Community-Acquired Pneumonia Due to Multidrug- and Non–Multidrug-Resistant Pseudomonas aeruginosa

Background: Pseudomonas aeruginosa is not a frequent pathogen in community-acquired pneumonia (CAP). However, in patients with severe CAP, P aeruginosa can be the etiology in 1.8% to 8.3% of patients, with a case-fatality rate of 50% to 100%. We describe the prevalence, clinical characteristics, out...

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Autores: Cillóniz, Catia, Gabarrús, Albert, Ferrer Monreal, Miquel, Puig de la Bellacasa, Jordi, Rinaudo, Mariano, Mensa Pueyo, Josep, Niederman, Michael S., Torres Martí, Antoni
Formato: artículo
Estado:Versión aceptada para publicación
Fecha de publicación:2016
País:España
Recursos:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/145339
Acesso em linha:https://hdl.handle.net/2445/145339
Access Level:acceso abierto
Palavra-chave:Pseudomonas
Pneumònia adquirida a la comunitat
Resistència als medicaments
Community-acquired pneumonia
Drug resistance
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spelling Community-Acquired Pneumonia Due to Multidrug- and Non–Multidrug-Resistant Pseudomonas aeruginosaCillóniz, CatiaGabarrús, AlbertFerrer Monreal, MiquelPuig de la Bellacasa, JordiRinaudo, MarianoMensa Pueyo, JosepNiederman, Michael S.Torres Martí, AntoniPseudomonasPneumònia adquirida a la comunitatResistència als medicamentsCommunity-acquired pneumoniaDrug resistanceBackground: Pseudomonas aeruginosa is not a frequent pathogen in community-acquired pneumonia (CAP). However, in patients with severe CAP, P aeruginosa can be the etiology in 1.8% to 8.3% of patients, with a case-fatality rate of 50% to 100%. We describe the prevalence, clinical characteristics, outcomes, and risk factors associated with CAP resulting from multidrug-resistant (MDR) and non-MDR P aeruginosa. Methods: Prospective observational study of 2,023 consecutive adult patients with CAP with definitive etiology. Results: P aeruginosa was found in 77 (4%) of the 2,023 cases with microbial etiology. In 22 (32%) of the 68 cases of P aeruginosa with antibiogram data, the isolates were MDR. Inappropriate therapy was present in 49 (64%) cases of P aeruginosa CAP, including 17/22 (77%) cases of MDR P aeruginosa CAP. Male sex, chronic respiratory disease, C-reactive protein <12.35 mg/dL, and pneumonia severity index risk class IV to V were independently associated with P aeruginosa CAP. Prior antibiotic treatment was more frequent in MDR P aeruginosa CAP compared with non-MDR P aeruginosa (58% vs 29%, P = .029), and was the only risk factor associated with CAP resulting from MDR P aeruginosa. In the multivariate analysis, age ≥65 years, CAP resulting from P aeruginosa, chronic liver disease, neurologic disease, nursing home, criteria of ARDS, acute renal failure, ICU admission, and inappropriate empiric treatment were the factors associated with 30-day mortality. Conclusions: P aeruginosa is an individual risk factor associated with mortality in CAP. The risk factors described can help clinicians to suspect P aeruginosa and MDR P aeruginosa.Elsevier2016info:eu-repo/semantics/articleinfo:eu-repo/semantics/acceptedVersionapplication/pdfhttps://hdl.handle.net/2445/145339Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésVersió postprint del document publicat a: https://doi.org/10.1016/j.chest.2016.03.042CHEST Journal, 2016, vol. 150, num. 2, p. 415-425https://doi.org/10.1016/j.chest.2016.03.042cc by-nc-nd (c) Elsevier, 2016http://creativecommons.org/licenses/by-nc-nd/3.0/es/info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/1453392026-05-27T06:46:51Z
dc.title.none.fl_str_mv Community-Acquired Pneumonia Due to Multidrug- and Non–Multidrug-Resistant Pseudomonas aeruginosa
title Community-Acquired Pneumonia Due to Multidrug- and Non–Multidrug-Resistant Pseudomonas aeruginosa
spellingShingle Community-Acquired Pneumonia Due to Multidrug- and Non–Multidrug-Resistant Pseudomonas aeruginosa
Cillóniz, Catia
Pseudomonas
Pneumònia adquirida a la comunitat
