Title
Prevalence and etiology of community-acquired pneumonia in immunocompromised patients
Date Issued
24 April 2019
Access level
open access
Resource Type
research article
Author(s)
Di Pasquale M.F.
Sotgiu G.
Gramegna A.
Radovanovic D.
Terraneo S.
Reyes L.F.
Rupp J.
González Del Castillo J.
Blasi F.
Aliberti S.
Restrepo M.I.
Aruj P.K.
Attorri S.
Barimboim E.
Caeiro J.P.
Garzón M.I.
Cambursano V.H.
Cazaux A.
Ceccato A.
Chertcoff J.
Lascar F.
Tulio F.D.
Díaz A.C.
de Vedia L.
Ganaha M.C.
Lambert S.
Lopardo G.
Luna C.M.
Malberti A.G.
Morcillo N.
Tartara S.
Cetrangolo A.A.
Pensotti C.
Pereyra B.
Scapellato P.G.
Stagnaro J.P.
Shah S.
Lötsch F.
Thalhammer F.
Anseeuw K.
Francois C.A.
Van Braeckel E.
Vincent J.L.
Djimon M.Z.
Bashi J.
Dodo R.
Nouér S.A.
Chipev P.
Encheva M.
Miteva D.
Petkova D.
Balkissou A.D.
Yone E.W.P.
Ngahane B.H.M.
Shen N.
Xu J.F.
Rico C.A.B.
Buitrago R.
Paternina F.J.P.
Ntumba J.K.
Carevic V.V.
Jakopovic M.
Jankovic M.
Matkovic Z.
Mitrecic I.
Jacobsson M.B.
Christensen A.B.
Bødtger U.C.H.
Meyer C.N.
Jensen A.V.
Baunbæk-Knudsen G.
Petersen P.T.
Andersen S.
El-Wahhab I.E.A.
Morsy N.E.
Shafiek H.
Sobh E.
Abdulsemed K.A.
Bertrand F.
Brun-Buisson C.
de Montmollin E.
Fartoukh M.
Messika J.
Tattevin P.
Khoury A.
Ebruke B.
Dreher M.
Kolditz M.
Meisinger M.
Niederlausitz K.
Pletz M.W.
Hagel S.
Schaberg T.
Spielmanns M.
Creutz P.
Suttorp N.
Siaw-Lartey B.
Dimakou K.
Papapetrou D.
Tsigou E.
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.
Start page
1482
End page
1493
Volume
68
Issue
9
Language
English
OCDE Knowledge area
Enfermedades infecciosas
Scopus EID
2-s2.0-85067867377
PubMed ID
Source
Clinical Infectious Diseases
ISSN of the container
10584838
Sponsor(s)
This project was not funded and relied solely on voluntary site and investigator participation. M. I. R.’s time is partially protected by the National Heart, Lung, and Blood Institute (award K23HL096054). Potential conflicts of interest. F. B. reports personal fees from AstraZeneca, GlaxoSmithKline, Guidotti, Grifols, Menarini, and Novartis, and grants and personal fees from Bayer, Chiesi, Insmed, Pfizer, Teva, and Zambon, outside the submitted work. All other authors report no potential conflicts.
Sources of information: Directorio de Producción Científica Scopus