Epidemiology Of Community-acquired Pneumonia Research Articles

Investigation of the prevalence of community-acquired and hospital-acquired pneumonia in patients referred to Sadri Ibn Sina Hospital in 1401

Background: Pneumonia is the sixth cause of death and the most common infectious syndrome associated with death. Most cases of pneumonia are caused by microorganisms. We evaluated the prevalence and epidemiology of community-acquired pneumonia in Sadri Ibn Sina Hospital in 1401. Methods: This cross-sectional-descriptive study was conducted from the beginning to the end of 1401 on the files of patients referred to the Chest Department of Ibn Sina Hospital. Results: 431 patients were examined for the final analysis. This research included 228 men and 203 women. The mean age of the subjects was 59 years. Most of the studied patients were from Kabul Province. Among the subjects studied, smoked, patients had a history of alcohol consumption, and patients had a history of hospitalization less than one week Conclusion: According to studies, hospital-acquired pneumonia is the second most common hospital infection and it happens abundantly in the intensive-care departments..The results of a study in Europe have shown that hospital-acquired pneumonia occurs in 47% of all infections in the intensive care unit. In our study (52.9%) patients had a history of hospitalization less than one week.

Aetiological agents of adult community-acquired pneumonia in Japan: systematic review and meta-analysis of published data

ObjectiveEpidemiological information is essential in providing appropriate empiric antimicrobial therapy for pneumonia. This study aimed to clarify the epidemiology of community-acquired pneumonia (CAP) by conducting a systematic review of published...

Differential diagnosis of community-acquired pneumonia and lung damage in respiratory viral infections, including COVID-19

With the development of the coronavirus pandemic and its decline, bacterial pathogens will again play a significant role in the epidemiology of community-acquired pneumonia (CAP). Numerous studies have already examined clinical, laboratory, and instrumental indicators that allow differential diagnosis between viral infection and bacterial pneumonia. The role of conventional (e.g., C-reactive protein, procalcitonin, leukocytes) and novel laboratory markers (e.g., MxA1 protein, progranulin, copeptin) was revealed. Differences in lung CT and ultrasound findings were noted. The aim of this publication is to present data on the differential diagnosis between pulmonary involvement in viral infections, including COVID-19 (COronaVIrus Disease 2019), and bacterial CAP. Conclusion. Despite numerous studies, distinguishing bacterial CAP from viral lung injury, including that associated with COVID-19 infection, without microbiologic testing is a challenging task that requires a combined assessment of clinical data, laboratory data, and modern imaging studies. Obviously, express testing will be of particular interest in this case.

Current Epidemiological Data on Community Acquired Pneumonia in Children After Improvements in the Health System and Socioeconomic Changes in Turkiye

In this study, it was investigated that current epidemiological situation and risk factors of community-acquired pneumonia (CAP) in pediatric patients in Türkiye, after socioeconomic changes and health system improvements in the past two decades. In total 1,488 children treated with a diagnosis of pneumonia in Gulhane Training and Research Hospital (Ankara) Pediatrics Department between 2016 to 2021 were included in the present study. The patients’ demographic data, personal and family histories, and socioeconomic status were recorded. Of the 1,488 pediatric patients (mean age; 43.20±41.04 months and 46.8% girls); 108 were aged 0-6 months (7.3%), 672 were aged >6-24 months (45.2%), 444 were aged >24-60 months (29.8%), and 264 were aged >60 months (17.7%). In total, 98.4% of patients underwent routine vaccination and the rate of seasonal influenza vaccination was 5.6%. Additionally, 444 patients (29.8%) had chronic disease; asthma and cerebral palsy were the most common chronic diseases, 276 and 84 patients respectively. A family history of asthma in first-degree relatives was present in 396 patients (26.6%). There have been substantial changes in the epidemiology of CAP in Türkiye, due to socioeconomic changes, increasing urbanization, and health system improvements and the current effects of these changes are presented in our study with comprehensive data that can be used in further comparative studies.

