| Title: |
Aspiration risk factors, microbiology, and empiric antibiotics for patients hospitalized with community-acquired pneumonia |
| Authors: |
Marin-Corral, Judith; Pascual-Guardia, Sergi; Amati, Francesco; Aliberti, Stefano; Masclans, Joan R.; Soni, Nilam; Rodriguez, Alejandro; Sibila, Oriol; Sanz, Francisco; Sotgiu, Giovanni; Anzueto, Antonio; Dimakou, Katerina; Petrino, Roberta; van de Garde, Ewoudt; Restrepo, Marcos I.; Van Braeckel, Eva; GLIMP Investigators, missing |
| Source: |
CHEST ; ISSN: 0012-3692 ; ISSN: 1931-3543 |
| Publication Year: |
2021 |
| Collection: |
Ghent University Academic Bibliography |
| Subject Terms: |
Medicine and Health Sciences; VENTILATOR-ASSOCIATED PNEUMONIA; PRACTICE GUIDELINES; METRONIDAZOLE; BACTERIOLOGY; ADULTS; MANAGEMENT; FEATURES; IMPACT; FLORA; anaerobic; aspiration; bacteria; pneumonia; risk factors |
| Description: |
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 gramnegative 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 microbiological flora between groups, a large ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
English |
| Relation: |
https://biblio.ugent.be/publication/8744440; https://doi.org/10.1016/j.chest.2020.06.079; https://biblio.ugent.be/publication/8744440/file/8744448 |
| DOI: |
10.1016/j.chest.2020.06.079 |
| Availability: |
https://biblio.ugent.be/publication/8744440; https://hdl.handle.net/1854/LU-8744440; https://doi.org/10.1016/j.chest.2020.06.079; https://biblio.ugent.be/publication/8744440/file/8744448 |
| Rights: |
info:eu-repo/semantics/restrictedAccess |
| Accession Number: |
edsbas.670B72B0 |
| Database: |
BASE |