata, S, Comel, A, Kurahashi, K, Bacha, Z, Ugalde, D, Zuniga, O, Villegas, J, Medenica, M, Mihsra, D, Shrestha, P, Ridgeon, E, Awokola, B, Adefuye Bolanle Olufunlola, O, Olumide, S, Ukwaja, K, Irfan, M, Minarowski, L, Szymon, S, Froes, F, Leuschner, P, Meireles, M, Ferrao, C, Neves, J, Abel, S, Ravara, S, Brocovschii, V, Rusu, D, Toma, C, Chirita, D, Dorobat, C, Birkun, A, Kaluzhenina, A, Almotairi, A, Ali Bukhary, Z, Edathodu, J, Fathy, A, Abdulaziz Enani, A, Mohamed, N, Memon, J, Bella, A, Bogdanovic, S, Milenkovic, B, Pesut, D, Borderias, L, Bordon Garcia, N, Alarcon, H, Cilloniz, C, Torres, A, Diaz-Brito, V, Casas, X, Gonzalez, A, Fernandez-Almira, M, Interna, M, Gallego, M, Gaspar-GarcIa, I, Gonzalez del Castillo, J, Victoria, P, Martinez, E, Malo de Molina, R, Marcos, P, Menendez, R, Pando-Sandoval, A, Aymerich, C, Lacoma de la Torre, A, Garcia-Olive, I, Rello, J, Moyano, S, Rodrigo-Troyano, A, Sole-Violan, J, Uranga, A, van Boven, J, Torra, E, Pujol, J, Feldman, C, Yum, H, Arnauld Attannon Fiogbe, I, Yangui, F, Bilaceroglu, S, Levent Dalar, I, Yilmaz, U, Bogomolov, A, Elahi, N, Dhasmana, D, Feneley, A, Hill, A, Rudran, B, Ruiz-Buitrago, S, Campbell, M, Whitaker, P, Youzguin, A, Singanayagam, A, Hancock, C, Villafuerte, D, Allen, K, Brito, V, Dietz, J, Dysart, C, Kellie, S, Ricardo, A, Meier, G, Gaga, M, Holland, T, Bergin, S, Kheir, F, Landmeier, M, Lois, M, Nair, G, Patel, H, Reyes, K, Rodriguez-Cintron, W, Saito, S, Noda, J, Hinojosa, C, Levine, S, Reyes, L, Angel, L, Whitlow, K, Hipskind, J, Sukhija, K, Totten, V, Wunderink, R, Shah, R, Mateyo, K, Noriega, L, Alvarado, E, Aman, M, Labra, L, Marin-Corral J., Pascual-Guardia S., Amati F., Aliberti S., Masclans J. R., Soni N., Rodriguez A., Sibila O., Sanz F., Sotgiu G., Anzueto A., Dimakou K., Petrino R., van de Garde E., Restrepo M. I., Aruj P. K., Attorri S., Barimboim E., Caeiro J. P., Garzon M. I., Cambursano V. H., Adrian Ceccato V. H. D. C. A., Chertcoff J., Lascar F., Di Tulio F., 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., Anseeuw K., Francois C. A., Van Braeckel E., Vincent J. L., Djimon M. Z., Bashi J., Dodo R., Nouer S. A., Chipev P., Encheva M., Miteva D., Petkova D., Balkissou A. D., Pefura Yone E. W., Mbatchou Ngahane B. H., Shen N., Xu J. -F., Bustamante Rico C. A., Buitrago R., Pereira Paternina F. J., Kayembe Ntumba J. -M., Carevic V. V., Jakopovic M., Jankovic M., Matkovic Z., Mitrecic I., Bouchy Jacobsson M. -L., Christensen A. B., Heitmann Bodtger U. C., Meyer C. N., Jensen A. V., Baunbaek-knudsen G., Petersen P. T., Andersen S., El-Said Abd El-Wahhab I., Morsy N. E., Shafiek H., Sobh E., Abdulsemed K. A., Bertrand F., Brun-Buisson C., de Montmollin E., Fartoukh M., Messika J., Tattevin P., Khoury A., Ebruke B., Dreher M., Kolditz M., Meisinger M., Pletz M. W., Hagel S., Rupp J., Schaberg T., Spielmanns M., Creutz P., Suttorp N., Siaw-Lartey B., Papapetrou D., Tsigou E., Ampazis D., Kaimakamis E., 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., Kant S., Swarnakar R., Limaye S., Salvi S., Golshani K., Keatings V. M., Martin-Loeches I., Maor Y., Strahilevitz J., Faverio P., Battaglia S., Carrabba M., Ceriana P., Confalonieri M., Monforte A. D., Del Prato B., De Rosa M., Fantini R., Fiorentino G., Gammino M. A., Menzella F., Milani G., Nava S., Palmiero G., Gabrielli B., Rossi P., Sorino C., Steinhilber G., Zanforlin A., San Luca O., Franzetti F., Carugati M., Morosi M., Monge E., Carone M., Patella V., Scarlata S., Comel A., Kurahashi K., Bacha Z. A., Ugalde D. B., Zuniga O. C., Villegas J. F., Medenica M., Mihsra D. R., Shrestha P., Ridgeon E., Awokola B. I., Adefuye Bolanle Olufunlola O. N. O., Olumide S., Ukwaja K. N., Irfan M., Minarowski L., Szymon S., Froes F., Leuschner P., Meireles M., Ferrao C., Neves J., Abel Salazar, Ravara S. B., Brocovschii V., Rusu D., Toma C., Chirita D., Dorobat C. M., Birkun A., Kaluzhenina A., Almotairi A., Ali Bukhary Z. A., Edathodu J., Fathy A., Abdulaziz Enani A. M., Mohamed N. E., Memon J. U., Bella A., Bogdanovic S. N., Milenkovic B., Pesut D., Borderias L., Bordon Garcia N. M., Alarcon H. C., Cilloniz C., Torres A., Diaz-Brito V., Casas X., Gonzalez A. E., Fernandez-Almira M. L., Interna M., Gallego M., Gaspar-GarcIa I., Gonzalez del Castillo J., Victoria P. J., Martinez E. L., Malo de Molina R., Marcos P. J., Menendez R., Pando-Sandoval A., Aymerich C. P., Lacoma de la Torre A., Garcia-Olive I., Rello J., Moyano S., Rodrigo-Troyano A., Sole-Violan J., Uranga A., van Boven J. F., Torra E. V., Pujol J. A., Feldman C., Yum H. K., Arnauld Attannon Fiogbe I. U., Yangui F., Bilaceroglu S., Levent Dalar I. D., Yilmaz U., Bogomolov A., Elahi N., Dhasmana D. J., Feneley A., Hill A. T., Rudran B., Ruiz-Buitrago S., Campbell M., Whitaker P., Youzguin A., Singanayagam A., Hancock C., Villafuerte D., Allen K. S., Brito V., Dietz J., Dysart C. E., Kellie S. M., Ricardo A. Franco-Sadud C. J., 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., Noda J., Hinojosa C. I., Levine S. M., Reyes L. F., Angel L. F., Whitlow K. S., Hipskind J., Sukhija K., Totten V., Wunderink R. G., Shah R. D., Mateyo K. J., Noriega L., Alvarado E., Aman M., and Labra L.

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 <.001) when compared with patients with severe CAP/AspRF+ and severe CAP/AspRF-, respectively. Most patients (>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

Published
2021

15. ESICM LIVES 2016: part three: Milan, Italy. 1–5 October 2016

Author

Velasquez, T., Mackey, G., Lusk, J., Kyle, U. G., Fontenot, T., Marshall, P., Shekerdemian, L. S., Coss-Bu, J. A., Nishigaki, A., Yatabe, T., Tamura, T., Yamashita, K., Yokoyama, M., Ruiz-Rodriguez, J. C., Encina, B., Belmonte, R., Troncoso, I., Tormos, P., Riveiro, M., Baena, J., Sanchez, A., Bañeras, J., Cordón, J., Duran, N., Ruiz, A., Caballero, J., Nuvials, X., Riera, J., Serra, J., Rutten, A. M. F., van Ieperen, S. N. M., Der Kinderen, E. P. H. M., Van Logten, T., Kovacikova, L., Skrak, P., Zahorec, M., Kyle, U. G., Akcan-Arikan, A., Silva, J. C., Mackey, G., Lusk, J., Goldsworthy, M., Shekerdemian, L. S., Coss-Bu, J. A., Wood, D., Harrison, D., Parslow, R., Davis, P., Pappachan, J., Goodwin, S., Ramnarayan, P., Chernyshuk, S., Yemets, H., Zhovnir, V., Pulitano’, S. M., De Rosa, S., Mancino, A., Villa, G., Tosi, F., Franchi, P., Conti, G., Patel, B., Khine, H., Shah, A., Sung, D., Singer, L., Haghbin, S., Inaloo, S., Serati, Z., Idei, M., Nomura, T., Yamamoto, N., Sakai, Y., Yoshida, T., Matsuda, Y., Yamaguchi, Y., Takaki, S., Yamaguchi, O., Goto, T., Longani, N., Medar, S., Abdel-Aal, I. R., El Adawy, A. S., Mohammed, H. M. E. H., Mohamed, A. N., Parry, S. M., Knight, L. D., Denehy, L., De Morton, N., Baldwin, C. E., Sani, D., Kayambu, G., da Silva, V. Z. M., Phongpagdi, P., Puthucheary, Z. A., Granger, C. L., Rydingsward, J. E., Horkan, C. M., Christopher, K. B., McWilliams, D., Jones, C., Reeves, E., Atkins, G., Snelson, C., Aitken, L. M., Rattray, J., Kenardy, J., Hull, A. M., Ullman, A., Le Brocque, R., Mitchell, M., Davis, C., Macfarlane, B., Azevedo, J. C., Rocha, L. L., De Freitas, F. F. M., Cavalheiro, A. M., Lucinio, N. M., Lobato, M. S., Ebeling, G., Kraegpoeth, A., Laerkner, E., De Brito-Ashurst, I., White, C., Gregory, S., Forni, L. G., Flowers, E., Curtis, A., Wood, C. A., Siu, K., Venkatesan, K., Muhammad, J. B. H., Ng, L., Seet, E., Baptista, N., Escoval, A., Tomas, E., Agrawal, R., Mathew, R., Varma, A., Dima, E., Charitidou, E., Perivolioti, E., Pratikaki, M., Vrettou, C., Giannopoulos, A., Zakynthinos, S., Routsi, C., Atchade, E., Houzé, S., Jean-Baptiste, S., Thabut, G., Genève, C., Tanaka, S., Lortat-Jacob, B., Augustin, P., Desmard, M., Montravers, P., de Molina, F. J. González, Barbadillo, S., Alejandro, R., Álvarez-Lerma, F., Vallés, J., Catalán, R. M., Palencia, E., Jareño, A., Granada, R. M., Ignacio, M. 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2016
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16. Prevalence and risk factors for Enterobacteriaceae in patients hospitalized with community-acquired pneumonia