Epidemiology of community-acquired pneumonia among hospitalised children in Indonesia: a multicentre, prospective study

ObjectiveTo identify aetiologies of childhood community-acquired pneumonia (CAP) based on a comprehensive diagnostic approach.Design‘Partnerships for Enhanced Engagement in Research-Pneumonia in Paediatrics (PEER-PePPeS)’ study was an observational prospective cohort study conducted...

MODERN VIEWS ON THE PREVALENCE OF PNEUMONIA IN CHILDREN AND THE ROLE OF LABORATORY DIAGNOSIS: A REVIEW OF THE LITERATURE

An analysis of domestic and foreign literature on the prevalence, causes and mechanisms of pneumonia in children. This article highlights the prevalence and features of the clinic and diagnosis of pneumonia in children based on a review of the literature. Out-of-hospital pneumonia today remains a pressing medical and social problem, often leading to complications and often causing the death of children, both in Ukraine and around the world, so it needs more in-depth diagnosis. It is known that the severity of this disease depends on age, etiology, comorbidity and timely hospitalization. The incidence and prevalence of respiratory diseases is one of the main indicators of health among children in the world. Therefore, the purpose of this research is to analyze foreign and domestic literature sources on the prevalence and search for the most informative diagnostic criteria for pneumonia in young children. More recent meta-analyzes of etiological data indicate a change in the profile of the pathogen, which increases the recognition that community-acquired pneumonia is caused by sequential or simultaneous interaction of more than one microorganism. Given the epidemiology of community-acquired pneumonia and long-term hospital stays, the study and synthesis of data on the diagnostic criteria for community-acquired pneumonia remains relevant. It is currently not possible to identify a single marker or clinical sign that can be used to distinguish bacterial from viral pneumonia. It is important to evaluate all indicators of objective, instrumental and laboratory examination. Based on literature data, cytokine status indicators can be used to prevent the development of complications from pneumonia, prescribe adequate therapy and determine the duration of treatment. There are many other biomarkers that have been linked to the severity of pneumonia in children. According to statistics, a study of children with COVID-19 showed that the blood of patients, especially those with severe disease, has high levels of proinflammatory cytokines, especially IL-6, which during infection may be a key cytokine that causes serious inflammation and acute damage to many organs and systems. In particular, such a biomarker is IL-6 - the only serum cytokine, the presence of which probably correlates with the severity of pneumonia. The relationship between serum IL-6 and IL-10 levels is an important diagnostic criterion for determining the severity of pneumonia in children on admission, which allows screening for the risk of complications and assessing the possibility of rapid recovery. The use of immune and inflammatory markers in children with pneumonia can potentially lead to the development of innovative methods for predicting complications of community-acquired pneumonia and determining the severity. In addition, it has been shown that serum IL-6 levels are significantly reduced in patients with pneumonia during the recovery period, which allows to evaluate the effectiveness of treatment. Procalcitonin is also an important indicator of the inflammatory process. There are conflicting data on the ability of procalcitonin to distinguish between bacterial and viral infections. Given these data, procalcitonin can be used as a diagnostic criterion for the presence of bacterial infection and the appropriateness of antibiotic therapy. Analysis of available scientific works on prevalence features of the clinic and diagnosis of pneumonia in children, showed that the issue of timely diagnosis and differential diagnosis of pneumonia in children is still relevant and requires further research.

Staphylococcus aureus Community-acquired Pneumonia in Children After 13-Valent Pneumococcal Vaccination (2008-2018): Epidemiology, Clinical Characteristics and Outcomes.

