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defining and predicting severe community acquired pneumonia

Enrique Bernal-Morell, Eva García-Villalba, Maria Del Carmen Vera, Blanca Medina, Monica Martinez, Victoria Callejo, Salvador Valero, Cesar Cinesi, Pascual Piñera, Antonia Alcaraz, Irene Marin, Angeles Muñoz, Alfredo Cano
BACKGROUND: Midregional proadrenomedullin (MR-proADM) is a prognostic biomarker in patients with community-acquired pneumonia (CAP) and sepsis. In this paper, we examined the ability of MR-proADM to predict organ damage and long-term mortality in sepsis patients, compared to that of procalcitonin, C-reactive protein and lactate. METHODS: This was a prospective observational cohort, enrolling severe sepsis or septic shock patients admitted to internal service department...
March 2018: Journal of Infection
June H Ahn, Kwan H Lee, Jin H Chung, Kyeong-Cheol Shin, Choong K Lee, Hyun Jung Kim, Eun Young Choi
The 2016 American Thoracic Society and Infectious Diseases Society of America (ATS/IDSA) guidelines removed the concept of healthcare-associated pneumonia (HCAP). We examined whether the 2016 ATS/IDSA guidelines are applicable in Korea.We conducted a retrospective, observational study of pneumonia patients who were hospitalized at a tertiary teaching hospital from March 2012 to February 2014. Identified pathogens that were not susceptible to β-lactams, macrolides, and fluoroquinolones were defined as community-acquired pneumonia drug-resistant pathogens (CAP-DRPs)...
October 2017: Medicine (Baltimore)
I Chkhaidze, N Kapanadze
In spite of many attempts to differentiate bacterial from viral disease and predict severity and outcome, the etiologic diagnosis of paediatric community acquired pneumonia and the estimation of potential outcomes remain unsolved problems in most cases. Mycoplasma pneumoniae is one of the major pathogens causing CAP in children. Although MP infection was traditionally thought to be a self-limited process, more and more severe cases even fatal cases of MP infections were reported in recent years. So it is essential for pediatricians to recognize severe or refractory or severe MP early, treat it promptly and prevent the progress of the disease...
June 2017: Georgian Medical News
Suzanne M McCluskey, Philipp Schuetz, Michael S Abers, Benjamin Bearnot, Maria E Morales, Debora Hoffman, Shreya Patel, Lauren Rosario, Victor Chiappa, Blair A Parry, Ryan T Callahan, Sheila A Bond, Kent Lewandrowski, William Binder, Michael R Filbin, Jatin M Vyas, Michael K Mansour
BACKGROUND: Procalcitonin (PCT) is a prohormone that rises in bacterial pneumonia and has promise in reducing antibiotic use. Despite these attributes, there are inconclusive data on its use for clinical prognostication. We hypothesize that serial PCT measurements can predict mortality, intensive care unit (ICU) admission, and bacteremia. METHODS: A prospective cohort study of inpatients diagnosed with pneumonia was performed at a large tertiary care center in Boston, Massachusetts...
2017: Open Forum Infectious Diseases
Akihiro Ito, Tadashi Ishida, Hironobu Tokumasu, Yasuyoshi Washio, Akio Yamazaki, Yuhei Ito, Hiromasa Tachibana
BACKGROUND: To date, only few studies have examined the prognostic factors of community-acquired pneumonia (CAP) defined according to the latest criteria, which excludes healthcare-associated pneumonia (HCAP). Therefore, we aimed to investigate the factors that affect prognosis, and evaluate the usefulness of existing pneumonia severity scores for predicting the prognosis of CAP. METHODS: We retrospectively analyzed patients with CAP, excluding HCAP, who were enrolled prospectively between April 2007 and February 2016...
May 2, 2017: BMC Pulmonary Medicine
Emanuela Cataudella, Chiara M Giraffa, Salvatore Di Marca, Alfredo Pulvirenti, Salvatore Alaimo, Marcella Pisano, Valentina Terranova, Thea Corriere, Maria L Ronsisvalle, Rosario Di Quattro, Benedetta Stancanelli, Mauro Giordano, Carlo Vancheri, Lorenzo Malatino
OBJECTIVES: To explore the performance of the neutrophil-to-lymphocyte ratio (NLR), an index of systemic inflammation that predicts prognosis of several diseases, in a cohort of elderly adults with community-acquired pneumonia (CAP). DESIGN: Prospective clinical study from January 2014 to July 2016. SETTING: Unit of Internal Medicine, University of Catania, Catania, Italy. PARTICIPANTS: Elderly adults admitted for CAP (N = 195)...
August 2017: Journal of the American Geriatrics Society
Canan Gündüz, Mehmet Sezai Taşbakan, Abdullah Sayıner, Aykut Çilli, Oğuz Kılınç, Ayşın Şakar Coşkun
Introduction: Pneumonia in cases with preceding hospitalization, hemodialysis, intravenous therapy, wound care, or chemotherapy within the prior 30 days and residence in nursing homes are defined as healthcare associated pneumonia (HCAP). The aim of this study was to compare the demographic and laboratory data, isolated causative agents and prognosis of patients with community-acquired pneumonia (CAP) and HCAP in a large population in Turkey. Materials and Methods: The data of 785 cases (average age 65...