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Villafuerte, D, Aliberti, S, Soni, N, Faverio, P, Marcos, P, Wunderink, R, Rodriguez, A, Sibila, O, Sanz, F, Martin-Loeches, I, Menzella, F, Reyes, L, Jankovic, M, Spielmanns, M, Restrepo, M, Aruj, P, Attorri, S, Barimboim, E, Caeiro, J, Garzon, M, Cambursano, V, Ceccato, A, Chertcoff, J, Cordon Diaz, A, de Vedia, L, Ganaha, M, Lambert, S, Lopardo, G, Luna, C, Malberti, A, Morcillo, N, Tartara, S, Pensotti, C, Pereyra, B, Scapellato, P, Stagnaro, J, Shah, S, Lotsch, F, Thalhammer, F, Anseeuw, K, Francois, C, Van Braeckel, E, Vincent, J, Djimon, M, Nouer, S, Chipev, P, Encheva, M, Miteva, D, Petkova, D, Balkissou, A, Yone, E, Ngahane, B, Shen, N, Xu, J, Rico, C, Buitrago, R, Paternina, F, Ntumba, J, Carevic, V, Jakopovic, M, Matkovic, Z, Mitrecic, I, Jacobsson, M, Christensen, A, Heitmann Bodtger, U, Meyer, C, Jensen, A, El-Said Abd El-Wahhab, I, Morsy, N, Shafiek, H, Sobh, E, Abdulsemed, K, Bertrand, F, Brun-Buisson, C, Montmollin, E, Fartoukh, M, Messika, J, Tattevin, P, Khoury, A, Ebruke, B, Dreher, M, Kolditz, M, Meisinger, M, Pletz, M, Hagel, S, Rupp, J, Schaberg, T, Creutz, P, Suttorp, N, Siaw-Lartey, B, Dimakou, K, Papapetrou, D, Tsigou, E, Ampazis, D, Kaimakamis, E, Bhatia, M, Dhar, R, D'Souza, G, Garg, R, Koul, P, Mahesh, P, Jayaraj, B, Narayan, K, Udnur, H, Krishnamurthy, S, Kant, S, Swarnakar, R, Limaye, S, Salvi, S, Golshani, K, Keatings, V, Maor, Y, Strahilevitz, J, Battaglia, S, Carrabba, M, Ceriana, P, Confalonieri, M, Monforte, A, Prato, B, Rosa, M, Fantini, R, Fiorentino, G, Gammino, M, Milani, G, Nava, S, Palmiero, G, Petrino, R, Gabrielli, B, Rossi, P, Sorino, C, Steinhilber, G, Zanforlin, A, Franzetti, F, Carone, M, Patella, V, Scarlata, S, Comel, A, Kurahashi, K, Bacha, Z, Ugalde, D, Zuniga, O, Villegas, J, Medenica, M, van de Garde, E, Mihsra, D, Shrestha, P, Ridgeon, E, Awokola, B, Nwankwo, O, Olufunlola, A, Olumide, S, Ukwaja, K, Irfan, M, Minarowski, L, Szymon, S, Froes, F, Leuschner, P, Meireles, M, Ravara, S, Brocovschii, V, Ion, C, Rusu, D, Toma, C, Chirita, D, Dorobat, C, Birkun, A, Kaluzhenina, A, Almotairi, A, Bukhary, Z, Edathodu, J, Fathy, A, Enani, A, Mohamed, N, Memon, J, Bella, A, Bogdanovic, N, Milenkovic, B, Pesut, D, Borderias, L, Garcia, N, Cabello Alarcon, H, Cilloniz, C, Torres, A, Diaz-Brito, V, Casas, X, Gonzalez, A, Fernandez-Almira, M, Gallego, M, Gaspar-Garcia, I, Castillo, J, Victoria, P, Laserna Martinez, E, Molina, R, Menendez, R, Pando-Sandoval, A, Aymerich, C, Rello, J, Moyano, S, Rodrigo-Troyano, A, Sole-Violan, J, Uranga, A, van Boven, J, Torra, E, Pujol, J, Feldman, C, Yum, H, Fiogbe, A, Yangui, F, Bilaceroglu, S, Dalar, L, Yilmaz, U, Bogomolov, A, Elahi, N, Dhasmana, D, Feneley, A, Hancock, C, Hill, A, Rudran, B, Ruiz-Buitrago, S, Campbell, M, Whitaker, P, Youzguin, A, Singanayagam, A, Allen, K, Brito, V, Dietz, J, Dysart, C, Kellie, S, Franco-Sadud, R, Meier, G, Gaga, M, Holland, T, Bergin, S, Kheir, F, Landmeier, M, Lois, M, Nair, G, Patel, H, Reyes, K, Rodriguez-Cintron, W, Saito, S, Noda, J, Hinojosa, C, Levine, S, Angel, L, Anzueto, A, Whitlow, K, Hipskind, J, Sukhija, K, Totten, V, Shah, R, Mateyo, K, Noriega, L, Alvarado, E, Aman, M, Labra, L, Villafuerte D., Aliberti S., Soni N. J., Faverio P., Marcos P. J., Wunderink R. G., Rodriguez A., Sibila O., Sanz F., Martin-Loeches I., Menzella F., Reyes L. F., Jankovic M., Spielmanns M., Restrepo M. I., Aruj P. K., Attorri S., Barimboim E., Caeiro J. P., Garzon M. I., Cambursano V. H., Ceccato A., Chertcoff J., Cordon Diaz A., 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., Anseeuw K., Francois C. A., Van Braeckel E., Vincent J. L., Djimon M. Z., Nouer S. A., Chipev P., Encheva M., Miteva D., Petkova D., Balkissou A. D., Yone E. W. P., Ngahane B. H. M., Shen N., Xu J. -F., Rico C. A. B., Buitrago R., Paternina F. J. P., Ntumba J. -M. K., Carevic V. V., Jakopovic M., Matkovic Z., Mitrecic I., Jacobsson M. -L. B., Christensen A. B., Heitmann Bodtger U. C., Meyer C. N., Jensen A. V., El-Said Abd El-Wahhab I., Morsy N. E., Shafiek H., Sobh E., Abdulsemed K. A., Bertrand F., Brun-Buisson C., Montmollin E. D., Fartoukh M., Messika J., Tattevin P., Khoury A., Ebruke B., Dreher M., Kolditz M., Meisinger M., Pletz M. W., Hagel S., Rupp J., Schaberg T., Creutz P., Suttorp N., Siaw-Lartey B., Dimakou K., Papapetrou D., Tsigou E., Ampazis D., Kaimakamis E., 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., Kant S., Swarnakar R., Limaye S., Salvi S., Golshani K., Keatings V. M., Maor Y., Strahilevitz J., Battaglia S., Carrabba M., Ceriana P., Confalonieri M., Monforte A. D., Prato B. D., Rosa M. D., Fantini R., Fiorentino G., Gammino M. A., Milani G., Nava S., Palmiero G., Petrino R., Gabrielli B., Rossi P., Sorino C., Steinhilber G., Zanforlin A., Franzetti F., Carone M., Patella V., Scarlata S., Comel 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., Leuschner P., Meireles M., Ravara S. B., Brocovschii V., Ion C., Rusu D., Toma C., Chirita D., Dorobat C. M., Birkun A., Kaluzhenina A., Almotairi A., Bukhary Z. A. A., Edathodu J., Fathy A., Enani A. M. A., Mohamed N. E., Memon J. U., Bella A., Bogdanovic N., Milenkovic B., Pesut D., Borderias L., Garcia N. M. B., Cabello Alarcon H., Cilloniz C., Torres A., Diaz-Brito V., Casas X., Gonzalez A. E., Fernandez-Almira M. L., Gallego M., Gaspar-Garcia I., Castillo J. G. D., Victoria P. J., Laserna Martinez E., Molina R. M. D., Menendez R., Pando-Sandoval A., Aymerich C. P., Rello J., Moyano S., Rodrigo-Troyano A., Sole-Violan J., Uranga A., van Boven J. F. M., 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., Feneley A., Hancock C., Hill A. T., Rudran B., Ruiz-Buitrago S., Campbell M., Whitaker P., Youzguin A., Singanayagam A., 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., Noda J., Hinojosa C. I., Levine S. M., Angel L. F., Anzueto A., Whitlow K. S., Hipskind J., Sukhija K., Totten V., Shah R. D., Mateyo K. J., Noriega L., Alvarado E., Aman M., Labra L., Villafuerte, D, Aliberti, S, Soni, N, Faverio, P, Marcos, P, Wunderink, R, Rodriguez, A, Sibila, O, Sanz, F, Martin-Loeches, I, Menzella, F, Reyes, L, Jankovic, M, Spielmanns, M, Restrepo, M, Aruj, P, Attorri, S, Barimboim, E, Caeiro, J, Garzon, M, Cambursano, V, Ceccato, A, Chertcoff, J, Cordon Diaz, A, de Vedia, L, Ganaha, M, Lambert, S, Lopardo, G, Luna, C, Malberti, A, Morcillo, N, Tartara, S, Pensotti, C, Pereyra, B, Scapellato, P, Stagnaro, J, Shah, S, Lotsch, F, Thalhammer, F, Anseeuw, K, Francois, C, Van Braeckel, E, Vincent, J, Djimon, M, Nouer, S, Chipev, P, Encheva, M, Miteva, D, Petkova, D, Balkissou, A, Yone, E, Ngahane, B, Shen, N, Xu, J, Rico, C, Buitrago, R, Paternina, F, Ntumba, J, Carevic, V, Jakopovic, M, Matkovic, Z, Mitrecic, I, Jacobsson, M, Christensen, A, Heitmann Bodtger, U, Meyer, C, Jensen, A, El-Said Abd El-Wahhab, I, Morsy, N, Shafiek, H, Sobh, E, Abdulsemed, K, Bertrand, F, Brun-Buisson, C, Montmollin, E, Fartoukh, M, Messika, J, Tattevin, P, Khoury, A, Ebruke, B, Dreher, M, Kolditz, M, Meisinger, M, Pletz, M, Hagel, S, Rupp, J, Schaberg, T, Creutz, P, Suttorp, N, Siaw-Lartey, B, Dimakou, K, Papapetrou, D, Tsigou, E, Ampazis, D, Kaimakamis, E, Bhatia, M, Dhar, R, D'Souza, G, Garg, R, Koul, P, Mahesh, P, Jayaraj, B, Narayan, K, Udnur, H, Krishnamurthy, S, Kant, S, Swarnakar, R, Limaye, S, Salvi, S, Golshani, K, Keatings, V, Maor, Y, Strahilevitz, J, Battaglia, S, Carrabba, M, Ceriana, P, Confalonieri, M, Monforte, A, Prato, B, Rosa, M, Fantini, R, Fiorentino, G, Gammino, M, Milani, G, Nava, S, Palmiero, G, Petrino, R, Gabrielli, B, Rossi, P, Sorino, C, Steinhilber, G, Zanforlin, A, Franzetti, F, Carone, M, Patella, V, Scarlata, S, Comel, A, Kurahashi, K, Bacha, Z, Ugalde, D, Zuniga, O, Villegas, J, Medenica, M, van de Garde, E, Mihsra, D, Shrestha, P, Ridgeon, E, Awokola, B, Nwankwo, O, Olufunlola, A, Olumide, S, Ukwaja, K, Irfan, M, Minarowski, L, Szymon, S, Froes, F, Leuschner, P, Meireles, M, Ravara, S, Brocovschii, V, Ion, C, Rusu, D, Toma, C, Chirita, D, Dorobat, C, Birkun, A, Kaluzhenina, A, Almotairi, A, Bukhary, Z, Edathodu, J, Fathy, A, Enani, A, Mohamed, N, Memon, J, Bella, A, Bogdanovic, N, Milenkovic, B, Pesut, D, Borderias, L, Garcia, N, Cabello Alarcon, H, Cilloniz, C, Torres, A, Diaz-Brito, V, Casas, X, Gonzalez, A, Fernandez-Almira, M, Gallego, M, Gaspar-Garcia, I, Castillo, J, Victoria, P, Laserna Martinez, E, Molina, R, Menendez, R, Pando-Sandoval, A, Aymerich, C, Rello, J, Moyano, S, Rodrigo-Troyano, A, Sole-Violan, J, Uranga, A, van Boven, J, Torra, E, Pujol, J, Feldman, C, Yum, H, Fiogbe, A, Yangui, F, Bilaceroglu, S, Dalar, L, Yilmaz, U, Bogomolov, A, Elahi, N, Dhasmana, D, Feneley, A, Hancock, C, Hill, A, Rudran, B, Ruiz-Buitrago, S, Campbell, M, Whitaker, P, Youzguin, A, Singanayagam, A, Allen, K, Brito, V, Dietz, J, Dysart, C, Kellie, S, Franco-Sadud, R, Meier, G, Gaga, M, Holland, T, Bergin, S, Kheir, F, Landmeier, M, Lois, M, Nair, G, Patel, H, Reyes, K, Rodriguez-Cintron, W, Saito, S, Noda, J, Hinojosa, C, Levine, S, Angel, L, Anzueto, A, Whitlow, K, Hipskind, J, Sukhija, K, Totten, V, Shah, R, Mateyo, K, Noriega, L, Alvarado, E, Aman, M, Labra, L, Villafuerte D., Aliberti S., Soni N. J., Faverio P., Marcos P. J., Wunderink R. G., Rodriguez A., Sibila O., Sanz F., Martin-Loeches I., Menzella F., Reyes L. F., Jankovic M., Spielmanns M., Restrepo M. I., Aruj P. K., Attorri S., Barimboim E., Caeiro J. P., Garzon M. I., Cambursano V. H., Ceccato A., Chertcoff J., Cordon Diaz A., 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., Anseeuw K., Francois C. A., Van Braeckel E., Vincent J. L., Djimon M. Z., Nouer S. A., Chipev P., Encheva M., Miteva D., Petkova D., Balkissou A. D., Yone E. W. P., Ngahane B. H. M., Shen N., Xu J. -F., Rico C. A. B., Buitrago R., Paternina F. J. P., Ntumba J. -M. K., Carevic V. V., Jakopovic M., Matkovic Z., Mitrecic I., Jacobsson M. -L. B., Christensen A. B., Heitmann Bodtger U. C., Meyer C. N., Jensen A. V., El-Said Abd El-Wahhab I., Morsy N. E., Shafiek H., Sobh E., Abdulsemed K. A., Bertrand F., Brun-Buisson C., Montmollin E. D., Fartoukh M., Messika J., Tattevin P., Khoury A., Ebruke B., Dreher M., Kolditz M., Meisinger M., Pletz M. W., Hagel S., Rupp J., Schaberg T., Creutz P., Suttorp N., Siaw-Lartey B., Dimakou K., Papapetrou D., Tsigou E., Ampazis D., Kaimakamis E., 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., Kant S., Swarnakar R., Limaye S., Salvi S., Golshani K., Keatings V. M., Maor Y., Strahilevitz J., Battaglia S., Carrabba M., Ceriana P., Confalonieri M., Monforte A. D., Prato B. D., Rosa M. D., Fantini R., Fiorentino G., Gammino M. A., Milani G., Nava S., Palmiero G., Petrino R., Gabrielli B., Rossi P., Sorino C., Steinhilber G., Zanforlin A., Franzetti F., Carone M., Patella V., Scarlata S., Comel 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., Leuschner P., Meireles M., Ravara S. B., Brocovschii V., Ion C., Rusu D., Toma C., Chirita D., Dorobat C. M., Birkun A., Kaluzhenina A., Almotairi A., Bukhary Z. A. A., Edathodu J., Fathy A., Enani A. M. A., Mohamed N. E., Memon J. U., Bella A., Bogdanovic N., Milenkovic B., Pesut D., Borderias L., Garcia N. M. B., Cabello Alarcon H., Cilloniz C., Torres A., Diaz-Brito V., Casas X., Gonzalez A. E., Fernandez-Almira M. L., Gallego M., Gaspar-Garcia I., Castillo J. G. D., Victoria P. J., Laserna Martinez E., Molina R. M. D., Menendez R., Pando-Sandoval A., Aymerich C. P., Rello J., Moyano S., Rodrigo-Troyano A., Sole-Violan J., Uranga A., van Boven J. F. M., 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., Feneley A., Hancock C., Hill A. T., Rudran B., Ruiz-Buitrago S., Campbell M., Whitaker P., Youzguin A., Singanayagam A., 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., Noda J., Hinojosa C. I., Levine S. M., Angel L. F., Anzueto A., Whitlow K. S., Hipskind J., Sukhija K., Totten V., Shah R. D., Mateyo K. J., Noriega L., Alvarado E., Aman M., and Labra L.

