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Practice Guideline
. 2020 Aug;39(8):1513-1525.
doi: 10.1007/s10096-020-03870-3. Epub 2020 Apr 3.

Bacterial etiology of community-acquired pneumonia in immunocompetent hospitalized patients and appropriateness of empirical treatment recommendations: an international point-prevalence study

Manuela Carugati  1   2 , S Aliberti  3   4 , G Sotgiu  5 , F Blasi  3   4 , A Gori  6   3   7 , R Menendez  8 , M Encheva  9 , M Gallego  10 , P Leuschner  11 , S Ruiz-Buitrago  12 , S Battaglia  13 , R Fantini  14 , S Pascual-Guardia  15 , J Marin-Corral  16 , M I Restrepo  17 ; GLIMP Collaborators
Collaborators, Affiliations
Practice Guideline

Bacterial etiology of community-acquired pneumonia in immunocompetent hospitalized patients and appropriateness of empirical treatment recommendations: an international point-prevalence study

Manuela Carugati et al. Eur J Clin Microbiol Infect Dis. 2020 Aug.

Erratum in

Abstract

An accurate knowledge of the epidemiology of community-acquired pneumonia (CAP) is key for selecting appropriate antimicrobial treatments. Very few etiological studies assessed the appropriateness of empiric guideline recommendations at a multinational level. This study aims at the following: (i) describing the bacterial etiologic distribution of CAP and (ii) assessing the appropriateness of the empirical treatment recommendations by clinical practice guidelines (CPGs) for CAP in light of the bacterial pathogens diagnosed as causative agents of CAP. Secondary analysis of the GLIMP, a point-prevalence international study which enrolled adults hospitalized with CAP in 2015. The analysis was limited to immunocompetent patients tested for bacterial CAP agents within 24 h of admission. The CAP CPGs evaluated included the following: the 2007 and 2019 American Thoracic Society/Infectious Diseases Society of America (ATS/IDSA), the European Respiratory Society (ERS), and selected country-specific CPGs. Among 2564 patients enrolled, 35.3% had an identifiable pathogen. Streptococcus pneumoniae (8.2%) was the most frequently identified pathogen, followed by Pseudomonas aeruginosa (4.1%) and Klebsiella pneumoniae (3.4%). CPGs appropriately recommend covering more than 90% of all the potential pathogens causing CAP, with the exception of patients enrolled from Germany, Pakistan, and Croatia. The 2019 ATS/IDSA CPGs appropriately recommend covering 93.6% of the cases compared with 90.3% of the ERS CPGs (p < 0.01). S. pneumoniae remains the most common pathogen in patients hospitalized with CAP. Multinational CPG recommendations for patients with CAP seem to appropriately cover the most common pathogens and should be strongly encouraged for the management of CAP patients.

Keywords: Antimicrobial treatment; Community-acquired pneumonia; Guidelines; Streptococcus pneumoniae.

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Conflict of interest statement

MC, AS, GS, RM, ME, MG, PL, SRB, SB, RF, SPG, JMC, and MIR have no conflict of interest to declare. FB reports recent grants and personal fees from AstraZeneca, Bayer, Chiesi, Grifols, GSK, Guidotti, Insmed, Menarini, Novartis, Pfizer, and Zambon outside the present manuscript. AG reports recent grants and personal fees from Abbvie, Gilead, Janssen, MSD, Pfizer, ViiV, Menarini, and Angelini outside the present manuscript.

Figures

Fig. 1
Fig. 1
MRSA detection and anti MRSA empirical treatment recommendations for CAP among ICU-admitted immunocompetent patients
Fig. 2
Fig. 2
Pseudomonas aeruginosa detection and anti P. aeruginosa empirical treatment recommendations for CAP among ICU-admitted immunocompetent patients
See this image and copyright information in PMC

References

    1. Aliberti S, Dela Cruz CS, Sotgiu G, Restrepo MI. Pneumonia is a neglected problem: it is now time to act. Lancet Respir. 2019;7:10–11. doi: 10.1016/S2213-2600(18)30470-3. - DOI - PubMed
    1. GBD 2017 Causes of Death Collaborators Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392:1736–1788. doi: 10.1016/S0140-6736(18)32203-7. - DOI - PMC - PubMed
    1. Murayama T, Fujisawa T, Ishida T, Ito A, Oyamada Y, Fujimoto K, Yoshida M, Maeda H, Miyashita N, Nagai H, Imamura Y, Shime N, Suzuki S, Amishima M, Higa F, Kobayashi H, Suga S, Tsutsui K, Kohno S, Brito V, Niederman MS. A therapeutic strategy for all pneumonia patients: a 3-year prospective multicenter cohort study using risk factors for multidrug-resistant pathogens to select initial empiric therapy. Clin Infect Dis. 2019;68:1080–1088. doi: 10.1093/cid/ciy631. - DOI - PubMed
    1. Aliberti S, Reyes LF, Faverio P, Sotgiu G, Dore S, Rodriguez AH, Soni NJ, Restrepo MI, GLIMP investigators Global initiative for methicillin-resistant Staphylococcus aureus pneumonia (GLIMP): an international, observational cohort study. Lancet Infect Dis. 2016;16:1364–1376. doi: 10.1016/S1473-3099(16)30267-5. - DOI - PubMed
    1. Di Pasquale MF, Sotgiu G, Gramegna A, Radovanovic D, Terraneo S, Reyes LF, Rupp J, González Del Castillo J, Blasi F, Aliberti S, Restrepo MI, GLIMP Investigators Prevalence and etiology of community-acquired pneumonia in immunocompromised patients. Clin Infect Dis. 2019;68:1482–1493. doi: 10.1093/cid/ciy723. - DOI - PMC - PubMed

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