September 2016: Tüberküloz Ve Toraks
Canan Gündüz, Mehmet Sezai Taşbakan, Abdullah Sayıner, Aykut Çilli, Oğuz Kılınç, Ayşın Şakar Coşkun
Introduction: Pneumonia in cases with preceding hospitalization, hemodialysis, intravenous therapy, wound care, or chemotherapy within the prior 30 days and residence in nursing homes are defined as healthcare associated pneumonia (HCAP). The aim of this study was to compare the demographic and laboratory data, isolated causative agents and prognosis of patients with community-acquired pneumonia (CAP) and HCAP in a large population in Turkey. Materials and Methods: The data of 785 cases (average age 65...
September 2016: Tüberküloz Ve Toraks
Nicola Principi, Susanna Esposito
Community-acquired pneumonia (CAP) is an infectious disease caused by bacteria, viruses, or a combination of these infectious agents. The severity of the clinical manifestations of CAP varies significantly. Consequently, both the differentiation of viral from bacterial CAP cases and the accurate assessment and prediction of disease severity are critical for effectively managing individuals with CAP. To solve questionable cases, several biomarkers indicating the etiology and severity of CAP have been studied...
February 19, 2017: International Journal of Molecular Sciences
Alaadin Vögeli, Manuel Ottiger, Marc A Meier, Christian Steuer, Luca Bernasconi, Prasad Kulkarni, Andreas Huber, Mirjam Christ-Crain, Christoph Henzen, Claus Hoess, Robert Thomann, Werner Zimmerli, Beat Mueller, Philipp Schuetz
BACKGROUND: During infection, there is an activation of the L-arginine-nitric-oxide pathway, with a shift from nitric oxide synthesis to a degradation of L-arginine to its metabolites, asymmetric and symmetric dimethylarginine (ADMA and SDMA). However, the prognostic implications for short-term or long-term survival remains unclear. We investigated the association of L-arginine, ADMA, and SDMA with adverse clinical outcomes in a well-defined cohort of patients with community-acquired pneumonia (CAP)...
January 23, 2017: Respiratory Research
Johanne Haugen, Ram K Chandyo, Manjeswori Ulak, Maria Mathisen, Sudha Basnet, Karl A Brokstad, Palle Valentiner-Branth, Prakash S Shrestha, Tor A Strand
Poor vitamin D status has been associated with increased risk and severity of respiratory tract infections. Whether or not inflammation and infection affects 25-hydroxy vitamin D (25(OH)D) concentration is controversial and is important in the interpretation of observational studies using plasma-25(OH)D as a biomarker for status. Our objectives were to measure whether 25(OH)D concentration was altered by an episode of acute lower respiratory tract infection and whether markers of inflammation predicted the 25(OH)D concentration...
January 17, 2017: Nutrients
Marc A Meier, Manuel Ottiger, Alaadin Vögeli, Christian Steuer, Luca Bernasconi, Robert Thomann, Mirjam Christ-Crain, Christoph Henzen, Claus Hoess, Werner Zimmerli, Andreas Huber, Beat Mueller, Philipp Schuetz
BACKGROUND: As part of the immune defense during infection, an increase in enzyme activity of indoleamine 2,3-dioxygenase (IDO) leads to a breakdown of tryptophan to kynurenine. In previous animal studies, therapeutic antagonism of IDO resulted in reduced sepsis mortality. We investigated the prognostic ability of tryptophan, serotonin, kynurenine and IDO (represented by the ratio of kynurenine/tryptophan) to predict adverse clinical outcomes in patients with community-acquired pneumonia (CAP)...
June 27, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
Diana Sbiti-Rohr, Alexander Kutz, Mirjam Christ-Crain, Robert Thomann, Werner Zimmerli, Claus Hoess, Christoph Henzen, Beat Mueller, Philipp Schuetz
OBJECTIVE: To investigate the accuracy of the National Early Warning Score (NEWS) to predict mortality and adverse clinical outcomes for patients with community-acquired pneumonia (CAP) compared to standard risk scores such as the pneumonia severity index (PSI) and CURB-65. DESIGN: Secondary analysis of patients included in a previous randomised-controlled trial with a median follow-up of 6.1 years. SETTINGS: Patients with CAP included on admission to the emergency departments (ED) of 6 tertiary care hospitals in Switzerland...
September 28, 2016: BMJ Open
Akihiro Ito, Tadashi Ishida, Hiromasa Tachibana, Yuhei Ito, Takuya Takaiwa
BACKGROUND AND OBJECTIVE: This study aimed to investigate the usefulness of addition of serial measurements of procalcitonin (PCT) to C-reactive protein (CRP) values and pneumonia severity scores, such as CURB-65 (confusion, urea > 7 mmol/L, respiratory rate ≥ 30 breaths/min, low blood pressure (systolic < 90 mm Hg or diastolic ≤ 60 mm Hg) and age ≥ 65 years) and the Pneumonia Severity Index, and attempted to create and evaluate a new scoring system for predicting mortality risk using the biomarkers and pneumonia severity scores...