Abstract

Background and objective: Enterobacteriaceae (EB) spp. family is known to include potentially multidrug-resistant (MDR) microorganisms, and remains as an important cause of community-acquired pneumonia (CAP) associated with high mortality. The aim of this study was to determine the prevalence and specific risk factors associated with EB and MDR-EB in a cohort of hospitalized adults with CAP. Methods: We performed a multinational, point-prevalence study of adult patients hospitalized with CAP. MDR-EB was defined when ≥3 antimicrobial classes were identified as non-susceptible. Risk factors assessment was also performed for patients with EB and MDR-EB infection. Results: Of the 3193 patients enrolled with CAP, 197 (6%) had a positive culture with EB. Fifty-one percent (n = 100) of EB were resistant to at least one antibiotic and 19% (n = 38) had MDR-EB. The most commonly EB identified were Klebsiella pneumoniae (n = 111, 56%) and Escherichia coli (n = 56, 28%). The risk factors that were independently associated with EB CAP were male gender, severe CAP, underweight (body mass index (BMI) < 18.5) and prior extended-spectrum beta-lactamase (ESBL) infection. Additionally, prior ESBL infection, being underweight, cardiovascular diseases and hospitalization in the last 12 months were independently associated with MDR-EB CAP. Conclusion: This study of adults hospitalized with CAP found a prevalence of EB of 6% and MDR-EB of 1.2%, respectively. The presence of specific risk factors, such as prior ESBL infection and being underweight, should raise the clinical suspicion for EB and MDR-EB in patients hospitalized with CAP.

Published
2020

18. Prevalence and risk factors for Enterobacteriaceae in patients hospitalized with community-acquired pneumonia

Author

Villafuerte D., Aliberti S., Soni N. J., Faverio P., Marcos P. J., Wunderink R. G., Rodriguez A., Sibila O., Sanz F., Martin-Loeches I., Menzella F., Reyes L. F., Jankovic M., Spielmanns M., Restrepo M. I., Aruj P. K., Attorri S., Barimboim E., Caeiro J. P., Garzon M. I., Cambursano V. H., Ceccato A., Chertcoff J., Cordon Diaz A., 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., Anseeuw K., Francois C. A., Van Braeckel E., Vincent J. L., Djimon M. Z., Nouer S. A., Chipev P., Encheva M., Miteva D., Petkova D., Balkissou A. D., Yone E. W. P., Ngahane B. H. M., Shen N., Xu J. -F., Rico C. A. B., Buitrago R., Paternina F. J. P., Ntumba J. -M. K., Carevic V. V., Jakopovic M., Matkovic Z., Mitrecic I., Jacobsson M. -L. B., Christensen A. B., Heitmann Bodtger U. C., Meyer C. N., Jensen A. V., El-Said Abd El-Wahhab I., Morsy N. E., Shafiek H., Sobh E., Abdulsemed K. A., Bertrand F., Brun-Buisson C., Montmollin E. D., Fartoukh M., Messika J., Tattevin P., Khoury A., Ebruke B., Dreher M., Kolditz M., Meisinger M., Pletz M. W., Hagel S., Rupp J., Schaberg T., Creutz P., Suttorp N., Siaw-Lartey B., Dimakou K., Papapetrou D., Tsigou E., Ampazis D., Kaimakamis E., 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., Kant S., Swarnakar R., Limaye S., Salvi S., Golshani K., Keatings V. M., Maor Y., Strahilevitz J., Battaglia S., Carrabba M., Ceriana P., Confalonieri M., Monforte A. D., Prato B. D., Rosa M. D., Fantini R., Fiorentino G., Gammino M. A., Milani G., Nava S., Palmiero G., Petrino R., Gabrielli B., Rossi P., Sorino C., Steinhilber G., Zanforlin A., Franzetti F., Carone M., Patella V., Scarlata S., Comel 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., Leuschner P., Meireles M., Ravara S. B., Brocovschii V., Ion C., Rusu D., Toma C., Chirita D., Dorobat C. M., Birkun A., Kaluzhenina A., Almotairi A., Bukhary Z. A. A., Edathodu J., Fathy A., Enani A. M. A., Mohamed N. E., Memon J. U., Bella A., Bogdanovic N., Milenkovic B., Pesut D., Borderias L., Garcia N. M. B., Cabello Alarcon H., Cilloniz C., Torres A., Diaz-Brito V., Casas X., Gonzalez A. E., Fernandez-Almira M. L., Gallego M., Gaspar-Garcia I., Castillo J. G. D., Victoria P. J., Laserna Martinez E., Molina R. M. D., Menendez R., Pando-Sandoval A., Aymerich C. P., Rello J., Moyano S., Rodrigo-Troyano A., Sole-Violan J., Uranga A., van Boven J. F. M., 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., Feneley A., Hancock C., Hill A. T., Rudran B., Ruiz-Buitrago S., Campbell M., Whitaker P., Youzguin A., Singanayagam A., 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., Noda J., Hinojosa C. I., Levine S. M., Angel L. F., Anzueto A., Whitlow K. S., Hipskind J., Sukhija K., Totten V., Shah R. D., Mateyo K. J., Noriega L., Alvarado E., Aman M., Labra L., Villafuerte, D, Aliberti, S, Soni, N, Faverio, P, Marcos, P, Wunderink, R, Rodriguez, A, Sibila, O, Sanz, F, Martin-Loeches, I, Menzella, F, Reyes, L, Jankovic, M, Spielmanns, M, Restrepo, M, Aruj, P, Attorri, S, Barimboim, E, Caeiro, J, Garzon, M, Cambursano, V, Ceccato, A, Chertcoff, J, Cordon Diaz, A, de Vedia, L, Ganaha, M, Lambert, S, Lopardo, G, Luna, C, Malberti, A, Morcillo, N, Tartara, S, Pensotti, C, Pereyra, B, Scapellato, P, Stagnaro, J, Shah, S, Lotsch, F, Thalhammer, F, Anseeuw, K, Francois, C, Van Braeckel, E, Vincent, J, Djimon, M, Nouer, S, Chipev, P, Encheva, M, Miteva, D, Petkova, D, Balkissou, A, Yone, E, Ngahane, B, Shen, N, Xu, J, Rico, C, Buitrago, R, Paternina, F, Ntumba, J, Carevic, V, Jakopovic, M, Matkovic, Z, Mitrecic, I, Jacobsson, M, Christensen, A, Heitmann Bodtger, U, Meyer, C, Jensen, A, El-Said Abd El-Wahhab, I, Morsy, N, Shafiek, H, Sobh, E, Abdulsemed, K, Bertrand, F, Brun-Buisson, C, Montmollin, E, Fartoukh, M, Messika, J, Tattevin, P, Khoury, A, Ebruke, B, Dreher, M, Kolditz, M, Meisinger, M, Pletz, M, Hagel, S, Rupp, J, Schaberg, T, Creutz, P, Suttorp, N, Siaw-Lartey, B, Dimakou, K, Papapetrou, D, Tsigou, E, Ampazis, D, Kaimakamis, E, Bhatia, M, Dhar, R, D'Souza, G, Garg, R, Koul, P, Mahesh, P, Jayaraj, B, Narayan, K, Udnur, H, Krishnamurthy, S, Kant, S, Swarnakar, R, Limaye, S, Salvi, S, Golshani, K, Keatings, V, Maor, Y, Strahilevitz, J, Battaglia, S, Carrabba, M, Ceriana, P, Confalonieri, M, Monforte, A, Prato, B, Rosa, M, Fantini, R, Fiorentino, G, Gammino, M, Milani, G, Nava, S, Palmiero, G, Petrino, R, Gabrielli, B, Rossi, P, Sorino, C, Steinhilber, G, Zanforlin, A, Franzetti, F, Carone, M, Patella, V, Scarlata, S, Comel, A, Kurahashi, K, Bacha, Z, Ugalde, D, Zuniga, O, Villegas, J, Medenica, M, van de Garde, E, Mihsra, D, Shrestha, P, Ridgeon, E, Awokola, B, Nwankwo, O, Olufunlola, A, Olumide, S, Ukwaja, K, Irfan, M, Minarowski, L, Szymon, S, Froes, F, Leuschner, P, Meireles, M, Ravara, S, Brocovschii, V, Ion, C, Rusu, D, Toma, C, Chirita, D, Dorobat, C, Birkun, A, Kaluzhenina, A, Almotairi, A, Bukhary, Z, Edathodu, J, Fathy, A, Enani, A, Mohamed, N, Memon, J, Bella, A, Bogdanovic, N, Milenkovic, B, Pesut, D, Borderias, L, Garcia, N, Cabello Alarcon, H, Cilloniz, C, Torres, A, Diaz-Brito, V, Casas, X, Gonzalez, A, Fernandez-Almira, M, Gallego, M, Gaspar-Garcia, I, Castillo, J, Victoria, P, Laserna Martinez, E, Molina, R, Menendez, R, Pando-Sandoval, A, Aymerich, C, Rello, J, Moyano, S, Rodrigo-Troyano, A, Sole-Violan, J, Uranga, A, van Boven, J, Torra, E, Pujol, J, Feldman, C, Yum, H, Fiogbe, A, Yangui, F, Bilaceroglu, S, Dalar, L, Yilmaz, U, Bogomolov, A, Elahi, N, Dhasmana, D, Feneley, A, Hancock, C, Hill, A, Rudran, B, Ruiz-Buitrago, S, Campbell, M, Whitaker, P, Youzguin, A, Singanayagam, A, Allen, K, Brito, V, Dietz, J, Dysart, C, Kellie, S, Franco-Sadud, R, Meier, G, Gaga, M, Holland, T, Bergin, S, Kheir, F, Landmeier, M, Lois, M, Nair, G, Patel, H, Reyes, K, Rodriguez-Cintron, W, Saito, S, Noda, J, Hinojosa, C, Levine, S, Angel, L, Anzueto, A, Whitlow, K, Hipskind, J, Sukhija, K, Totten, V, Shah, R, Mateyo, K, Noriega, L, Alvarado, E, Aman, M, Labra, L, University of St Andrews. Infection Group, University of St Andrews. School of Medicine, University of St Andrews. Infection and Global Health Division, Villafuerte D., Aliberti S., Soni N.J., Faverio P., Marcos P.J., Wunderink R.G., Rodriguez A., Sibila O., Sanz F., Martin-Loeches I., Menzella F., Reyes L.F., Jankovic M., Spielmanns M., Restrepo M.I., Aruj P.K., Attorri S., Barimboim E., Caeiro J.P., Garzon M.I., Cambursano V.H., Ceccato A., Chertcoff J., Cordon Diaz A., 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., Anseeuw K., Francois C.A., Van Braeckel E., Vincent J.L., Djimon M.Z., Nouer S.A., Chipev P., Encheva M., Miteva D., Petkova D., Balkissou A.D., Yone E.W.P., Ngahane B.H.M., Shen N., Xu J.-F., Rico C.A.B., Buitrago R., Paternina F.J.P., Ntumba J.-M.K., Carevic V.V., Jakopovic M., Matkovic Z., Mitrecic I., Jacobsson M.-L.B., Christensen A.B., Heitmann Bodtger U.C., Meyer C.N., Jensen A.V., El-Said Abd El-Wahhab I., Morsy N.E., Shafiek H., Sobh E., Abdulsemed K.A., Bertrand F., Brun-Buisson C., Montmollin E.D., Fartoukh M., Messika J., Tattevin P., Khoury A., Ebruke B., Dreher M., Kolditz M., Meisinger M., Pletz M.W., Hagel S., Rupp J., Schaberg T., Creutz P., Suttorp N., Siaw-Lartey B., Dimakou K., Papapetrou D., Tsigou E., Ampazis D., Kaimakamis E., 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., Kant S., Swarnakar R., Limaye S., Salvi S., Golshani K., Keatings V.M., Maor Y., Strahilevitz J., Battaglia S., Carrabba M., Ceriana P., Confalonieri M., Monforte A.D., Prato B.D., Rosa M.D., Fantini R., Fiorentino G., Gammino M.A., Milani G., Nava S., Palmiero G., Petrino R., Gabrielli B., Rossi P., Sorino C., Steinhilber G., Zanforlin A., Franzetti F., Carone M., Patella V., Scarlata S., Comel 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., Leuschner P., Meireles M., Ravara S.B., Brocovschii V., Ion C., Rusu D., Toma C., Chirita D., Dorobat C.M., Birkun A., Kaluzhenina A., Almotairi A., Bukhary Z.A.A., Edathodu J., Fathy A., Enani A.M.A., Mohamed N.E., Memon J.U., Bella A., Bogdanovic N., Milenkovic B., Pesut D., Borderias L., Garcia N.M.B., Cabello Alarcon H., Cilloniz C., Torres A., Diaz-Brito V., Casas X., Gonzalez A.E., Fernandez-Almira M.L., Gallego M., Gaspar-Garcia I., Castillo J.G.D., Victoria P.J., Laserna Martinez E., Molina R.M.D., Menendez R., Pando-Sandoval A., Aymerich C.P., Rello J., Moyano S., Rodrigo-Troyano A., Sole-Violan J., Uranga A., van Boven J.F.M., 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., Feneley A., Hancock C., Hill A.T., Rudran B., Ruiz-Buitrago S., Campbell M., Whitaker P., Youzguin A., Singanayagam A., 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., Noda J., Hinojosa C.I., Levine S.M., Angel L.F., Anzueto A., Whitlow K.S., Hipskind J., Sukhija K., Totten V., Shah R.D., Mateyo K.J., Noriega L., Alvarado E., Aman M., Labra L., Villafuerte, D., Aliberti, S., Soni, N. J., Faverio, P., Marcos, P. J., Wunderink, R. G., Rodriguez, A., Sibila, O., Sanz, F., Martin-Loeches, I., Menzella, F., Reyes, L. F., Jankovic, M., Spielmanns, M., Restrepo, M. I., Aruj, P. K., Attorri, S., Barimboim, E., Caeiro, J. P., Garzon, M. I., Cambursano, V. H., Ceccato, A., Chertcoff, J., Cordon Diaz, A., 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., Anseeuw, K., Francois, C. A., Van Braeckel, E., Vincent, J. L., Djimon, M. Z., Nouer, S. A., Chipev, P., Encheva, M., Miteva, D., Petkova, D., Balkissou, A. D., Yone, E. W. P., Ngahane, B. H. M., Shen, N., Xu, J. -F., Rico, C. A. B., Buitrago, R., Paternina, F. J. P., Ntumba, J. -M. K., Carevic, V. V., Jakopovic, M., Matkovic, Z., Mitrecic, I., Jacobsson, M. -L. B., Christensen, A. B., Heitmann Bodtger, U. C., Meyer, C. N., Jensen, A. V., El-Said Abd El-Wahhab, I., Morsy, N. E., Shafiek, H., Sobh, E., Abdulsemed, K. A., Bertrand, F., Brun-Buisson, C., Montmollin, E. D., Fartoukh, M., Messika, J., Tattevin, P., Khoury, A., Ebruke, B., Dreher, M., Kolditz, M., Meisinger, M., Pletz, M. W., Hagel, S., Rupp, J., Schaberg, T., Creutz, P., Suttorp, N., Siaw-Lartey, B., Dimakou, K., Papapetrou, D., Tsigou, E., Ampazis, D., Kaimakamis, E., 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., Kant, S., Swarnakar, R., Limaye, S., Salvi, S., Golshani, K., Keatings, V. M., Maor, Y., Strahilevitz, J., Battaglia, S., Carrabba, M., Ceriana, P., Confalonieri, M., Monforte, A. D., Prato, B. D., Rosa, M. D., Fantini, R., Fiorentino, G., Gammino, M. A., Milani, G., Nava, S., Palmiero, G., Petrino, R., Gabrielli, B., Rossi, P., Sorino, C., Steinhilber, G., Zanforlin, A., Franzetti, F., Carone, M., Patella, V., Scarlata, S., Comel, 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., Leuschner, P., Meireles, M., Ravara, S. B., Brocovschii, V., Ion, C., Rusu, D., Toma, C., Chirita, D., Dorobat, C. M., Birkun, A., Kaluzhenina, A., Almotairi, A., Bukhary, Z. A. A., Edathodu, J., Fathy, A., Enani, A. M. A., Mohamed, N. E., Memon, J. U., Bella, A., Bogdanovic, N., Milenkovic, B., Pesut, D., Borderias, L., Garcia, N. M. B., Cabello Alarcon, H., Cilloniz, C., Torres, A., Diaz-Brito, V., Casas, X., Gonzalez, A. E., Fernandez-Almira, M. L., Gallego, M., Gaspar-Garcia, I., Castillo, J. G. D., Victoria, P. J., Laserna Martinez, E., Molina, R. M. D., Menendez, R., Pando-Sandoval, A., Aymerich, C. P., Rello, J., Moyano, S., Rodrigo-Troyano, A., Sole-Violan, J., Uranga, A., van Boven, J. F. M., 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., Feneley, A., Hancock, C., Hill, A. T., Rudran, B., Ruiz-Buitrago, S., Campbell, M., Whitaker, P., Youzguin, A., Singanayagam, A., 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., Noda, J., Hinojosa, C. I., Levine, S. M., Angel, L. F., Anzueto, A., Whitlow, K. S., Hipskind, J., Sukhija, K., Totten, V., Shah, R. D., Mateyo, K. J., Noriega, L., Alvarado, E., Aman, M., and Labra, L.