Resistència als medicaments
Community-acquired pneumonia
Drug resistance
title_short Community-Acquired Pneumonia Due to Multidrug- and Non–Multidrug-Resistant Pseudomonas aeruginosa
title_full Community-Acquired Pneumonia Due to Multidrug- and Non–Multidrug-Resistant Pseudomonas aeruginosa
title_fullStr Community-Acquired Pneumonia Due to Multidrug- and Non–Multidrug-Resistant Pseudomonas aeruginosa
title_full_unstemmed Community-Acquired Pneumonia Due to Multidrug- and Non–Multidrug-Resistant Pseudomonas aeruginosa
title_sort Community-Acquired Pneumonia Due to Multidrug- and Non–Multidrug-Resistant Pseudomonas aeruginosa
dc.creator.none.fl_str_mv Cillóniz, Catia
Gabarrús, Albert
Ferrer Monreal, Miquel
Puig de la Bellacasa, Jordi
Rinaudo, Mariano
Mensa Pueyo, Josep
Niederman, Michael S.
Torres Martí, Antoni
author Cillóniz, Catia
author_facet Cillóniz, Catia
Gabarrús, Albert
Ferrer Monreal, Miquel
Puig de la Bellacasa, Jordi
Rinaudo, Mariano
Mensa Pueyo, Josep
Niederman, Michael S.
Torres Martí, Antoni
author_role author
author2 Gabarrús, Albert
Ferrer Monreal, Miquel
Puig de la Bellacasa, Jordi
Rinaudo, Mariano
Mensa Pueyo, Josep
Niederman, Michael S.
Torres Martí, Antoni
author2_role author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Pseudomonas
Pneumònia adquirida a la comunitat
Resistència als medicaments
Community-acquired pneumonia
Drug resistance
topic Pseudomonas
Pneumònia adquirida a la comunitat
Resistència als medicaments
Community-acquired pneumonia
Drug resistance
description Background: Pseudomonas aeruginosa is not a frequent pathogen in community-acquired pneumonia (CAP). However, in patients with severe CAP, P aeruginosa can be the etiology in 1.8% to 8.3% of patients, with a case-fatality rate of 50% to 100%. We describe the prevalence, clinical characteristics, outcomes, and risk factors associated with CAP resulting from multidrug-resistant (MDR) and non-MDR P aeruginosa. Methods: Prospective observational study of 2,023 consecutive adult patients with CAP with definitive etiology. Results: P aeruginosa was found in 77 (4%) of the 2,023 cases with microbial etiology. In 22 (32%) of the 68 cases of P aeruginosa with antibiogram data, the isolates were MDR. Inappropriate therapy was present in 49 (64%) cases of P aeruginosa CAP, including 17/22 (77%) cases of MDR P aeruginosa CAP. Male sex, chronic respiratory disease, C-reactive protein <12.35 mg/dL, and pneumonia severity index risk class IV to V were independently associated with P aeruginosa CAP. Prior antibiotic treatment was more frequent in MDR P aeruginosa CAP compared with non-MDR P aeruginosa (58% vs 29%, P = .029), and was the only risk factor associated with CAP resulting from MDR P aeruginosa. In the multivariate analysis, age ≥65 years, CAP resulting from P aeruginosa, chronic liver disease, neurologic disease, nursing home, criteria of ARDS, acute renal failure, ICU admission, and inappropriate empiric treatment were the factors associated with 30-day mortality. Conclusions: P aeruginosa is an individual risk factor associated with mortality in CAP. The risk factors described can help clinicians to suspect P aeruginosa and MDR P aeruginosa.
publishDate 2016
dc.date.none.fl_str_mv 2016
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/acceptedVersion
format article
status_str acceptedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/145339
url https://hdl.handle.net/2445/145339
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Versió postprint del document publicat a: https://doi.org/10.1016/j.chest.2016.03.042
CHEST Journal, 2016, vol. 150, num. 2, p. 415-425
https://doi.org/10.1016/j.chest.2016.03.042
dc.rights.none.fl_str_mv cc by-nc-nd (c) Elsevier, 2016
http://creativecommons.org/licenses/by-nc-nd/3.0/es/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc by-nc-nd (c) Elsevier, 2016
http://creativecommons.org/licenses/by-nc-nd/3.0/es/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.301603

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