The epidemiology of community-acquired pneumonia (CAP) has changed, influenced by sociosanitary conditions and vaccination status. We aimed to analyze the recent epidemiology of bacterial CAP in hospitalized children in a setting with high pneumococcal vaccination coverage and to describe the clinical characteristics of pediatric Staphylococcus aureus CAP. Children <17 years old hospitalized from 2008 to 2018 with bacterial CAP in 5 tertiary hospitals in Spain were included. Cases with pneumococcal CAP were randomly selected as comparative group following a case-control ratio of 2:1 with S. aureus CAP. A total of 313 bacterial CAP were diagnosed: Streptococcus pneumoniae CAP (n = 236, 75.4%), Streptococcus pyogenes CAP (n = 43, 13.7%) and S. aureus CAP (n = 34, 10.9%). Throughout the study period, the prevalence of S. pyogenes increased (annual percentage change: +16.1% [95% CI: 1.7-32.4], P = 0.031), S. pneumoniae decreased (annual percentage change: -4.4% [95 CI: -8.8 to 0.2], P = 0.057) and S. aureus remained stable. Nine isolates of S. aureus (26.5%) were methicillin-resistant. Seventeen cases (50%) with S. aureus CAP had some pulmonary complication and 21 (61.7%) required intensive care. S. pneumoniae CAP showed a trend toward higher prevalence of pulmonary complications compared with S. aureus CAP (69.1% vs. 50.0%, P = 0.060), including higher frequency of pulmonary necrosis (32.4% vs. 5.9%, P = 0.003). The incidence of S. aureus CAP in children remained stable, whereas the prevalence of pneumococcal CAP decreased and S. pyogenes CAP increased. Patients with S. aureus presented a high frequency of severe outcomes, but a lower risk of pulmonary complications than patients with S. pneumoniae.

Pneumonia in older adults.

The purpose of this review is to address the relevant issues surrounding older adults with community-acquired pneumonia (CAP) today. Approximately 1 million people >65 years have CAP in the US per year, which is more than previously reported (or realized). Older adults are vulnerable to the increasing prevalence of viral CAP, as the SARS-CoV-2 pandemic emphasizes, but pneumococcus is still the most common pathogen to cause CAP. Racial disparities continue to need to be addressed in order to improve early and late outcomes of older adults with CAP. The epidemiology of CAP, specifically for older adults is changing. More recent pathogen incidence studies have included culture, as well as newer microbiological methods to determine etiology. Current disparities among disadvantaged populations, including African-Americans, result in more comorbidities which predisposes to more severe CAP. However, outcomes in the hospital between races tend to be similar, and outcomes between age groups tends to be worse for older compared to younger adults. Finally, the cost of CAP is significant compared to diabetes mellitus, myocardial infarction and stroke.

Community-Acquired Bacterial Pneumonia-Changing Epidemiology, Resistance Patterns, and Newer Antibiotics: Spotlight on Delafloxacin.

Community-acquired pneumonia (CAP) is a major cause of morbidity and mortality both in the USA and globally. As the burden of CAP continues to increase due to several factors, the advances in its diagnosis, prevention, and treatment have taken on even greater interest and importance. The majority of CAP patients are treated empirically, and selection of appropriate antibiotic treatment is increasingly difficult because the epidemiology of CAP is changing, in part due to antimicrobial resistance, and the causative CAP pathogens differ between countries and regions. There is also an increasing prevalence of chronic co-morbid diseases among CAP patients. Treatment of CAP has become challenging because of these factors along with the varying safety profiles and efficacy of well-established antibiotics, as well as limited new therapeutic options. Recently, however, new antibiotics have been approved, which will expand the treatment options for CAP, particularly in those patients with underlying complications. Recently approved delafloxacin, an anionic fluoroquinolone, has a unique structure and distinct chemical characteristics; it demonstrated non-inferiority to moxifloxacin in a phase III clinical trial, but was shown to be superior to moxifloxacin at early clinical response in CAP patients who also have chronic obstructive pulmonary disease (COPD) or asthma as a co-morbidity, and in CAP patients who may have severe illness. Delafloxacin could offer an additional therapy against resistant isolates and among these difficult-to-treat patients. This review summarizes the development, latest research, and safety profile of the new antibiotic delafloxacin, and its potential future role in the treatment of CAP.