Subjects
Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, community-acquired pneumonia, Community-acquired pneumonia, Enterobacteriaceae, multidrug-resistance, prevalence, risk factors, International Cooperation, Multidrug-resistance, Microbial Sensitivity Tests, Settore MED/10 - Malattie Dell'Apparato Respiratorio, Research initiative, E-NDAS, Cohort Studies, SDG 3 - Good Health and Well-being, Prevalence, Humans, Medicine, In patient, Risk factor, Veterans Affairs, health care economics and organizations, Aged, business.industry, Enterobacteriaceae Infections, QR Microbiology, medicine.disease, Drug Resistance, Multiple, humanities, Quality enhancement, QR, Community-Acquired Infections, Hospitalization, Risk factors, risk factor, Family medicine, Female, business, Risk assessment, Cohort study
Abstract

N.J.S. is partially funded by the Department of Veterans Affairs, Quality Enhancement Research Initiative (QUERI) Partnered Evaluation Initiative Grant (HX002263-01A1). Background and objective : Enterobacteriaceae (EB) spp. family is known to include potentially multidrug-resistant (MDR) microorganisms, and remains as an important cause of community-acquired pneumonia (CAP) associated with high mortality. The aim of this study was to determine the prevalence and specific risk factors associated with EB and MDR-EB in a cohort of hospitalized adults with CAP. Methods : We performed a multinational, point-prevalence study of adult patients hospitalized with CAP. MDR-EB was defined when ≥3 antimicrobial classes were identified as non-susceptible. Risk factors assessment was also performed for patients with EB and MDR-EB infection. Results : Of the 3193 patients enrolled with CAP, 197 (6%) had a positive culture with EB. Fifty-one percent (n = 100) of EB were resistant to at least one antibiotic and 19% (n = 38) had MDR-EB. The most commonly EB identified were Klebsiella pneumoniae (n = 111, 56%) and Escherichia coli (n = 56, 28%). The risk factors that were independently associated with EB CAP were male gender, severe CAP, underweight (body mass index (BMI)

Published
2020

23. International prevalence and risk factors evaluation for drug-resistant Streptococcus pneumoniae pneumonia

Author

Aliberti, S, Cook, GS, Babu, BL, Reyes, LF, Rodriguez, AH, Sanz, F, Soni, NJ, Anzueto, A, Faverio, P, Sadud, RF, Muhammad, I, Prat, C, Vendrell, E, Neves, J, Kaimakamis, E, Feneley, A, Swarnakar, R, Franzetti, F, Carugati, M, Morosi, M, Monge, E, Restrepo, MI, Aruj, PK, Attorri, S, Barimboim, E, Caeiro, JP, Garzon, MI, Cambursano, VH, Ceccato, A, Chertcoff, J, Lascar, F, Di Tulio, F, Diaz, AC, de Vedia, L, Ganaha, MC, Lambert, S, Lopardo, G, Lopez, V, Luna, CM, Malberti, AG, Morcillo, N, Tartara, S, Pensotti, C, Pereyra, B, Scapellato, PG, Stagnaro, JP, Shah, S, Lotsch, F, Thalhammer, F, Anseeuw, K, Francois, CA, Van Braeckel, E, Vincent, JL, Djimon, MZ, Bashi, J, Dodo, R, Nouer, SA, Chipev, P, Encheva, M, Miteva, D, Petkova, D, Balkissou, AD, Yone, EWP, Ngahane, BHM, Shen, N, Xu, JF, Rico, CAB, Buitrago, R, Paternina, FJP, Ntumba, JMK, Carevic, VV, Jakopovic, M, Jankovic, M, Matkovic, Z, Mitrecic, I, Jacobsson, MLB, Christensen, AB, Bodtger, UCH, Meyer, CN, Jensen, AV, Baunbaek-knudsen, G, Petersen, PT, Andersen, S, Abd El-Wahhab, IES, Morsy, NE, Shafiek, H, Sobh, E, Abdulsemed, KA, Bertrand, F, Brun-Buisson, C, de Montmollin, E, Fartoukh, M, Messika, J, Tattevin, P, Khoury, A, Ebruke, B, Dreher, M, Kolditz, M, Meisinger, M, Pletz, MW, Hagel, S, Rupp, J, Schaberg, T, Spielmanns, M, Creutz, P, Suttorp, N, Siaw-Lartey, B, Dimakou, K, Papapetrou, D, Tsigou, E, Ampazis, D, Bhatia, M, Dhar, R, D'Souza, G, Garg, R, Koul, PA, Mahesh, PA, Jayaraj, BS, Narayan, KV, Udnur, HB, Krishnamurthy, SB, Kant, S, Limaye, S, Salvi, S, Golshani, K, Keatings, VM, Martin-Loeches, I, Maor, Y, Strahilevitz, J, Battaglia, S, Carrabba, M, Ceriana, P, Confalonieri, M, Monforte, AD, Del Prato, B, De Rosa, M, Fantini, R, Fiorentino, G, Gammino, MA, Menzella, F, Milani, G, Nava, S, Palmiero, G, Petrino, R, Gabrielli, B, Rossi, P, Sorino, C, Steinhilber, G, Zanforlin, A, Carone, M, Patella, V, Scarlata, S, Comel, A, Kurahashi, K, Bacha, ZA, Ugalde, DB, Zuniga, OC, Villegas, JF, Medenica, M, van de Garde, EMW, Mihsra, DR, Shrestha, P, Ridgeon, E, Awokola, BI, Nwankwo, ONO, Olufunlola, AB, Olumide, S, Ukwaja, KN, Irfan, M, Minarowski, L, Szymon, S, Froes, F, Leuschner, P, Meireles, M, Ferrao, C, Ravara, SB, Brocovschii, V, Ion, C, Rusu, D, Toma, C, Chirita, D, Dorobat, CM, Birkun, A, Kaluzhenina, A, Almotairi, A, Bukhary, ZAA, Edathodu, J, Fathy, A, Enani, AMA, Mohamed, NE, Memon, JU, Bella, A, Bogdanovic, N, Milenkovic, B, Pesut, D, Borderias, L, Garcia, NMB, Alarcon, HC, Cilloniz, C, Torres, A, Diaz-Brito, V, Casas, X, Gonzalez, AE, Fernandez-Almira, ML, Gallego, M, Gaspar-Garcia, I, del Castillo, JG, Victoria, PJ, Martinez, EL, de Molina, RM, Marcos, PJ, Menendez, R, Pando-Sandoval, A, Aymerich, CP, de la Torre, AL, Garcia-Olive, I, Rello, J, Moyano, S, Sibila, O, Rodrigo-Troyano, A, Sole-Violan, J, Uranga, A, van Boven, JFM, Torra, EV, Pujol, JA, Feldman, C, Yum, HK, Fiogbe, AA, Yangui, F, Bilaceroglu, S, Dalar, L, Yilmaz, U, Bogomolov, A, Elahi, N, Dhasmana, DJ, Ions, R, Skeemer, J, Woltmann, G, Hancock, C, Hill, AT, Rudran, B, Ruiz-Buitrago, S, Campbell, M, Whitaker, P, Youzguin, A, Singanayagam, A, Allen, KS, Brito, V, Dietz, J, Dysart, CE, Kellie, SM, Franco-Sadud, RA, Meier, G, Gaga, M, Holland, TL, Bergin, SP, Kheir, F, Landmeier, M, Lois, M, Nair, GB, Patel, H, Reyes, K, Rodriguez-Cintron, W, Saito, S, Noda, J, Hinojosa, CI, Levine, SM, Angel, LF, Whitlow, KS, Hipskind, J, Sukhija, K, Totten, V, Wunderink, RG, Shah, RD, Mateyo, KJ, Noriega, L, Alvarado, E, Aman, M, Labra, L, Aliberti, S, Cook, G, Babu, B, Reyes, L, H. Rodriguez, A, Sanz, F, Soni, N, Anzueto, A, Faverio, P, Sadud, R, Muhammad, I, Prat, C, Vendrell, E, Neves, J, Kaimakamis, E, Feneley, A, Swarnakar, R, Franzetti, F, Carugati, M, Morosi, M, Monge, E, Restrepo, M, Aliberti, S., Cook, G. S., Babu, B. L., Reyes, L. F., Rodriguez, A. H., Sanz, F., Soni, N. J., Anzueto, A., Faverio, P., Sadud, R. F., Muhammad, I., Prat, C., Vendrell, E., Neves, J., Kaimakamis, E., Feneley, A., Swarnakar, R., Franzetti, F., Carugati, M., Morosi, M., Monge, E., 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., Di Tulio, F., 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., Anseeuw, K., Francois, C. A., Van Braeckel, E., Vincent, J. L., Djimon, M. Z., Bashi, J., Dodo, R., Nouer, S. A., Chipev, P., Encheva, M., Miteva, D., Petkova, D., Balkissou, A. D., Yone, E. W. P., Ngahane, B. H. M., Shen, N., Xu, J. -F., Rico, C. A. B., Buitrago, R., Paternina, F. J. P., Ntumba, J. -M. K., Carevic, V. V., Jakopovic, M., Jankovic, M., Matkovic, Z., Mitrecic, I., Jacobsson, M. -L. B., Christensen, A. B., Bodtger, U. C. H., 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., Abdulsemed, K. A., Bertrand, F., Brun-Buisson, C., de Montmollin, E., Fartoukh, M., Messika, J., Tattevin, P., Khoury, A., Ebruke, B., Dreher, M., Kolditz, M., Meisinger, M., Pletz, M. W., Hagel, S., Rupp, J., Schaberg, T., Spielmanns, M., Creutz, P., Suttorp, N., 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., Kant, S., Limaye, S., Salvi, S., Golshani, K., Keatings, V. M., Martin-Loeches, I., Maor, Y., Strahilevitz, J., Battaglia, S., Carrabba, M., Ceriana, P., Confalonieri, M., D'Arminio Monforte, A., Del Prato, B., De Rosa, M., Fantini, R., 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., Carone, M., Patella, V., Scarlata, S., Comel, 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., Leuschner, P., Meireles, M., Ferrao, C., Ravara, S. B., Brocovschii, V., Ion, C., Rusu, D., Toma, C., Chirita, D., Dorobat, C. M., Birkun, A., Kaluzhenina, A., Almotairi, A., Bukhary, Z. A. A., Edathodu, J., Fathy, A., Enani, A. M. A., Mohamed, N. E., Memon, J. U., Bella, A., 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., Gallego, M., Gaspar-Garcia, I., Del Castillo, J. G., Victoria, P. J., Martinez, E. L., de Molina, R. M., Marcos, P. J., Menendez, R., Pando-Sandoval, A., Aymerich, C. P., de la Torre, A. L., Garcia-Olive, I., Rello, J., Moyano, S., Sibila, O., Rodrigo-Troyano, A., Sole-Violan, J., Uranga, A., van Boven, J. F. M., 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., Ruiz-Buitrago, S., Campbell, M., Whitaker, P., Youzguin, A., Singanayagam, A., 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., Noda, J., Hinojosa, C. I., Levine, S. M., Angel, L. F., Whitlow, K. S., Hipskind, J., Sukhija, K., Totten, V., Wunderink, R. G., Shah, R. D., Mateyo, K. J., Noriega, L., Alvarado, E., Aman, M., Labra, L., Aliberti S., Cook G.S., Babu B.L., Reyes L.F., Rodriguez A.H., Sanz F., Soni N.J., Anzueto A., Faverio P., Sadud R.F., Muhammad I., Prat C., Vendrell E., Neves J., Kaimakamis E., Feneley A., Swarnakar R., Franzetti F., Carugati M., Morosi M., Monge E., 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., Di Tulio F., 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., Anseeuw K., Francois C.A., Van Braeckel E., Vincent J.L., Djimon M.Z., Bashi J., Dodo R., Nouer S.A., Chipev P., Encheva M., Miteva D., Petkova D., Balkissou A.D., Yone E.W.P., Ngahane B.H.M., Shen N., Xu J.-F., Rico C.A.B., Buitrago R., Paternina F.J.P., Ntumba J.-M.K., Carevic V.V., Jakopovic M., Jankovic M., Matkovic Z., Mitrecic I., Jacobsson M.-L.B., Christensen A.B., Bodtger U.C.H., 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., Abdulsemed K.A., Bertrand F., Brun-Buisson C., de Montmollin E., Fartoukh M., Messika J., Tattevin P., Khoury A., Ebruke B., Dreher M., Kolditz M., Meisinger M., Pletz M.W., Hagel S., Rupp J., Schaberg T., Spielmanns M., Creutz P., Suttorp N., 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., Kant S., Limaye S., Salvi S., Golshani K., Keatings V.M., Martin-Loeches I., Maor Y., Strahilevitz J., Battaglia S., Carrabba M., Ceriana P., Confalonieri M., D'Arminio Monforte A., Del Prato B., De Rosa M., Fantini R., 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., Carone M., Patella V., Scarlata S., Comel 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., Leuschner P., Meireles M., Ferrao C., Ravara S.B., Brocovschii V., Ion C., Rusu D., Toma C., Chirita D., Dorobat C.M., Birkun A., Kaluzhenina A., Almotairi A., Bukhary Z.A.A., Edathodu J., Fathy A., Enani A.M.A., Mohamed N.E., Memon J.U., Bella A., 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., Gallego M., Gaspar-Garcia I., Del Castillo J.G., Victoria P.J., Martinez E.L., de Molina R.M., Marcos P.J., Menendez R., Pando-Sandoval A., Aymerich C.P., de la Torre A.L., Garcia-Olive I., Rello J., Moyano S., Sibila O., Rodrigo-Troyano A., Sole-Violan J., Uranga A., van Boven J.F.M., 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., Ruiz-Buitrago S., Campbell M., Whitaker P., Youzguin A., Singanayagam A., 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., Noda J., Hinojosa C.I., Levine S.M., Angel L.F., Whitlow K.S., Hipskind J., Sukhija K., Totten V., Wunderink R.G., Shah R.D., Mateyo K.J., Noriega L., Alvarado E., Aman M., and Labra L.

