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Patógenos atípicos en pacientes hospitalizados con neumonía adquirida en la comunidad: una perspectiva mundial

Authors :
Gramegna A.
Sotgiu G.
Di Pasquale M.
Radovanovic D.
Terraneo S.
Reyes L. F.
Vendrell E.
Neves J.
Menzella F.
Blasi F.
Aliberti S.
Restrepo M. I.
Aruj P. K.
Attorri S.
Barimboim E.
Caeiro J. P.
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.
Lotsch F.
Vincent J. L.
Anseeuw K.
Francois C. A.
Van Braeckel E.
Djimon M. Z.
Bashi J.
Roger D.
Nouer S. A.
Chipev P.
Encheva M.
Miteva D.
Petkova D.
Dodo B. A.
Hugo M. N. B.
Shen N.
Xu J. -F.
Rico C. A. B.
Buitrago R.
Paternina F. J. P.
Jean-Marie K. N.
Carevic V. V.
Jakopovic M.
Jankovic M.
Matkovic Z.
Mitrecic I.
Jacobsson M. -L. B.
Christensen A. B.
HeitmannBodtger U. C.
Meyer C. N.
Jensen A. V.
Baunbaek-knudsen G.
Petersen P. T.
Andersen S.
El-Wahhab I. E. -S. A.
Morsy N. E.
Shafi ek H.
Sobh E.
Bertrand F.
Brun- Buisson C.
de Montmollin E.
Fartoukh M.
Messika J.
Tattevin P.
Dreher M.
Kolditz M.
Meisinger M.
Pletz M. W.
Hagel S.
Rupp J.
Schaberg T.
Spielmanns M.
Siaw-Lartey B.
Dimakou K.
Papapetrou D.
Tsigou E.
Bhatia M.
Ampazis D.
Dhar R.
D'Souza G.
Garg R.
Koul P. A.
Mahesh P. A.
Jayaraj B. S.
Narayan K. V.
Udnur H. B.
Krishnamurthy S. B.
Golshani K.
Keatings V. M.
Martin-Loeches I.
Maor Y.
Strahilevitz J.
Battaglia S.
Carrabba M.
Ceriana P.
Confalonieri M.
d'Arminio A.
Del Prato B.
De Rosa M.
Fantini R.
Fiorentino G.
Gammino M. A.
Milani G.
Nava S.
Palmiero G.
Petrino R.
Gabrielli B.
Rossi P.
Steinhilber G.
Zanforlin A.
Kurahashi K.
Bacha Z. A.
Ugalde D. B.
Zuniga O. C.
Villegas J. F.
Medenica M.
van de Garde E. M. W.
Mihsra D. R.
Ridgeon E.
Nwankwo O. N. O.
Olufunlola A. B.
Olumide S.
Ukwaja K. N.
Irfan M.
Minarowski L.
Szymo S.
Froes F.
Meireles M.
Ferrao C.
Leuschner P.
Ravara S. B.
Brocovschii V.
Ion C.
Rusu D.
Chirita D.
Birkun A.
Kaluzhenina A.
Almotairi A.
Bukhary Z. A. A.
Edathodu J.
Fathy A.
Enani A. M. A.
Mohamed N. E.
Memon J. U.
Bogdanovic N.
Milenkovic B.
Borderias L.
Garcia N. M. B.
Alarcon H. C.
Cilloniz C.
Torres A.
Diaz-Brito V.
Casas X.
Gonzalez A. E.
FernandezAlmira 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.
del la Torre A. L.
Garcia-Olive I.
Rello J.
Moyano S.
Sanz F.
Sibila O.
Rodrigo-Troyano A.
Sole-Violan J.
Uranga A.
van Boven J. F. 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.
Rudran B.
Ruiz-Buitrago S.
Campbell M.
Whitaker P.
Allen K. S.
Brito V.
Dietz J.
Dysart C. E.
Franco-Sadud R. A.
Kellie G. M. S. M.
Gaga M.
Bergin S. P.
Kheir F.
Landmeier M.
Lois M.
Nair G. B.
Patel H.
Reyes K.
Rodriguez-Cintron W.
Saito S.
Soni N. J.
Noda J.
Hinojosa C. I.
Levine S. M.
Angel L. F.
Anzueto A.
Whitlow K. S.
Hipskind J.
Sukhija K.
Wunderink R. G.
Shah R. D.
Mateyo K. J.
Gramegna A.
Sotgiu G.
Di Pasquale M.
Radovanovic D.
Terraneo S.
Reyes L.F.
Vendrell E.
Neves J.
Menzella F.
Blasi F.