Epidemiology and aetiology of community-acquired pneumonia in children: South African Thoracic Society guidelines (part 1)

Background. Pneumonia remains a major cause of morbidity and mortality among South African (SA) children. Improved immunisation regimens, strengthening of HIV programmes, better socioeconomic conditions and new preventive strategies have influenced the epidemiology of pneumonia. Furthermore, sensitive diagnostic tests and better sampling methods in young children improve aetiological diagnosis. Objectives. To summarise current information on childhood community-acquired pneumonia (CAP) epidemiology and aetiology in children as part of the revised South African Thoracic Society guidelines. Methods. The Paediatric Assembly of the South African Thoracic Society and the National Institute for Communicable Diseases expert subgroup on epidemiology and aetiology revised the existing SA guidelines.The subgroup reviewed the published evidence in their area; in the absence of evidence, expert opinion was accepted. Evidence was graded using the British Thoracic Society (BTS) grading system, and the relevant section underwent peer review. Results. Respiratory viruses, particularly respiratory syncytial virus, are the key pathogens associated with hospitalisation for radiologically confirmed pneumonia in HIV-uninfected children. Opportunistic organisms, including Pneumocystis jirovecii , are important pathogens in HIV-infected infants, while non-typable Haemophilus influenzae and Staphylococcus aureus are important in older HIV-infected children. Co-infections with bacteria or other respiratory viruses are common in hospitalised children. Mycobacterium tuberculosis is common in children hospitalised with CAP in SA. Conclusions. Numerous public health measures, including changes in immunisation schedules and expansion of HIV prevention and treatment programmes, have influenced the epidemiology and aetiology of CAP in SA children. These changes have necessitated a revision of the South African Paediatric CAP guidelines, further sections of which will be published as part of a CME series in SAMJ .

The Burden of Community-Acquired Pneumonia Requiring Admission to ICU in the United States

A paucity of studies have assessed the epidemiology of community-acquired pneumonia (CAP) that require ICU admission. We conducted a study on this group of patients with the primary objective of defining the incidence, epidemiology, and mortality rate of CAP in the ICUs in Louisville, Kentucky. The secondary objective was to estimate the number of patients who were hospitalized and the number of deaths that were associated with CAP in ICU in the United States. What is epidemiology of CAP in the ICU in Louisville, Kentucky, and the projected incidence in the United States? This was a secondary analysis of a prospective population-based cohort study. The setting was all nine adult hospitals in Louisville, Kentucky. The annual incidence of CAP in the ICU per 100,000 adults was calculated for the whole adult population of Louisville. The number of patients who were hospitalized because of CAP in ICU in the United States was estimated by multiplying the Louisville incidence rate of CAP in ICU by the 2014 US adult population. From a total of 7,449 unique patients who were hospitalized with CAP, 1,707 patients (23%) were admitted to the ICU. The incidence of CAP in the ICU was 145 cases per 100,000 population of adults. Cases of CAP in the ICU were clustered in patients from areas of the city with high poverty. The mortality rate of patients with CAP in ICU was 27%at 30days and 47%at one year. In the United States, the estimated number of patients who were hospitalized with CAP requiring the ICU was 356,326 per year, and the estimated number of deaths at 30days and one year were 96,206 and 167,474, respectively. Almost one in five patients who are hospitalized with CAP requires intensive care. Poverty is associated with CAP in the ICU. Nearly one-half of patients with CAP in the ICU will die within one year. Because of its significant burden, CAP in the ICU should be a high priority in research agenda and health policy.