Subjects
0301 basic medicine, Male, Streptococcus pneumonia, antibiotic resistance, Internationality, sputum examination, bronchiectasis, very elderly, Antibiotics, Prevalence, Drug resistance, medicine.disease_cause, Logistic regression, Global Health, Community-Acquired Infections/epidemiology, lung lavage, 0302 clinical medicine, Community-acquired pneumonia, Cost of Illness, Risk Factors, drug resistant Streptococcus pneumoniae pneumonia, 030212 general & internal medicine, Microbial drug resistant, Aged, 80 and over, adult, international cooperation, drug effect, Middle Aged, influenza vaccination, Anti-Bacterial Agents, antiinfective agent, Europe, Community-Acquired Infections, Hospitalization, Global burden of disease, Streptococcus pneumoniae, Infectious Diseases, risk factor, bacterium identification, Female, community acquired infection, influenza, liver disease, pneumococcal vaccination, Pneumococcal infection, hospitalization, medicine.drug, Microbiology (medical), medicine.medical_specialty, Asia, medicine.drug_class, 030106 microbiology, Settore MED/10 - Malattie Dell'Apparato Respiratorio, Article, Anti-Bacterial Agents/pharmacology, 03 medical and health sciences, Internal medicine, Drug Resistance, Bacterial, Pneumonia, Pneumococcal/epidemiology, medicine, Humans, controlled study, human, tetracycline, Hospitalization/statistics & numerical data, Aged, levofloxacin, nonhuman, business.industry, disease association, microbiology, community acquired pneumonia, macrolide, Pneumonia, asthma, South America, Pneumonia, Pneumococcal, vaccination, medicine.disease, major clinical study, antibiotic sensitivity, penicillin derivative, Penicillin, Streptococcus pneumoniae/drug effects, blood examination, Africa, North America, microbiological examination, business
Abstract

Objective: Streptococcus pneumoniae is the most frequent bacterial pathogen isolated in subjects with Community-acquired pneumonia (CAP) worldwide. Limited data are available regarding the current global burden and risk factors associated with drug-resistant Streptococcus pneumoniae (DRSP) in CAP subjects. We assessed the multinational prevalence and risk factors for DRSP-CAP in a multinational point-prevalence study. Design: The prevalence of DRSP-CAP was assessed by identification of DRSP in blood or respiratory samples among adults hospitalized with CAP in 54 countries. Prevalence and risk factors were compared among subjects that had microbiological testing and antibiotic susceptibility data. Multivariate logistic regressions were used to identify risk factors independently associated with DRSP-CAP. Results: 3,193 subjects were included in the study. The global prevalence of DRSP-CAP was 1.3% and continental prevalence rates were 7.0% in Africa, 1.2% in Asia, and 1.0% in South America, Europe, and North America, respectively. Macrolide resistance was most frequently identified in subjects with DRSP-CAP (0.6%) followed by penicillin resistance (0.5%). Subjects in Africa were more likely to have DRSP-CAP (OR: 7.6; 95% CI: 3.34-15.35, p < 0.001) when compared to centres representing other continents. Conclusions: This multinational point-prevalence study found a low global prevalence of DRSP-CAP that may impact guideline development and antimicrobial policies. Published by Elsevier Ltd on behalf of The British Infection Association.

Published
2019

24. Approccio pragmatico alla diagnosi di polmonite da SARS-CoV-2 (COVID-19). Dalla fase epidemica alle fasi due e tre

Author

Vaghi A, Calderazzo M, Carone M, Confalonieri Marco, Dal Farra Fabrizio, Dottorini M, Gasparini S, Poletti V, Renda T, Scala R, Zuccatosta L., Vaghi, A, Calderazzo, M, Carone, M, Confalonieri, Marco, Dal Farra, Fabrizio, Dottorini, M, Gasparini, S, Poletti, V, Renda, T, Scala, R, and Zuccatosta, L.

Subjects
RT-PCR, TC torace, polmonite da COVID-19, SARS-CoV-2, falsi negativi, probabilità pre-test
Abstract

La polmonite rappresenta la principale causa di ricovero ospedaliero e di mortalità conseguente all'infezione da SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2). La diagnosi eziologica di polmonite da COVID-19 necessita di una conferma della presenza di materiale genetico virale rilevato con il test RT-PCR (Reverse Transcriptase-Polymerase Chain Reaction) ottenuto solitamente utilizzando un tampone naso-faringeo o orofaringeo; tuttavia, numerose evidenze dimostrano che una significativa quota di tamponi, in particolare alla prima determinazione, risulta negativa anche in presenza di una polmonite da OCVID-19. Questi pazienti possono essere erroneamente ricoverati in area non-COVID-19 e pertanto contribuire alla diffusione nosocomiale del virus. Per questo motivo AIPO-ITS (Associazione Italiana Pneumologi Ospedalieri - Italian Thoracic Society) ha promosso la pubblicazione di un documento che propone un approccio pragmatico alla diagnosi di polmonite da da COVID-19 con RT-PCR negativa utilizzando un algoritmo decisionale clinico-radiologico come proxy al gold standard comunemente adottato, rappresentato dalla RT-PCR, finalizzato a isolare il paziente e a promuovere le indagini per un corretto inquadramento clinico-terapeutico. La difficile prova della prima fase della pandemia da OCVID-19 ci ha permesso di conoscere meglio le caratteristiche e la pericolosità di questo nuovo virus e quanto abbiamo appreso deve essere utilmente implementato nella pratica clinica al fine di contenere l'infezione nella cosiddetta seconda e terza fase per prevenire una possibile ondata di ritorno dell'infezione dei mesi autunnali.

Published
2020

25. Defining Kawasaki disease and pediatric inflammatory multisystem syndrome-temporally associated to SARS-CoV-2 infection during SARS-CoV-2 epidemic in Italy: results from a national, multicenter survey

Author

Cattalini, M, Della Paolera, S, Zunica, F, Bracaglia, C, Giangreco, M, Verdoni, L, Meini, A, Sottile, R, Caorsi, R, Zuccotti, G, Fabi, M, Montin, D, Meneghel, A, Consolaro, A, Dellepiane, Rm, Maggio, Mc, La Torre, F, Marchesi, A, Simonini, G, Villani, A, Cimaz, R, Ravelli, A, Taddio, A, Adamoli, P, Alberelli, Mc, Alizzi, C, Barone, P, Bennato, V, Biscaro, F, Bossi, G, Campana, A, Carone, M, Civino, A, Conti, Giorgio, Dei Rossi, E, Del Giudice, E, Dell'Anna, A, De Luca, M, Felici, E, Filocamo, G, Floretta, I, Foschini, Ml, Lanari, M, Lattanzi, B, Lazzerotti, A, Licciardi, F, Manerba, A, Mannarino, S, Marino, A, Marolda, A, Martelli, L, Martini, G, Mauro, A, Mastrolia, Mv, Mazza, A, Miniaci, A, Minoia, F, Olivieri, A, Pennoni, G, Pignataro, R, Ricci, F, Rigante, Donato, Rossi, M, Santagati, C, Soliani, M, Sonego, S, Sperlì, D, Stucchi, S, Teruzzi, B, Tierno, E, Utytatnikova, T, Valentini, Piero, Vergine, G, Conti G (ORCID:0000-0002-8566-9365), Rigante D (ORCID:0000-0001-7032-7779), Valentini P (ORCID:0000-0001-6095-9510), Cattalini, M, Della Paolera, S, Zunica, F, Bracaglia, C, Giangreco, M, Verdoni, L, Meini, A, Sottile, R, Caorsi, R, Zuccotti, G, Fabi, M, Montin, D, Meneghel, A, Consolaro, A, Dellepiane, Rm, Maggio, Mc, La Torre, F, Marchesi, A, Simonini, G, Villani, A, Cimaz, R, Ravelli, A, Taddio, A, Adamoli, P, Alberelli, Mc, Alizzi, C, Barone, P, Bennato, V, Biscaro, F, Bossi, G, Campana, A, Carone, M, Civino, A, Conti, Giorgio, Dei Rossi, E, Del Giudice, E, Dell'Anna, A, De Luca, M, Felici, E, Filocamo, G, Floretta, I, Foschini, Ml, Lanari, M, Lattanzi, B, Lazzerotti, A, Licciardi, F, Manerba, A, Mannarino, S, Marino, A, Marolda, A, Martelli, L, Martini, G, Mauro, A, Mastrolia, Mv, Mazza, A, Miniaci, A, Minoia, F, Olivieri, A, Pennoni, G, Pignataro, R, Ricci, F, Rigante, Donato, Rossi, M, Santagati, C, Soliani, M, Sonego, S, Sperlì, D, Stucchi, S, Teruzzi, B, Tierno, E, Utytatnikova, T, Valentini, Piero, Vergine, G, Conti G (ORCID:0000-0002-8566-9365), Rigante D (ORCID:0000-0001-7032-7779), and Valentini P (ORCID:0000-0001-6095-9510)

Abstract

Background: There is mounting evidence on the existence of a Pediatric Inflammatory Multisystem Syndrome temporally associated to SARS-CoV-2 infection (PIMS-TS), sharing similarities with Kawasaki Disease (KD). The main outcome of the study were to better characterize the clinical features and the treatment response of PIMS-TS and to explore its relationship with KD determining whether KD and PIMS are two distinct entities. Methods: The Rheumatology Study Group of the Italian Pediatric Society launched a survey to enroll patients diagnosed with KD (Kawasaki Disease Group – KDG) or KD-like (Kawacovid Group - KCG) disease between February 1st 2020, and May 31st 2020. Demographic, clinical, laboratory data, treatment information, and patients’ outcome were collected in an online anonymized database (RedCAP®). Relationship between clinical presentation and SARSCoV-2 infection was also taken into account. Moreover, clinical characteristics of KDG during SARS-CoV-2 epidemic (KDG-CoV2) were compared to Kawasaki Disease patients (KDG-Historical) seen in three different Italian tertiary pediatric hospitals (Institute for Maternal and Child Health, IRCCS “Burlo Garofolo”, Trieste; AOU Meyer, Florence;IRCCS Istituto Giannina Gaslini, Genoa) from January 1st 2000 to December 31st 2019. Chi square test or exact Fisher test and non-parametric Wilcoxon Mann-Whitney test were used to study differences between two groups. Results: One-hundred-forty-nine cases were enrolled, (96 KDG and 53 KCG). KCG children were significantly older and presented more frequently from gastrointestinal and respiratory involvement. Cardiac involvement was more common in KCG, with 60,4% of patients with myocarditis. 37,8% of patients among KCG presented hypotension/ non-cardiogenic shock. Coronary artery abnormalities (CAA) were more common in the KDG. The risk of ICU admission were higher in KCG. Lymphopenia, higher CRP levels, elevated ferritin and troponin-T characterized KCG. KDG received more freque

Published
2021

26. Carga y factores de riesgo para la neumonía adquirida en la comunidad de Pseudomonas aeruginosa : un estudio multinacional de prevalencia puntual de pacientes hospitalizados