Aliberti S.
Restrepo M.I.
Aruj P.K.
Attorri S.
Barimboim E.
Caeiro J.P.
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.
Lotsch F.
Vincent J.L.
Anseeuw K.
Francois C.A.
Van Braeckel E.
Djimon M.Z.
Bashi J.
Roger D.
Nouer S.A.
Chipev P.
Encheva M.
Miteva D.
Petkova D.
Dodo B.A.
Hugo M.N.B.
Shen N.
Xu J.-F.
Rico C.A.B.
Buitrago R.
Paternina F.J.P.
Jean-Marie K.N.
Carevic V.V.
Jakopovic M.
Jankovic M.
Matkovic Z.
Mitrecic I.
Jacobsson M.-L.B.
Christensen A.B.
HeitmannBodtger U.C.
Meyer C.N.
Jensen A.V.
Baunbaek-knudsen G.
Petersen P.T.
Andersen S.
El-Wahhab I.E.-S.A.
Morsy N.E.
Shafi ek H.
Sobh E.
Bertrand F.
Brun- Buisson C.
de Montmollin E.
Fartoukh M.
Messika J.
Tattevin P.
Dreher M.
Kolditz M.
Meisinger M.
Pletz M.W.
Hagel S.
Rupp J.
Schaberg T.
Spielmanns M.
Siaw-Lartey B.
Dimakou K.
Papapetrou D.
Tsigou E.
Bhatia M.
Ampazis D.
Dhar R.
D'Souza G.
Garg R.
Koul P.A.
Mahesh P.A.
Jayaraj B.S.
Narayan K.V.
Udnur H.B.
Krishnamurthy S.B.
Golshani K.
Keatings V.M.
Martin-Loeches I.
Maor Y.
Strahilevitz J.
Battaglia S.
Carrabba M.
Ceriana P.
Confalonieri M.
d'Arminio A.
Del Prato B.
De Rosa M.
Fantini R.
Fiorentino G.
Gammino M.A.
Milani G.
Nava S.
Palmiero G.
Petrino R.
Gabrielli B.
Rossi P.
Steinhilber G.
Zanforlin A.
Kurahashi K.
Bacha Z.A.
Ugalde D.B.
Zuniga O.C.
Villegas J.F.
Medenica M.
van de Garde E.M.W.
Mihsra D.R.
Ridgeon E.
Nwankwo O.N.O.
Olufunlola A.B.
Olumide S.
Ukwaja K.N.
Irfan M.
Minarowski L.
Szymo S.
Froes F.
Meireles M.
Ferrao C.
Leuschner P.
Ravara S.B.
Brocovschii V.
Ion C.
Rusu D.
Chirita D.
Birkun A.
Kaluzhenina A.
Almotairi A.
Bukhary Z.A.A.
Edathodu J.
Fathy A.
Enani A.M.A.
Mohamed N.E.
Memon J.U.
Bogdanovic N.
Milenkovic B.
Borderias L.
Garcia N.M.B.
Alarcon H.C.
Cilloniz C.
Torres A.
Diaz-Brito V.
Casas X.
Gonzalez A.E.
FernandezAlmira 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.
del la Torre A.L.
Garcia-Olive I.
Rello J.
Moyano S.
Sanz F.
Sibila O.
Rodrigo-Troyano A.
Sole-Violan J.
Uranga A.
van Boven J.F.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.
Rudran B.
Ruiz-Buitrago S.
Campbell M.
Whitaker P.
Allen K.S.
Brito V.
Dietz J.
Dysart C.E.
Franco-Sadud R.A.
Kellie G.M.S.M.
Gaga M.
Bergin S.P.
Kheir F.
Landmeier M.
Lois M.
Nair G.B.
Patel H.
Reyes K.
Rodriguez-Cintron W.
Saito S.
Soni N.J.
Noda J.
Hinojosa C.I.
Levine S.M.
Angel L.F.
Anzueto A.
Whitlow K.S.
Hipskind J.
Sukhija K.
Wunderink R.G.
Shah R.D.
Mateyo K.J.
Source :
Universidad de La Sabana, Intellectum Repositorio Universidad de La Sabana, Repositorio Universidad de la Sabana, Universidad de la Sabana, instacron:Universidad de la Sabana, BMC Infectious Diseases, Vol 18, Iss 1, Pp 1-11 (2018), BMC Infectious Diseases, Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos), Agência para a Sociedade do Conhecimento (UMIC)-FCT-Sociedade da Informação, instacron:RCAAP
Publication Year :
2018
Publisher :
Enfermedades infecciosas BMC, 2018.