Etiology and epidemiology of community-acquired pneumonia in adults requiring hospital admission: A prospective study in rural Central Philippines

BackgroundCommunity-acquired pneumonia (CAP) is a common cause of morbidity and mortality among adults worldwide. However, the distribution of the etiology of CAP varies from one country to another, with limited data from rural areas. MethodsA prospective hospital-based study on adult CAP was conducted in Leyte, Central Philippines from May 2010 to May 2012. Blood, sputum, and nasopharyngeal samples obtained from patients were used to identify pathogens using standard microbiological culture methods and PCR. ResultsOf the 535 patients enrolled, 38% were younger than 50 years old. More than half of the patients had an underlying disease, including pulmonary tuberculosis (22%). The detection rate was higher for bacteria (40%) than viruses (13%). Haemophilus influenzae (12%) was the most commonly detected bacterium and influenza virus (5%) was the most commonly detected virus. The proportion of CAP patients with Mycobacterium tuberculosis infection was higher in the younger age group than in the older age group. Among CAP patients, 14% died during hospitalization, and drowsiness on admission and SpO2 <90% were independent risk factors for mortality. ConclusionsBacterial infections contribute substantially to the number of hospitalizations among CAP patients in rural Philippines. This study also highlights the importance of treatment of tuberculosis in reducing the burden of adult CAP in the country.

The Use of Statins and Risk of Community-Acquired Pneumonia.

Community-acquired pneumonia (CAP) is still associated with a large burden and causes significant morbidity and mortality. Besides universal vaccination and antibiotic treatment, statins as adjunctive therapy may also have a beneficial role in the prevention and treatment of CAP. Our goal from this review is to discuss the epidemiology of CAP, and role of statins as adjunctive therapy in the development of CAP. Statins are lipid-lowering medications characterized by their ability to control hypercholesterolemia in addition to other pleiotropic effects that could explain their role in the pathogenesis of CAP. While most observational studies have shown that statins reduce risk of pneumonia in the general population, patients with diabetes, and recently in patients with myocardial infarction, no randomized controlled trial (RCT) to date has been conducted to assess the efficacy of statins to prevent development of CAP. Given the paucity of robust randomized evidence to assess statin use and the development of CAP, and considering conflicting results of the observational studies, we are not in favor of initiation of statins for either the prevention or treatment of CAP.

Community-Acquired Pneumonia in Sub-Saharan Africa.

Community-acquired pneumonia (CAP) in sub-Saharan Africa is a common cause of adult hospitalization and is associated with significant mortality. Human immunodeficiency virus (HIV) prevalence in the region leads to differences in CAP epidemiology compared with most high-income settings: patients are younger, and coinfection with tuberculosis and opportunistic infections is common and difficult to diagnose. Resource limitations affect the availability of medical expertise as well as radiological and laboratory diagnostic services. These factors impact on key aspects of health care, including pathways of investigation, severity assessment, and the selection of empirical antimicrobial therapy. This review summarizes recent data from sub-Saharan Africa describing the burden, etiology, risk factors, and outcome of CAP. We describe the rational and context-appropriate approach to CAP diagnosis and management, including supportive therapy. Priorities for future research to inform strategies for CAP prevention and initial management are suggested.

Recent Developments in Pediatric Community-Acquired Pneumonia.

Community-acquired pneumonia (CAP) is the most common acute infectious cause of death in children worldwide. Consequently, research into the epidemiology, diagnosis, treatment, and prevention of pediatric CAP spans the translational research spectrum. Herein, we aim to review the most significant findings reported by investigators focused on pediatric CAP research that has been reported in 2014 and 2015. Our review focuses on several key areas relevant to the clinical management of CAP. First, we will review recent advances in the understanding of CAP epidemiology worldwide, including the role of vaccination in the prevention of pediatric CAP. We also report on the expanding role of existing and emerging diagnostic technologies in CAP classification and management, as well as advances in optimizing antimicrobial use. Finally, we will review CAP management from the policy and future endeavors standpoint, including the influence of clinical practice guidelines on clinician management and patient outcomes, and future potential research directions that are in the early stages of investigation.

Time to reconsider routine high-dose amoxicillin for community-acquired pneumonia in all Canadian children.