Author

Restrepo M. I., Babu B. L., Reyes L. F., Chalmers J. D., Soni N. J., Sibila O., Faverio P., Cilloniz C., Rodriguez-Cintron W., Aliberti S., Aruj P. K., Attorri S., Barimboim E., Caeiro J. P., Garzon M. I., Cambursano V. H., Ceccato A., Chertcoff J., Lascar F., Di Tulio F., 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., Anseeuw K., Francois C. A., Van Braeckel E., Vincent J. L., Djimon M. Z., Bashi J., Dodo R., Nouer S. A., Chipev P., Encheva M., Miteva D., Petkova D., Dodo Balkissou A., Pefura Yone E. W., Mbatchou Ngahane B. H., Shen N., Xu J. F., Bustamante Rico C. A., Buitrago R., Pereira Paternina F. J., Kayembe Ntumba J. M., Carevic V. V., Jakopovic M., Jankovic M., Matkovic Z., Mitrecic I., Bouchy Jacobsson M. L., Bro Christensen A., Heitmann Bodtger U. C., Niels Meyer C., Vestergaard Jensen A., Baunbaek-Knudsen G., Petersen P. T., Andersen S., Abd El-Wahhab I. E., Elsayed Morsy N., Shafiek H., Sobh E., Abdella Abdulsemed K., Bertrand F., Brun-Buisson C., de Montmollin E., Fartoukh M., Messika J., Tattevin P., Khoury A., Ebruke B., Dreher M., Kolditz M., Meisinger M., Pletz M. W., Hagel S., Rupp J., Schaberg T., Spielmanns M., Creutz P., Suttorp N., Siaw-Lartey B., Dimakou K., Papapetrou D., Tsigou E., Ampazis D., Kaimakamis E., 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., Kant S., Swarnakar R., Limaye S., Salvi S., Golshani K., Keatings V. M., Martin-Loeches I., Maor Y., Strahilevitz J., Battaglia S., Carrabba M., Ceriana P., Confalonieri M., Monforte A. D., Del Prato B., De Rosa M., Fantini R., 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., Franzetti F., Carugati M., Morosi M., Monge E., Carone M., Patella V., Scarlata S., Comel A., Kurahashi K., Bacha Z. A., Ugalde D. B., Zuniga O. C., Villegas J. F., Medenica M., van de Garde E. M. W., Raj Mihsra D., 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., Leuschner P., Meireles M., Ferrao C., Neves J., Ravara S. B., Brocovschii V., Ion C., Rusu D., Toma C., Chirita D., Dorobat C. M., Birkun A., Kaluzhenina A., Almotairi A., Ali Bukhary Z. A., Edathodu J., Fathy A., Abdulaziz Enani A. M., Mohamed N. E., Memon J. U., Bella A., Bogdanovic N., Milenkovic B., Pesut D., Feldman C., Yum H. K., Borderias L., Bordon Garcia N. M., Cabello Alarcon H., Torres A., Diaz-Brito V., Casas X., Gonzalez A. E., Fernandez-Almira M. L., Gallego M., Gaspar-Garcia I., Del Castillo J. G., Victoria P. J., Martinez E. L., de Molina R. M., Marcos P. J., Menendez R., Pando-Sandoval A., Aymerich C. P., de la Torre A. L., Garcia-Olive I., Rello J., Moyano S., Sanz F., Rodrigo-Troyano A., Sole-Violan J., Uranga A., van Boven J. F. M., Torra E. V., Pujol J. A., Fiogbe A. A., Yangui F., Bilaceroglu S., Dalar L., Yilmaz U., Bogomolov A., Elahi N., Dhasmana D. J., Feneley A., Ions R., Skeemer J., Woltmann G., Hancock C., Hill A. T., Rudran B., Ruiz-Buitrago S., Campbell M., Whitaker P., Youzguin A., Singanayagam A., Allen K. S., Brito V., Dietz J., Dysart C. E., Kellie S. M., Zablocki C. J., MurphyMurphy R. G., 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., Saito S., Noda J., Hinojosa C. I., Levine S. M., Angel L. F., Anzueto A., Whitlow K. S., Hipskind J., Sukhija K., Totten V., Wunderink R. G., Shah R. D., Mateyo K. J., Noriega L., Alvarado E., Aman M., Labra L., Restrepo, M. I., Babu, B. L., Reyes, L. F., Chalmers, J. D., Soni, N. J., Sibila, O., Faverio, P., Cilloniz, C., Rodriguez-Cintron, W., Aliberti, S., Aruj, P. K., Attorri, S., Barimboim, E., Caeiro, J. P., Garzon, M. I., Cambursano, V. H., Ceccato, A., Chertcoff, J., Lascar, F., Di Tulio, F., 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., Anseeuw, K., Francois, C. A., Van Braeckel, E., Vincent, J. L., Djimon, M. Z., Bashi, J., Dodo, R., Nouer, S. A., Chipev, P., Encheva, M., Miteva, D., Petkova, D., Dodo Balkissou, A., Pefura Yone, E. W., Mbatchou Ngahane, B. H., Shen, N., Xu, J. F., Bustamante Rico, C. A., Buitrago, R., Pereira Paternina, F. J., Kayembe Ntumba, J. M., Carevic, V. V., Jakopovic, M., Jankovic, M., Matkovic, Z., Mitrecic, I., Bouchy Jacobsson, M. L., Bro Christensen, A., Heitmann Bodtger, U. C., Niels Meyer, C., Vestergaard Jensen, A., Baunbaek-Knudsen, G., Petersen, P. T., Andersen, S., Abd El-Wahhab, I. E., Elsayed Morsy, N., Shafiek, H., Sobh, E., Abdella Abdulsemed, K., Bertrand, F., Brun-Buisson, C., de Montmollin, E., Fartoukh, M., Messika, J., Tattevin, P., Khoury, A., Ebruke, B., Dreher, M., Kolditz, M., Meisinger, M., Pletz, M. W., Hagel, S., Rupp, J., Schaberg, T., Spielmanns, M., Creutz, P., Suttorp, N., Siaw-Lartey, B., Dimakou, K., Papapetrou, D., Tsigou, E., Ampazis, D., Kaimakamis, E., 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., Kant, S., Swarnakar, R., Limaye, S., Salvi, S., Golshani, K., Keatings, V. M., Martin-Loeches, I., Maor, Y., Strahilevitz, J., Battaglia, S., Carrabba, M., Ceriana, P., Confalonieri, M., Monforte, A. D., Del Prato, B., De Rosa, M., Fantini, R., 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., Franzetti, F., Carugati, M., Morosi, M., Monge, E., Carone, M., Patella, V., Scarlata, S., Comel, A., Kurahashi, K., Bacha, Z. A., Ugalde, D. B., Zuniga, O. C., Villegas, J. F., Medenica, M., van de Garde, E. M. W., Raj Mihsra, D., 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., Leuschner, P., Meireles, M., Ferrao, C., Neves, J., Ravara, S. B., Brocovschii, V., Ion, C., Rusu, D., Toma, C., Chirita, D., Dorobat, C. M., Birkun, A., Kaluzhenina, A., Almotairi, A., Ali Bukhary, Z. A., Edathodu, J., Fathy, A., Abdulaziz Enani, A. M., Mohamed, N. E., Memon, J. U., Bella, A., Bogdanovic, N., Milenkovic, B., Pesut, D., Feldman, C., Yum, H. K., Borderias, L., Bordon Garcia, N. M., Cabello Alarcon, H., Torres, A., Diaz-Brito, V., Casas, X., Gonzalez, A. E., Fernandez-Almira, M. L., Gallego, M., Gaspar-Garcia, I., Del Castillo, J. G., Victoria, P. J., Martinez, E. L., de Molina, R. M., Marcos, P. J., Menendez, R., Pando-Sandoval, A., Aymerich, C. P., de la Torre, A. L., Garcia-Olive, I., Rello, J., Moyano, S., Sanz, F., Rodrigo-Troyano, A., Sole-Violan, J., Uranga, A., van Boven, J. F. M., Torra, E. V., Pujol, J. A., Fiogbe, A. A., Yangui, F., Bilaceroglu, S., Dalar, L., Yilmaz, U., Bogomolov, A., Elahi, N., Dhasmana, D. J., Feneley, A., Ions, R., Skeemer, J., Woltmann, G., Hancock, C., Hill, A. T., Rudran, B., Ruiz-Buitrago, S., Campbell, M., Whitaker, P., Youzguin, A., Singanayagam, A., Allen, K. S., Brito, V., Dietz, J., Dysart, C. E., Kellie, S. M., Zablocki, C. J., Murphymurphy, R. G., 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., Saito, S., Noda, J., Hinojosa, C. I., Levine, S. M., Angel, L. F., Anzueto, A., Whitlow, K. S., Hipskind, J., Sukhija, K., Totten, V., Wunderink, R. G., Shah, R. D., Mateyo, K. J., Noriega, L., Alvarado, E., Aman, M., Labra, L., Restrepo, M, Babu, B, Reyes, L, Chalmers, J, Soni, N, Sibila, O, Faverio, P, Cilloniz, C, Rodriguez-Cintron, W, Aliberti, S, Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Value, Affordability and Sustainability (VALUE), Groningen Research Institute for Asthma and COPD (GRIAC), Restrepo M.I., Babu B.L., Reyes L.F., Chalmers J.D., Soni N.J., Sibila O., Faverio P., Cilloniz C., Rodriguez-Cintron W., Aliberti S., Aruj P.K., Attorri S., Barimboim E., Caeiro J.P., Garzon M.I., Cambursano V.H., Ceccato A., Chertcoff J., Lascar F., Di Tulio F., 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., Anseeuw K., Francois C.A., Van Braeckel E., Vincent J.L., Djimon M.Z., Bashi J., Dodo R., Nouer S.A., Chipev P., Encheva M., Miteva D., Petkova D., Dodo Balkissou A., Pefura Yone E.W., Mbatchou Ngahane B.H., Shen N., Xu J.F., Bustamante Rico C.A., Buitrago R., Pereira Paternina F.J., Kayembe Ntumba J.M., Carevic V.V., Jakopovic M., Jankovic M., Matkovic Z., Mitrecic I., Bouchy Jacobsson M.L., Bro Christensen A., Heitmann Bodtger U.C., Niels Meyer C., Vestergaard Jensen A., Baunbaek-Knudsen G., Petersen P.T., Andersen S., Abd El-Wahhab I.E., Elsayed Morsy N., Shafiek H., Sobh E., Abdella Abdulsemed K., Bertrand F., Brun-Buisson C., de Montmollin E., Fartoukh M., Messika J., Tattevin P., Khoury A., Ebruke B., Dreher M., Kolditz M., Meisinger M., Pletz M.W., Hagel S., Rupp J., Schaberg T., Spielmanns M., Creutz P., Suttorp N., Siaw-Lartey B., Dimakou K., Papapetrou D., Tsigou E., Ampazis D., Kaimakamis E., 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., Kant S., Swarnakar R., Limaye S., Salvi S., Golshani K., Keatings V.M., Martin-Loeches I., Maor Y., Strahilevitz J., Battaglia S., Carrabba M., Ceriana P., Confalonieri M., Monforte A.D., Del Prato B., De Rosa M., Fantini R., 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., Franzetti F., Carugati M., Morosi M., Monge E., Carone M., Patella V., Scarlata S., Comel A., Kurahashi K., Bacha Z.A., Ugalde D.B., Zuniga O.C., Villegas J.F., Medenica M., van de Garde E.M.W., Raj Mihsra D., 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., Leuschner P., Meireles M., Ferrao C., Neves J., Ravara S.B., Brocovschii V., Ion C., Rusu D., Toma C., Chirita D., Dorobat C.M., Birkun A., Kaluzhenina A., Almotairi A., Ali Bukhary Z.A., Edathodu J., Fathy A., Abdulaziz Enani A.M., Mohamed N.E., Memon J.U., Bella A., Bogdanovic N., Milenkovic B., Pesut D., Feldman C., Yum H.K., Borderias L., Bordon Garcia N.M., Cabello Alarcon H., Torres A., Diaz-Brito V., Casas X., Gonzalez A.E., Fernandez-Almira M.L., Gallego M., Gaspar-Garcia I., Del Castillo J.G., Victoria P.J., Martinez E.L., de Molina R.M., Marcos P.J., Menendez R., Pando-Sandoval A., Aymerich C.P., de la Torre A.L., Garcia-Olive I., Rello J., Moyano S., Sanz F., Rodrigo-Troyano A., Sole-Violan J., Uranga A., van Boven J.F.M., Torra E.V., Pujol J.A., Fiogbe A.A., Yangui F., Bilaceroglu S., Dalar L., Yilmaz U., Bogomolov A., Elahi N., Dhasmana D.J., Feneley A., Ions R., Skeemer J., Woltmann G., Hancock C., Hill A.T., Rudran B., Ruiz-Buitrago S., Campbell M., Whitaker P., Youzguin A., Singanayagam A., Allen K.S., Brito V., Dietz J., Dysart C.E., Kellie S.M., Zablocki C.J., MurphyMurphy R.G., 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., Saito S., Noda J., Hinojosa C.I., Levine S.M., Angel L.F., Anzueto A., Whitlow K.S., Hipskind J., Sukhija K., Totten V., Wunderink R.G., Shah R.D., Mateyo K.J., Noriega L., Alvarado E., Aman M., and Labra L.

Subjects
Pneumonia, Pseudomonas aeruginosa, Male, antibiotic resistance, Internationality, Cross-sectional study, bacterial colonization, very elderly, Prevalence, Drug Resistance, Drug resistance, Pneumònia adquirida a la comunitat, Pseudomonas aeruginosa community acquired pneumonia, Pulmonary Disease, Chronic Obstructive, 0302 clinical medicine, Tracheostomy, Community-acquired pneumonia, Risk Factors, Epidemiology, 80 and over, Medicine, Community-Acquired Infection, 030212 general & internal medicine, Aged, 80 and over, Cross Infection, adult, article, Bacterial, Middle Aged, Antibiotic coverage, Bronchiectasis, Community-Acquired Infections, hospital patient, priority journal, risk factor, Aged, Cross-Sectional Studies, Drug Resistance, Bacterial, Female, Humans, Logistic Models, Pneumonia, Bacterial, Pseudomonas aeruginosa, Infectious diseases, Human, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Chronic Obstructive, Logistic Model, Admission, Settore MED/10 - Malattie Dell'Apparato Respiratorio, chronic lung disease, Pulmonary Disease, 03 medical and health sciences, Bronchiectasi, Internal medicine, Pseudomonas, controlled study, human, Cross-Sectional Studie, business.industry, Risk Factor, community acquired pneumonia, Pneumonia, medicine.disease, logistic regression analysis, major clinical study, antibiotic sensitivity, hospital admission, 030228 respiratory system, microbiological examination, business, chronic obstructive lung disease
Abstract

Pseudomonas aeruginosa is a challenging bacterium to treat due to its intrinsic resistance to the antibiotics used most frequently in patients with community-acquired pneumonia (CAP). Data about the global burden and risk factors associated with P. aeruginosa-CAP are limited. We assessed the multinational burden and specific risk factors associated with P. aeruginosa-CAP. We enrolled 3193 patients in 54 countries with confirmed diagnosis of CAP who underwent microbiological testing at admission. Prevalence was calculated according to the identification of P. aeruginosa. Logistic regression analysis was used to identify risk factors for antibiotic-susceptible and antibiotic-resistant P. aeruginosa-CAP. The prevalence of P. aeruginosa and antibiotic-resistant P. aeruginosa-CAP was 4.2% and 2.0%, respectively. The rate of P. aeruginosa CAP in patients with prior infection/colonisation due to P. aeruginosa and at least one of the three independently associated chronic lung diseases (i.e. tracheostomy, bronchiectasis and/or very severe chronic obstructive pulmonary disease) was 67%. In contrast, the rate of P. aeruginosa-CAP was 2% in patients without prior P. aeruginosa infection/colonisation and none of the selected chronic lung diseases. The multinational prevalence of P. aeruginosa-CAP is low. The risk factors identified in this study may guide healthcare professionals in deciding empirical antibiotic coverage for CAP patients.