Abstract

Background Empirical antibiotic coverage for atypical pathogens in community-acquired pneumonia (CAP) has long been debated, mainly because of a lack of epidemiological data. We aimed to assess both testing for atypical pathogens and their prevalence in hospitalized patients with CAP worldwide, especially in relation with disease severity. Methods A secondary analysis of the GLIMP database, an international, multicentre, point-prevalence study of adult patients admitted for CAP in 222 hospitals across 6 continents in 2015, was performed. The study evaluated frequency of testing for atypical pathogens, including L. pneumophila, M. pneumoniae, C. pneumoniae, and their prevalence. Risk factors for testing and prevalence for atypical pathogens were assessed through univariate analysis. Results Among 3702 CAP patients 1250 (33.8%) underwent at least one test for atypical pathogens. Testing varies greatly among countries and its frequency was higher in Europe than elsewhere (46.0% vs. 12.7%, respectively, p L. pneumophila urinary antigen was the most common test performed worldwide (32.0%). Patients with severe CAP were less likely to be tested for both atypical pathogens considered together (30.5% vs. 35.0%, p = 0.009) and specifically for legionellosis (28.3% vs. 33.5%, p = 0.003) than the rest of the population. Similarly, L. pneumophila testing was lower in ICU patients. At least one atypical pathogen was isolated in 62 patients (4.7%), including M. pneumoniae (26/251 patients, 10.3%), L. pneumophila (30/1186 patients, 2.5%), and C. pneumoniae (8/228 patients, 3.5%). Patients with CAP due to atypical pathogens were significantly younger, showed less cardiovascular, renal, and metabolic comorbidities in comparison to adult patients hospitalized due to non-atypical pathogen CAP. Conclusions Testing for atypical pathogens in patients admitted for CAP in poorly standardized in real life and does not mirror atypical prevalence in different settings. Further evidence on the impact of atypical pathogens, expecially in the low-income countries, is needed to guidelines implementation.

Subjects

Subjects :
medicine.medical_specialty
Atypical pathogens
Epidemiology
Population
Settore MED/10 - Malattie Dell'Apparato Respiratorio
lcsh:Infectious and parasitic diseases
03 medical and health sciences
0302 clinical medicine
Medical microbiology
Community-acquired pneumonia
Internal medicine
Risk Factors
Medicine
lcsh:RC109-216
030212 general & internal medicine
education
Aged, 80 and over
education.field_of_study
business.industry
Incidence (epidemiology)
Atypical pathogen
Healthcare-Associated Pneumonia
Chlamydophila pneumoniae
medicine.disease
Antibiotic coverage
CAP
Pneumonia
Infectious Diseases
030228 respiratory system
Legionnaires' disease
business
Research Article

Details

Language :
English
Database :
OpenAIRE
Journal :
Universidad de La Sabana, Intellectum Repositorio Universidad de La Sabana, Repositorio Universidad de la Sabana, Universidad de la Sabana, instacron:Universidad de la Sabana, BMC Infectious Diseases, Vol 18, Iss 1, Pp 1-11 (2018), BMC Infectious Diseases, Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos), Agência para a Sociedade do Conhecimento (UMIC)-FCT-Sociedade da Informação, instacron:RCAAP
Accession number :
edsair.doi.dedup.....65d60a0bbe3cafff7f752720e191a6a3
Full Text :
https://doi.org/10.1186/s12879-018-3565-z
Full Text Access
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