Prevalence and Etiology of Community-acquired Pneumonia in Immunocompromised Patients

Background: The correct management of immunocompromised patients with pneumonia is debated. We evaluated the prevalence, risk factors, and characteristics of immunocompromised patients coming from the community with pneumonia. Methods: We conducted a secondary analysis of an international, multicent...

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Autores: Pasquale, Marta Francesca Di, Sotgiu, Giovanni, Gramegna, Andrea, Radovanovic, Dejan, Terraneo, Silvia, Reyes, Luis F., Rupp, Jan, González del Castillo, Juan, Blasi, Francesco, Aliberti, Stefano, Restrepo, Marcos I., Cillóniz, Catia, Torres Martí, Antoni, GLIMP Investigators
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2018
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/136778
Acceso en línea:https://hdl.handle.net/2445/136778
Access Level:acceso abierto
Palabra clave:Pneumònia adquirida a la comunitat
Etiologia
Community-acquired pneumonia
Etiology
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spelling Prevalence and Etiology of Community-acquired Pneumonia in Immunocompromised PatientsPasquale, Marta Francesca DiSotgiu, GiovanniGramegna, AndreaRadovanovic, DejanTerraneo, SilviaReyes, Luis F.Rupp, JanGonzález del Castillo, JuanBlasi, FrancescoAliberti, StefanoRestrepo, Marcos I.Cillóniz, CatiaTorres Martí, AntoniGLIMP InvestigatorsPneumònia adquirida a la comunitatEtiologiaCommunity-acquired pneumoniaEtiologyBackground: The correct management of immunocompromised patients with pneumonia is debated. We evaluated the prevalence, risk factors, and characteristics of immunocompromised patients coming from the community with pneumonia. Methods: We conducted a secondary analysis of an international, multicenter study enrolling adult patients coming from the community with pneumonia and hospitalized in 222 hospitals in 54 countries worldwide. Risk factors for immunocompromise included AIDS, aplastic anemia, asplenia, hematological cancer, chemotherapy, neutropenia, biological drug use, lung transplantation, chronic steroid use, and solid tumor. Results: At least 1 risk factor for immunocompromise was recorded in 18% of the 3702 patients enrolled. The prevalences of risk factors significantly differed across continents and countries, with chronic steroid use (45%), hematological cancer (25%), and chemotherapy (22%) the most common. Among immunocompromised patients, community-acquired pneumonia (CAP) pathogens were the most frequently identified, and prevalences did not differ from those in immunocompetent patients. Risk factors for immunocompromise were independently associated with neither Pseudomonas aeruginosa nor non–community-acquired bacteria. Specific risk factors were independently associated with fungal infections (odds ratio for AIDS and hematological cancer, 15.10 and 4.65, respectively; both P = .001), mycobacterial infections (AIDS; P = .006), and viral infections other than influenza (hematological cancer, 5.49; P < .001). Conclusions: Our findings could be considered by clinicians in prescribing empiric antibiotic therapy for CAP in immunocompromised patients. Patients with AIDS and hematological cancer admitted with CAP may have higher prevalences of fungi, mycobacteria, and noninfluenza viruses.Oxford University Press2018info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/136778Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció del document publicat a: https://dx.doi/10.1093/cid/ciy723Clinical Infectious Diseases, 2019, vol. 68, num. 9, p. 1482-1493https://dx.doi/10.1093/cid/ciy723(c) Pasquale et al., 2019info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/1367782026-05-27T06:46:51Z
dc.title.none.fl_str_mv Prevalence and Etiology of Community-acquired Pneumonia in Immunocompromised Patients
title Prevalence and Etiology of Community-acquired Pneumonia in Immunocompromised Patients
spellingShingle Prevalence and Etiology of Community-acquired Pneumonia in Immunocompromised Patients
Pasquale, Marta Francesca Di
Pneumònia adquirida a la comunitat
Etiologia
Community-acquired pneumonia
Etiology
title_short Prevalence and Etiology of Community-acquired Pneumonia in Immunocompromised Patients
title_full Prevalence and Etiology of Community-acquired Pneumonia in Immunocompromised Patients
title_fullStr Prevalence and Etiology of Community-acquired Pneumonia in Immunocompromised Patients
title_full_unstemmed Prevalence and Etiology of Community-acquired Pneumonia in Immunocompromised Patients
title_sort Prevalence and Etiology of Community-acquired Pneumonia in Immunocompromised Patients
dc.creator.none.fl_str_mv Pasquale, Marta Francesca Di
Sotgiu, Giovanni
Gramegna, Andrea
Radovanovic, Dejan
Terraneo, Silvia
Reyes, Luis F.