Published
2018

27. Early management of COPD: Where are we now and where do we go from here? a delphi consensus project

Author

Di Marco F., Balbo P., de Blasio F., Cardaci V., Crimi N., Girbino G., Pelaia G., Pirina P., Roversi P., Santus P., Scichilone N., Vatrella A., Pasqualetti P., Carone M., Di Marco F., Balbo P., de Blasio F., Cardaci V., Crimi N., Girbino G., Pelaia G., Pirina P., Roversi P., Santus P., Scichilone N., Vatrella A., Pasqualetti P., and Carone M.

Subjects
Adrenergic beta-2 Receptor Agonist, Pulmonary and Respiratory Medicine, drug combinations, practice guidelines as topic, Consensu, Predictive Value of Test, bronchodilator therapy, dyspnea, italy, respiratory symptoms, adrenal cortex hormones, adrenergic beta-2 receptor agonists, adult, bronchodilator agents, consensus, delphi technique, early diagnosis, early medical intervention, evidence-based medicine, female, humans, male, middle aged, muscarinic antagonists, predictive value of tests, pulmonary disease, chronic obstructive, surveys and questionnaires, treatment outcome, Settore MED/10 - Malattie Dell'Apparato Respiratorio, International Journal of Chronic Obstructive Pulmonary Disease, dyspnoea, Adrenal Cortex Hormone, Pulmonary Disease, Chronic Obstructive, Drug Combination, Early Diagnosi, Surveys and Questionnaire, Bronchodilator Agent, Original Research, lcsh:RC705-779, Health Policy, Environmental and Occupational Health, lcsh:Diseases of the respiratory system, Bronchodilator therapy, Dyspnea, Italy, Respiratory symptoms, Public Health, Environmental and Occupational Health, Muscarinic Antagonist, Respiratory symptom, Public Health, Human
Abstract

Fabiano Di Marco,1 Piero Balbo,2 Francesco de Blasio,3 Vittorio Cardaci,4 Nunzio Crimi,5 Giuseppe Girbino,6 Girolamo Pelaia,7 Pietro Pirina,8 Pietro Roversi,9 Pierachille Santus,10,11 Nicola Scichilone,12 Alessandro Vatrella,13 Patrizio Pasqualetti,14 Mauro Carone15 1Department of Health Sciences, University of Milan, Respiratory Unit, Papa Giovanni XXIII Hospital, Bergamo, Italy; 2SC Malattie dell’Apparato Respiratorio, AOU Maggiore della Carità, Novara, Italy; 3Respiratory Medicine and Pulmonary Rehabilitation Section, Clinic Center S.p.A. Private Hospital, Department of Medicine and Health Sciences “V Tiberio”, University of Molise, Campobasso, Italy; 4Unit of Pulmonary Rehabilitation, IRCCS “San Raffaele Pisana”, Rome, Italy; 5Unità Operativa Complessa di Pneumologia e Allergologia, Policlinico Rodolico Vittorio Emanuele, Università di Catania, Catania, Italy; 6Dipartimento di Scienze Biomediche, Odontoiatriche e delle Immagini Morfologiche e Funzionali (BIOMORF), Università degli Studi di Messina, Messina, Italy; 7Department of Medical and Surgical Sciences, Unit of Respiratory Diseases, University Magna Graecia of Catanzaro, Catanzaro, Italy; 8Respiratory Unit, AOU Sassari, Sassari, Italy; 9Azienda Ospedaliera Universitaria, Policlinico di Modena, Modena, Italy; 10Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy; 11Division of Respiratory Diseases “L. Sacco” Hospital, ASST Fatebenefratelli Sacco, Milan, Italy; 12Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), University of Palermo, Palermo, Italy; 13Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Salerno, Italy; 14Fondazione Fatebenefratelli per la Ricerca e la Formazione Sanitaria e Sociale, Rome, Italy; 15Istituti Clinici Scientifici Maugeri, IRCCS di Cassano delle Murge, Cassano delle Murge (BA), Italy Purpose: There is a lack of consensus on the most appropriate early diagnostic strategy, criteria for early access to treatment and follow-up approach for patients with COPD. Materials and methods: A Delphi consensus project investigated the early management of COPD. We formulated two questionnaires for completion by pneumologists in Italy. Results: A total of 207 specialists completed questionnaire 1 and 184 of them questionnaire 2, between November 2016 and October 2017. Early diagnosis of COPD was considered uncommon for 93.2% of the expert panel. Regardless of the definition of “early diagnosis” – a diagnosis made before the clinical manifestation of the disease for most responders (60.4%) – experts were confident of the positive effects of early disease management, which they consider is effective in modifying the natural history of the disease. Lack of awareness of the disease was considered the first limiting factor to early COPD management for 78% of respondents. The most effective steps to reduce functional decline were considered to be smoking cessation, followed by long-acting β2-agonist (LABA)/long-acting muscarinic antagonist (LAMA), LAMA, LABA, and finally inhaled corticosteroid/LABA(P

Published
2019

29. An international perspective on hospitalized patients with viral community-acquired pneumonia

Author

Radovanovic, D., Sotgiu, G., Jankovic, M., Mahesh, P.A., Marcos, P.J., Abdalla, M.I., Di Pasquale, M.F., Gramegna, A., Terraneo, S., Blasi, F., Santus, P., Aliberti, S., Reyes, L.F., Restrepo, M.I., Aruj, P.K., Attorri, S., Barimboim, E., Caeiro, J.P., Garzón, M.I., Cambursano, V.H., Ceccato, A., Chertcoff, J., Cordon Díaz, A., 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., Lötsch, F., Thalhammer, F., Anseeuw, K., Francois, C.A., Van Braeckel, E., Vincent, J.L., Djimon, M.Z., Aranha Nouér, S., Chipev, P., Encheva, M., Miteva, D., Petkova, D., Balkissou, A.D., Pefura Yone, E.W., Mbatchou Ngahane, B.H., Shen, N., Xu, J.F., Bustamante Rico, C.A., Buitrago, R., Pereira Paternina, F.J., Kayembe Ntumba, J.M., Vladic-Carevic, V., Jakopovic, M., Matkovic, Z., Mitrecic, I., Bouchy Jacobsson, M.L., Bro Christensen, A., Heitmann Bødtger, U.C., Meyer, C.N., Vestergaard Jensen, A., El-Said Abd El-Wahhab, I., Elsayed Morsy, N., Shafiek, H., Sobh, E., Abdulsemed, K.A., Bertrand, F., Brun-Buisson, C., de Montmollin, E., Fartoukh, M., Messika, J., Tattevin, P., Khoury, A., Ebruke, B., Dreher, M., Kolditz, M., Meisinger, M., Pletz, M.W., Hagel, S., Rupp, J., Schaberg, T., Spielmanns, M., Creutz, P., Suttorp, N., Siaw-Lartey, B., Dimakou, K., Papapetrou, D., Tsigou, E., Ampazis, D., Kaimakamis, E., Bhatia, M., Dhar, R., D'Souza, G., Garg, R., Koul, P.A., Jayaraj, B.S., Narayan, K.V., Udnur, H.B., Krishnamurthy, S.B., Kant, S., Swarnakar, R., Salvi, S., Limaye, S., Golshani, K., Keatings, V.M., Martin-Loeches, I., Maor, Y., Strahilevitz, J., Battaglia, S., Carrabba, M., Ceriana, P., Confalonieri, M., d'Arminio Monforte, A., Del Prato, B., De Rosa, M., Fantini, R., 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., Franzetti, F., Carone, M., Patella, V., Scarlata, S., Comel, A., Kurahashi, K., Aoun Bacha, Z., Barajas Ugalde, D., Ceballos Zuñiga, O., Villegas, J.F., Medenica, M., van de Garde, E.M.W., Raj Mihsra, D., Shrestha, P., Ridgeon, E., Ishola Awokola, B., Nwankwo, O.N.O., Olufunlola, A.B., Olumide, S., Ukwaja, K.N., Irfan, M., Minarowski, L., Szymon, S., Froes, F., Leuschner, P., Meireles, M., Ferrão, C., Neves, J., Ravara, S.B., Brocovschii, V., Ion, C., Rusu, D., Toma, C., Chirita, D., Dorobat, C.M., Birkun, A., Kaluzhenina, A., Almotairi, A., Bukhary, Z.A.A., Edathodu, J., Fathy, A., Mushira Abdulaziz Enani, A., Eltayeb Mohamed, N., Ulhadi Memon, J., Bella, A., Bogdanovic, N., Milenkovic, B., Pesut, D., Borderìas, L., Bordon Garcia, N.M., Cabello Alarcón, H., Cilloniz, C., Torres, A., Diaz-Brito, V., Casas, X., Encabo González, A., Fernández-Almira, M.L., Gallego, M., Gaspar-GarcÍa, I., González Del Castillo, J., Javaloyes Victoria, P., Laserna Martínez, E., Malo de Molina, R., and Menéndez, R.

Subjects
viruses
Abstract

Background: Who should be tested for viruses in patients with community acquired pneumonia (CAP), prevalence and risk factors for viral CAP are still debated. We evaluated the frequency of viral testing, virus prevalence, risk factors and treatment coverage with oseltamivir in patients admitted for CAP. Methods: Secondary analysis of GLIMP, an international, multicenter, point-prevalence study of hospitalized adults with CAP. Testing frequency, prevalence of viral CAP and treatment with oseltamivir were assessed among patients who underwent a viral swab. Univariate and multivariate analysis was used to evaluate risk factors. Results: 553 (14.9%) patients with CAP underwent nasal swab. Viral CAP was diagnosed in 157 (28.4%) patients. Influenza virus was isolated in 80.9% of cases. Testing frequency and viral CAP prevalence were inhomogeneous across the participating centers. Obesity (OR 1.59, 95%CI: 1.01–2.48; p = 0.043) and need for invasive mechanical ventilation (OR 1.62, 95%CI: 1.02–2.56; p = 0.040) were independently associated with viral CAP. Prevalence of empirical treatment with oseltamivir was 5.1%. Conclusion: In an international scenario, testing frequency for viruses in CAP is very low. The most common cause of viral CAP is Influenza virus. Obesity and need for invasive ventilation represent independent risk factors for viral CAP. Adherence to recommendations for treatment with oseltamivir is poor.

Published
2019

32. Management of Chronic Respiratory Failure in Interstitial Lung Diseases: Overview and Clinical Insights

Author

Faverio, P, De Giacomi, F, Bonaiti, G, Stainer, A, Sardella, L, Pellegrino, G, Sferrazza Papa, G, Bini, F, Bodini, B, Carone, M, Annoni, S, Messinesi, G, Pesci, A, Faverio, Paola, De Giacomi, Federica, Bonaiti, Giulia, Stainer, Anna, Sardella, Luca, Pellegrino, Giulia, Sferrazza Papa, Giuseppe Francesco, Bini, Francesco, Bodini, Bruno Dino, Carone, Mauro, Annoni, Sara, Messinesi, Grazia, Pesci, Alberto, Faverio, P, De Giacomi, F, Bonaiti, G, Stainer, A, Sardella, L, Pellegrino, G, Sferrazza Papa, G, Bini, F, Bodini, B, Carone, M, Annoni, S, Messinesi, G, Pesci, A, Faverio, Paola, De Giacomi, Federica, Bonaiti, Giulia, Stainer, Anna, Sardella, Luca, Pellegrino, Giulia, Sferrazza Papa, Giuseppe Francesco, Bini, Francesco, Bodini, Bruno Dino, Carone, Mauro, Annoni, Sara, Messinesi, Grazia, and Pesci, Alberto

Abstract

Interstitial lung diseases (ILDs) may be complicated by chronic respiratory failure (CRF), especially in the advanced stages. Aim of this narrative review is to evaluate the current evidence in management of CRF in ILDs.Many physiological mechanisms underlie CRF in ILDs, including lung restriction, ventilation/perfusion mismatch, impaired diffusion capacity and pulmonary vascular damage. Intermittent exertional hypoxemia is often the initial sign of CRF, evolving, as ILD progresses, into continuous hypoxemia. In the majority of the cases, the development of CRF is secondary to the worsening of the underlying disease; however, associated comorbidities may also play a role. When managing CRF in ILDs, the need for pulmonary rehabilitation, the referral to lung transplant centers and palliative care should be assessed and, if necessary, promptly offered. Long-term oxygen therapy is commonly prescribed in case of resting or exertional hypoxemia with the purpose to decrease dyspnea and improve exercise tolerance. High-Flow Nasal Cannula oxygen therapy may be used as an alternative to conventional oxygen therapy for ILD patients with severe hypoxemia requiring both high flows and high oxygen concentrations. Non-Invasive Ventilation may be used in the chronic setting for palliation of end-stage ILD patients, although the evidence to support this application is very limited.

