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Title: Prevalence and Etiology of Community-acquired Pneumonia in Immunocompromised Patients
Author: 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
Keywords: Pneumònia adquirida a la comunitat
Community-acquired pneumonia
Issue Date: 23-Aug-2018
Publisher: Oxford University Press
Abstract: 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.
Note: Reproducció del document publicat a: https://dx.doi/10.1093/cid/ciy723
It is part of: Clinical Infectious Diseases, 2019, vol. 68, num. 9, p. 1482-1493
Related resource: https://dx.doi/10.1093/cid/ciy723
ISSN: 1537-6591
Appears in Collections:Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)

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