Rupp, Jan
González del Castillo, Juan
Blasi, Francesco
Aliberti, Stefano
Restrepo, Marcos I.
Cillóniz, Catia
Torres Martí, Antoni
GLIMP Investigators
author Pasquale, Marta Francesca Di
author_facet Pasquale, Marta Francesca Di
Sotgiu, Giovanni
Gramegna, Andrea
Radovanovic, Dejan
Terraneo, Silvia
Reyes, Luis F.
Rupp, Jan
González del Castillo, Juan
Blasi, Francesco
Aliberti, Stefano
Restrepo, Marcos I.
Cillóniz, Catia
Torres Martí, Antoni
GLIMP Investigators
author_role author
author2 Sotgiu, Giovanni
Gramegna, Andrea
Radovanovic, Dejan
Terraneo, Silvia
Reyes, Luis F.
Rupp, Jan
González del Castillo, Juan
Blasi, Francesco
Aliberti, Stefano
Restrepo, Marcos I.
Cillóniz, Catia
Torres Martí, Antoni
GLIMP Investigators
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Pneumònia adquirida a la comunitat
Etiologia
Community-acquired pneumonia
Etiology
topic Pneumònia adquirida a la comunitat
Etiologia
Community-acquired pneumonia
Etiology
description Background: The correct management of immunocompromised patients with pneumonia is debated. We evaluated the prevalence, risk factors, and characteristics of immunocompromised patients coming from the community with pneumonia. Methods: We conducted a secondary analysis of an international, multicenter study enrolling adult patients coming from the community with pneumonia and hospitalized in 222 hospitals in 54 countries worldwide. Risk factors for immunocompromise included AIDS, aplastic anemia, asplenia, hematological cancer, chemotherapy, neutropenia, biological drug use, lung transplantation, chronic steroid use, and solid tumor. Results: At least 1 risk factor for immunocompromise was recorded in 18% of the 3702 patients enrolled. The prevalences of risk factors significantly differed across continents and countries, with chronic steroid use (45%), hematological cancer (25%), and chemotherapy (22%) the most common. Among immunocompromised patients, community-acquired pneumonia (CAP) pathogens were the most frequently identified, and prevalences did not differ from those in immunocompetent patients. Risk factors for immunocompromise were independently associated with neither Pseudomonas aeruginosa nor non–community-acquired bacteria. Specific risk factors were independently associated with fungal infections (odds ratio for AIDS and hematological cancer, 15.10 and 4.65, respectively; both P = .001), mycobacterial infections (AIDS; P = .006), and viral infections other than influenza (hematological cancer, 5.49; P < .001). Conclusions: Our findings could be considered by clinicians in prescribing empiric antibiotic therapy for CAP in immunocompromised patients. Patients with AIDS and hematological cancer admitted with CAP may have higher prevalences of fungi, mycobacteria, and noninfluenza viruses.
publishDate 2018
dc.date.none.fl_str_mv 2018
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/136778
url https://hdl.handle.net/2445/136778
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://dx.doi/10.1093/cid/ciy723
Clinical Infectious Diseases, 2019, vol. 68, num. 9, p. 1482-1493
https://dx.doi/10.1093/cid/ciy723
dc.rights.none.fl_str_mv (c) Pasquale et al., 2019
info:eu-repo/semantics/openAccess
rights_invalid_str_mv (c) Pasquale et al., 2019
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Oxford University Press
publisher.none.fl_str_mv Oxford University Press
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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