Community-acquired pneumonia (CAP) is one of the most common reasons for hospitalization in otherwise healthy Canadian children. The introduction of effective vaccinations, such as the pneumococcal conjugate vaccines, to the routine immunization schedule, has led to decreased rates of illness and, possibly, changes in the epidemiology of CAP in Canada. Unfortunately, in many children diagnosed with pneumonia, no causative agent can be isolated and up to date local data regarding the most common causes of pneumonia are difficult to obtain. The 2011 national guideline from the Canadian Paediatric Society (CPS) (1) and international guideline from the Infectious Diseases Society of America (2) recommend high-dose amoxicillin as the first-line treatment for otherwise healthy children with CAP who can be treated with oral antibiotics (1,2). This recommendation was initiated before the widespread introduction of the 13-valent pneumococcal conjugate vaccine to immunization schedules, when penicillin-resistant serotype 19A disease was a rising concern. We sought to determine the appropriateness of this recommendation in our setting based on our current local Streptococcus pneumoniae susceptibility patterns.

Актуальные вопросы эпидемиологии внебольничных пневмоний в Российской Федерации в 2015 г.

Актуальные вопросы эпидемиологии внебольничных пневмоний в Российской Федерации в 2015 г.

The Impact of Prior Antibiotic Therapy on Outcomes in Children Hospitalized for Community-Acquired Pneumonia.

Here, we review current available literature regarding the effect of prior antibiotic treatment on outcomes of children hospitalized for community-acquired pneumonia (CAP). To date, no prospective trial has reported information regarding morbidity or mortality in this group of patients. Retrospective studies have provided evidence for the advantage of treatment with broad-spectrum antibiotics in children who failed prior antibiotic therapy. We discuss the changing epidemiology of CAP in the post PCV13 and Hib vaccines era and its relevance to the outcome of pediatric patients hospitalized for CAP. Current studies still report Streptococcus pneumoniae as the most common typical bacterial causative agent in pediatric CAP. However, in children who fail to respond to guideline directed antibiotic therapy, a non-pneumococcal, possibly one of several β-lactam resistant causative bacterial agents should be considered thus clarifying the advantage for broad-spectrum empirical antibiotic treatment in this group of patients.

Continuing Professional Development: Acute community-acquired pneumonia

Overview This Continuing Professional Development (CPD) module will explore acute community-acquired pneumonia (CAP). The pathophysiology and epidemiology of CAP will be discussed, before highlighting key diagnostic features and how it can be managed by paramedics in the pre-hospital setting. Learning Outcomes After completing this module you will be able to: Outline the definition, pathophysiology and epidemiology of acute community-acquired pneumonia. Identify the key diagnostic features of acute pneumonia, including the causes and physical presentation. Outline how acute community-acquired pneumonia can be managed by paramedics.

Community-acquired pneumonia.

Community-acquired pneumonia (CAP) is the most common infectious disease cause of death. We summarize recent findings regarding the epidemiology of CAP in adults, efficacy of vaccines against Streptococcus pneumoniae, diagnostics, and discuss the current controversy between CAP and healthcare-associated pneumonia (HCAP). The emergence of the Middle East respiratory syndrome coronavirus and the avian influenza A strain H7N9 are of concern but still these are infrequent causes of CAP. Recent data indicate that vaccinating children also protects adults against CAP by generating significant herd immunity, and that the conjugated pneumococcal vaccine in adults may offer some efficacy in preventing CAP caused by vaccine serotypes. The immunochromotagraphic urinary antigen test has improved the diagnostic yield for the aetiology of CAP, and initial data demonstrate that a novel multiplex urinary antigen test will further increase the sensitivity for detection of S. pneumoniae. There has been significant concern that a relatively recently described pneumonia category, HCAP, requires empirical treatment for potentially multidrug-resistant organisms (MDRO). However, new evidence shows that (at least in Europe) pneumonia caused by MDRO remains uncommon even in HCAP category patients. CAP remains a major cause of morbidity and mortality. Advances in vaccination and diagnosis should help reduce the amount of disease due to S. pneumoniae, the commonest cause of CAP. Outside of the United States, MDRO are relatively uncommon causes of CAP, and the increased mortality of HCAP category patients seems to be related to their comorbidities and age rather than microbial aetiology.