November 2016: Respirology: Official Journal of the Asian Pacific Society of Respirology
J Burgos, I Los-Arcos, D Álvarez de la Sierra, V Falcó, A Aguiló, I Sánchez, B Almirante, M Martinez-Gallo
The expression of CD64 in neutrophils (nCD64) has shown utility in the diagnosis of sepsis. The aim of this study was to assess the usefulness of nCD64 expression to identify patients with community-acquired pneumonia (CAP) at risk of a poor outcome. A prospective study of nCD64 expression (determined by flow cytometry) in patients with CAP was performed. The sensitivity/specificity of nCD64 in predicting poor outcome [defined as intensive care unit (ICU) admission and/or clinical deterioration after arrival at the emergency department] was calculated...
September 2016: European Journal of Clinical Microbiology & Infectious Diseases
Dan Liu, Lixin Xie, Haiyan Zhao, Xueyao Liu, Jie Cao
BACKGROUND: The early identification of patients at risk of dying from community-acquired pneumonia (CAP) is critical for their treatment and for defining hospital resource consumption. Mid-regional pro-adrenomedullin (MR-proADM) has been extensively investigated for its prognostic value in CAP. However, the results are conflicting. The purpose of the present meta-analysis was to explore the diagnostic accuracy of MR-proADM for predicting mortality in patients suffering from CAP, particularly emergency department (ED) patients...
May 26, 2016: BMC Infectious Diseases
Rosanel Amaro, Adamantia Liapikou, Catia Cilloniz, Albert Gabarrus, Francesc Marco, Jacobo Sellares, Eva Polverino, Javier Garau, Miquel Ferrer, Daniel M Musher, Antoni Torres
In patients with pneumococcal community-acquired pneumonia (CAP), the risk factors for bacteraemia and its impact on outcomes are not fully elucidated. We aimed to compare characteristics of patients with blood-culture-positive versus blood-culture-negative pneumococcal CAP, and to characterise bacteraemic serotypes.We describe a prospective, observational study on nonimmunocompromised patients with pneumococcal CAP, from 1996 to 2013. We define severe pneumonia according to American Thoracic Society/Infectious Diseases Society of America guidelines...
September 2016: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Alberto Papi, Paul W Jones, Prashant S Dalvi, Kirsten McAulay, Tammy McIver, Sanjeeva Dissanayake
Inhaled corticosteroid/long-acting β2-agonist combination therapy is recommended in chronic obstructive pulmonary disease (COPD) patients at high risk of exacerbations. The EFFECT (Efficacy of Fluticasone propionate/FormotErol in COPD Treatment) trial is a Phase III, 52-week, randomized, double-blind study to evaluate the efficacy and safety of two doses of fluticasone propionate/formoterol compared to formoterol monotherapy in COPD patients with FEV1 ≥50% predicted and a history of exacerbations. The primary endpoint is the annualized rate of moderate and severe exacerbations...
2015: International Journal of Chronic Obstructive Pulmonary Disease
HamidReza Naderi, Fereshte Sheybani, MohammadReza Sarvghad, Mehdi Jabbari Nooghabi
BACKGROUND: The first decision confronting clinicians in the management of patients with community acquired pneumonia (CAP) is whether the patient is to be hospitalized or not. We sought to validate the pneumonia scoring system and assess the power of procalcitonin (PCT) level to predict in-hospital mortality (IHM) and intensive vasopressor and respiratory support (IVRS) requirements in patients with CAP. MATERIALS AND METHODS: A total of 120 patients with CAP were evaluated for severity of illness based on the defined scoring systems including pneumonia severity index (PSI), confusion, urea, respiratory rate, blood pressure, age>65 (CURB-65), confusion, respiratory rate, blood pressure, age>65 (CRB-65), infectious diseases society of America/American thoracic society 2007 criteria (IDSA/ATS 2007) and systolic blood pressure, multilobar infiltrate, albumin, respiratory rate, tachycardia, confusion, low oxygen, low pH (SMART-COP)...
2015: Tanaffos
Yalcin Golcuk, Burcu Golcuk, Adnan Bilge, Ayhan Korkmaz, Mehmet Irik, Mustafa Hayran, Alper Tunga Ozdemir, Yusuf Kurtulmus
OBJECTIVE: This study aims to compare serum pregnancy-associated plasma protein A (PAPP-A) levels in surviving and nonsurviving elderly patients with community-acquired pneumonia (CAP), investigating whether PAPP-A is correlated with CAP prediction scores and whether PAPP-A can successfully predict 28-day mortality rates in elderly patients. METHODS: This prospective, observational, single-center, cross-sectional study was conducted at the emergency department (ED) of Celal Bayar University Hospital in Manisa, Turkey, between January and September 2014...
September 2015: American Journal of Emergency Medicine
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