Published
2019

33. Incidence of Lung Cancer in Patients with IPF Treated by Pirfenidone or Nintedanib - a Real Life Multicentric Experience

Author

Lacedonia, D., primary, Ventura, V.A., additional, Mesto, M., additional, Iamele, L., additional, Labate, L., additional, Refolo, L., additional, Salerno, F.G., additional, de Tullio, R., additional, Tedeschi, E., additional, Rollo, M., additional, Caccavo, I., additional, Patricelli, G., additional, Profilo, E., additional, Carone, M., additional, di Napoli, P., additional, Picca, V., additional, Sabato, E., additional, Giorgio, V., additional, Resta, O., additional, and Foschino Barbaro, M.P., additional

Published
2019
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35. Management of acute respiratory failure in interstitial lung diseases: Overview and clinical insights

Author

Faverio, P, De Giacomi, F, Sardella, L, Fiorentino, G, Carone, M, Salerno, F, Ora, J, Rogliani, P, Pellegrino, G, Sferrazza Papa, G, Bini, F, Bodini, B, Messinesi, G, Pesci, A, Esquinas, A, Faverio, Paola, De Giacomi, Federica, Sardella, Luca, Fiorentino, Giuseppe, Carone, Mauro, Salerno, Francesco, Ora, Jousel, Rogliani, Paola, Pellegrino, Giulia, Sferrazza Papa, Giuseppe Francesco, Bini, Francesco, Bodini, Bruno Dino, Messinesi, Grazia, Pesci, Alberto, Esquinas, Antonio, Faverio, P, De Giacomi, F, Sardella, L, Fiorentino, G, Carone, M, Salerno, F, Ora, J, Rogliani, P, Pellegrino, G, Sferrazza Papa, G, Bini, F, Bodini, B, Messinesi, G, Pesci, A, Esquinas, A, Faverio, Paola, De Giacomi, Federica, Sardella, Luca, Fiorentino, Giuseppe, Carone, Mauro, Salerno, Francesco, Ora, Jousel, Rogliani, Paola, Pellegrino, Giulia, Sferrazza Papa, Giuseppe Francesco, Bini, Francesco, Bodini, Bruno Dino, Messinesi, Grazia, Pesci, Alberto, and Esquinas, Antonio

Abstract

Background: Interstitial lung diseases (ILDs) are a heterogeneous group of diseases characterized by widespread fibrotic and inflammatory abnormalities of the lung. Respiratory failure is a common complication in advanced stages or following acute worsening of the underlying disease. Aim of this review is to evaluate the current evidence in determining the best management of acute respiratory failure (ARF) in ILDs. Methods: A literature search was performed in the Medline/PubMed and EMBASE databases to identify studies that investigated the management of ARF in ILDs (the last search was conducted on November 2017). Results: In managing ARF, it is important to establish an adequate diagnostic and therapeutic management depending on whether the patient has an underlying known chronic ILD or ARF is presenting in an unknown or de novo ILD. In the first case both primary causes, such as acute exacerbations of the disease, and secondary causes, including concomitant pulmonary infections, fluid overload and pulmonary embolism need to be investigated. In the second case, a diagnostic work-up that includes investigations in regards to ILD etiology, such as autoimmune screening and bronchoalveolar lavage, should be performed, and possible concomitant causes of ARF have to be ruled out. Oxygen supplementation and ventilatory support need to be titrated according to the severity of ARF and patients' therapeutic options. High-Flow Nasal oxygen might potentially be an alternative to conventional oxygen therapy in patients requiring both high flows and high oxygen concentrations to correct hypoxemia and control dyspnea, however the evidence is still scarce. Neither Non-Invasive Ventilation (NIV) nor Invasive Mechanical Ventilation (IMV) seem to change the poor outcomes associated to advanced stages of ILDs. However, in selected patients, such as those with less severe ARF, a NIV trial might help in the early recognition of NIV-responder patients, who may present a better short-ter

Published
2018

36. Global sensitivity analysis for repeated measures studies with informative drop-out: A semi-parametric approach

Author

Scharfstein, D, Mcdermott, A, Díaz, I, Carone, M, Lunardon, N, Turkoz, I, Scharfstein, D, Mcdermott, A, Díaz, I, Carone, M, Lunardon, N, and Turkoz, I

Abstract

In practice, both testable and untestable assumptions are generally required to draw inference about the mean outcome measured at the final scheduled visit in a repeated measures study with drop-out. Scharfstein et al. (2014) proposed a sensitivity analysis methodology to determine the robustness of conclusions within a class of untestable assumptions. In their approach, the untestable and testable assumptions were guaranteed to be compatible; their testable assumptions were based on a fully parametric model for the distribution of the observable data. While convenient, these parametric assumptions have proven especially restrictive in empirical research. Here, we relax their distributional assumptions and provide a more flexible, semi-parametric approach. We illustrate our proposal in the context of a randomized trial for evaluating a treatment of schizoaffective disorder.

Published
2018

39. Italian Survey on Prevalence and Disease Management of Chronic Heart Failure and Chronic Obstructive Pulmonary Disease comorbidity in ambulatory patients. SUSPIRIUM study rationale and design

Author

Griffo, R., Spanevello, A., Temporelli, P.l., Faggiano, P., Carones, M., Magni, G., Ambrosino, N., Tavazzi, L, Giannuzzi, P., Balbi, B., Caporotondi, A., Fracchia, C., Pedretti, R.f., Del Corso, L., Scrabogna, P., Passantino, A., Carone, M., Chieffo, C., de Blasio, F., Bertoli, D., Bancalari, L., Fattirolli, F., Pistoiesi, M., Carlon, R., Idotta, G., VIGORITO, CARLO, MORMILE, MAURO, Griffo, R., Spanevello, A., Temporelli, P. l., Faggiano, P., Carones, M., Magni, G., Ambrosino, N., Tavazzi, L, Giannuzzi, P., Balbi, B., Caporotondi, A., Fracchia, C., Pedretti, R. f., Del Corso, L., Scrabogna, P., Passantino, A., Carone, M., Chieffo, C., de Blasio, F., Bertoli, D., Bancalari, L., Fattirolli, F., Pistoiesi, M., Carlon, R., Idotta, G., Vigorito, Carlo, and Mormile, Mauro

Subjects
Heart Failure, Pulmonary Disease, Chronic Obstructive, Italy, Health Care Survey, Patient Selection, Chronic Disease, Peptide, Prevalence, Comorbidity, Human
Abstract

Chronic heart failure (CHF) and chronic obstructive pulmonary disease (COPD) are leading causes of morbidity and mortality worldwide. Through shared risk factors and pathophysiological mechanisms, CHF and COPD frequently coexist. The concurrent disease has important therapeutic implications and independently predicts worsened mortality, impaired functional status, and health service use. However, assessment of the comorbidity varies widely according to the population studied, diagnostic criteria and measurement tools applied. Both syndromes have been studied extensively but largely separately, mostly in the domain of the pulmonologist for COPD and in the domain of the cardiologist for CHF.

Published
2014

40. Acute disseminated encephalomyelitis in China, Singapore and Japan: a comparison with the USA

Author

Koelman, D. L. H., primary, Benkeser, D. C., additional, Xu, Y., additional, Neo, S. X., additional, Tan, K., additional, Katsuno, M., additional, Sobue, G., additional, Natsume, J., additional, Chahin, S., additional, Mar, S. S., additional, Venkatesan, A., additional, Chitnis, T., additional, Hoganson, G. M., additional, Yeshokumar, A. K., additional, Barreras, P., additional, Majmudar, B., additional, Carone, M., additional, and Mateen, F. J., additional

Published
2016
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41. Antibiotic treatment of severe exacerbations of chronic obstructive pulmonary disease with procalcitonin: a randomized noninferiority trial

Author

Verduri, A, Luppi, F, D'Amico, R, Balduzzi, S, Vicini, R, Liverani, A, Ruggieri, V, Plebani, M, Barbaro, Mp, Spanevello, A, Canonica, Gw, Papi, A, Fabbri, Lm, Beghè, B, FARM58J2XH Study Group: Fabbri LM, Beghé, B, Franco, F, De Carlo MR, Confalonieri, M, Milani, G, Pozzi, E, Luisetti, M, Cerveri, I, Niniano, R, Marsico, S, Calabrese, C, Olivieri, D, Tzani, P, Torre, O, Braido, F, Salerno, F, Carone, M, Zucchi, L, Menzella, F, Castagnetti, C, Paggiaro, Pl, Vagaggini, B, Costa, F, Contoli, M, Marku, B, Cagnazzo, Mg, Crimi, Nunzio, Mastruzzo, C, Ciccarelli, M, Calabro, S, Balestro, E, Rossi, A, Donazzan, G, Bonazza, L, Zuin, R, Pistolesi, M, and Bigazzi, F.

Subjects
Sepsis, C-Reactive Protein, Serum procalcitonin
Published
2015

42. The pathogenetic role of the chaperonin Hsp60 in chronic obstructive pulmonary disease: new data and perspectives

Author

CAPPELLO, Francesco, CAMPANELLA, Claudia, ZUMMO, Giovanni, Caramori, G., Vicari, C., Gemmi, I., Zanini, A., Spanevello, A., Capelli, A., D’Anna, S., Ricciardolo, F., Brun, P., Balbi, B., Carone, M., Conway de Macario, E., Macario, A., Di Stefano, A., Cappello, F., Caramori, G., Campanella, C., Vicari, C., Gemmi, I., Zanini, A., Spanevello, A., Capelli, A., D’Anna, S., Ricciardolo, F., Brun, P., Balbi, B., Carone, M., Zummo, G., Conway de Macario, E., Macario, A., and Di Stefano, A.

Subjects
Settore BIO/16 - Anatomia Umana, COPD Hsp60
Published
2012

43. A multipronged approach to unveil the emerging role of Hsp60 in chronic obstructive pulmonary disease

Author

CAPPELLO, Francesco, CAMPANELLA, Claudia, LA ROCCA, Giampiero, ANZALONE, Rita, BUCCHIERI, Fabio, ZUMMO, Giovanni, Di Stefano, A, Caramori, G, Vicari, C, Gemmi, I, Zanini, A, Spanevello, A, Capelli, A, D’Anna, SE, Ricciardolo, FLM, Brun, P, Balbi, B, Carone, M, de Macario, EC, Macario, AJL, Cappello, F, Di Stefano, A, Caramori, G, Campanella, C, Vicari, C, Gemmi, I, Zanini, A, Spanevello, A, Capelli, A, La Rocca, G, Anzalone, R, Bucchieri, F, D’Anna, SE, Ricciardolo, FLM, Brun, P, Balbi, B, Carone, M, de Macario, EC, Macario, AJL, and Zummo, G

Subjects
bronchial mucosa, neutrophils, airway, inflammation, heat shock protein, chaperone, chemical and pharmacologic phenomena, airways, heat shock proteins, chaperones
Abstract

Inflammation is a major component of chronic obstructive pulmonary disease (COPD) and its cause and mechanisms are still incompletely understood. For example, the role of heat shock proteins (Hsps), many of which are molecular chaperones, has not been explored in detail in COPD, despite the fact that these molecules are known to participate in inflammation in other diseases. It has been shown that extracellular Hsps can signal certain types of T cells, macrophages, dendritic cells, and neutrophils and, thereby, elicit inflammation and immunity. However, these phenomena have not been investigated in COPD despite: a) the increasing awareness of Hsp participation in inflammation and immunity; and b) the fact that this disease is waiting for new knowledge to benefit from effective treatment and continues to be one of the commonest and most serious illnesses in the Western countries. We developed a strategy to study Hsps in COPD involving a multipronged approach, using in vivo and in vitro methods, which would, at least in part, compensate for the limitations inherent to the analysis of human diseases. We determined the levels of six Hsps in bronchial mucosa biopsies, as well as several inflammatory markers, from patients at various stages compared to smoker and non-smoker controls by immunohistochemistry, and found significant increase of Hsp60, Hsp10, and Hsp40 in COPD but no changes for Hsp27, Hsp70 and Hsp90. We also found that the increase in Hsp60 positively correlated with number of neutrophils, and it localized in them. Hsp60 has been implicated in human inflammatory pathology; hence it was pertinent to investigate whether the chaperonin originated only in the neutrophils or also in other cells. In vitro experiments showed that in bronchial epithelial cells submitted to oxidative stress, a characteristic of COPD mucosa, Hsp60 was overexpressed and was released into the extracellular medium. Other measurements indicated that NFkB-p65 was involved in the hsp60-gene upregulation whereas HSF-1 apparently was not. All the data we obtained using a battery of complementary in vivo and in vitro methods coincided to indicate that Hsp60 plays an active role in inflammation in COPD. Hence, one can infer that the chaperonin does contribute to the etiology and/or pathogenesis of COPD and that it is pertinent to investigate this aspect of Hsp60 biology-COPD pathology with renewed intensity. The results could have a significant impact on the developing of strategies for diagnosis, determining prognosis, and treatment that should be centered on Hsp60., Italian Journal of Anatomy and Embryology, Vol 116, No 1 (Supplement) 2011

Published
2011
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44. Chaperones in disease: quantitative changes in chronic obstructive pulmonary disease (COPD)

Author

CAPPELLO, Francesco, CORRAO, Simona, Carbone, Marco, LA ROCCA, Giampiero, Gnemmi, I, Vicari, C, Caramori, G, Carone, M, Balbi, B, Conway de Macario, E, Macario, AJ, Di Stefano, A., Cappello, F, Corrao, S, Carbone, M, Gnemmi, I, Vicari, C, Caramori, G, Carone, M, La Rocca, G, Balbi, B, Conway de Macario, E, Macario, AJ, and Di Stefano, A

Subjects
Settore BIO/16 - Anatomia Umana, chaperones, COPD, lung cells, epithelium, hsp10, hsp60, hsp27, hsp40, hsp70, hsp90, cigarette smoke
Published
2010

45. Correspondence between clinical improvement and proteomic changes of the salivary peptide complex ina child with primary Sjogren syndrome

Author

RIGANTE D, INZITARI R, Carone M, FANALI C, STABILE A, CABRAS T, CAPOLUONGO ED, Gaspari S, BARONE G, CASTAGNOLA M, Rigante, D, Inzitari, R, Carone, M, Fanali, C, Stabile, A, Cabras, T, Capoluongo, Ed, Gaspari, S, Barone, G, and Castagnola, M

Subjects
child, Settore MED/38 - PEDIATRIA GENERALE E SPECIALISTICA, salivary peptide, Sjogren syndrome
Published
2008

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