Characteristics Of Community-acquired Pneumonia Research Articles

Clinical and epidemiological features of community-acquired pneumonia during an epidemic of respiratory viral infection

Community-acquired pneumonia (CAP) is one of the most common lower respiratory tract diseases. An increase in the CAP incidence has been reported to be associated with epidemics of acute respiratory viral infections (ARVI).Aim. Аssess clinical and epidemiological features of CAP in patients admitted to hospital during an ARVI epidemic.Methods. A cross-sectional study included 208 patient records. Medical history, physical examination, laboratory and imaging data were analyzed. CAP severity was assessed by CRB-65 scale and the systemic inflammatory response syndrome (SIRS) criteria.Results. Most CAP patients (75%) were of active working age; all presented signs of ARVI upon admission. Nasal mucosa diagnostic smears have revealed type A influenza viruses: H1N1 – 5 (83.3%) and H3N2 – 1 (16.7%) cases. 195 (93.8%) patients were not vaccinated against influenza. X-rays showed that unilateral (81.7%) and lobular pneumonia (55.8%) were the most common CAP types. 93.2% patients had nonsevere CAP, according to CRB-65. But 88 (42.3%) subjects qualified for SIRS upon admission. Concomitant conditions as risk factors of an adverse course of CAP were present in 89 patients (42.8%). Sputum analysis, if available, most frequently identified Streptococcus pneumoniae (23 cases or 38.9%) as a causative agent. Antibacterial drugs (ABD) used to treat CAP were ceftriaxone 206 (99%), macrolides 188 (90.4%), and fluoroquinolones 94 (45.2%). The initial antibacterial treatment regimens were: 186 (89.4%) prescriptions of ceftriaxone + macrolides, 16 (7.7%) prescriptions of ceftriaxone alone, and 6 (2.9%) prescriptions of levofloxacin. A switch between ABDs was reported in 78 (37.5%) cases, including 61 switches to fluoroquinolones. The median ABD administration duration was 10 (8 – 13) days.Conclusion. Most of the hospitalized CAP patients were of working age and not vaccinated against influenza. Streptococcus pneumoniae was the most common causative agent. PCR (polymerase chain reaction) smear analysis was performed only in 6 patients with ARVI, which does not allow us to assess the role of viruses and viral-bacterial associations in the etiology of CAP. In spite of non-severe CAP, all hospitalizations were justified, due to multiple risk factors of unfavorable prognosis of CAP and epidemiological factors. Most patients received a combination of generation 3 cephalosporins and macrolides as the initial therapy for CAP.

Features of Community-acquired Pneumonia in Children with Children's Cerebral Paralysis

Features of Community-acquired Pneumonia in Children with Children's Cerebral Paralysis

Molecular epidemiology of Streptococcus pneumoniae isolated from pediatric community-acquired pneumonia in pre-conjugate vaccine era in Western China

BackgroundStreptococcus pneumoniae (S. pneumoniae) is one of the most common pathogens which can cause morbidity and mortality in pediatric infections worldwide. This study aimed to describe the phenotypic and molecular characteristics of community-acquired pneumonia (CAP)-causing S. pneumoniae recovered from children in Western China.MethodsWe retrospectively enrolled pediatric patients younger than 5 years diagnosed with CAP. All 419 S. pneumoniae isolates were tested for antibiotic susceptibility, serotypes, virulence genes, resistance genes, and sequence types. The potential relationships between molecular characteristics were tested by correspondence analysis.ResultsMost of S. pneumoniae isolates were resistant to erythromycin, tetracycline, clindamycin and trimethoprim-sulfamethoxazole, with 93.8% isolates classified as multidrug resistant. The dominant STs were ST271 (30.8%) and ST320 (12.2%), while the prevailing serotypes were 19F (46.8%), 6B (11.5%), 23F (9.5%) and 19A (9.3%). The coverage rates of PCV-7 and PCV-13 were 73.03% and 86.16%, while the coverage rates of PCV13 among children aged < 1 year and 1–2 years were high in 93.18% and 93.62%. We also observed that CC271 expressed more of mef (A/E), lytA, rlrA and sipA than non-CC271 isolates. Moreover, there were strong corresponding relationships between molecular characteristics.ConclusionsThe high coverage rate of PCV13 suggests the necessity of introducing the PCV13 vaccine in Western China. Our findings underscore the value of monitoring multiple molecular characteristics to provide new guidance for developing future pneumococcal vaccines.

Особенности течения и терапии респираторного микоплазмоза у детей в эпидемический сезон 2020–2021 гг.

According to some authors, infection caused by M. pneumoniae is one of the most common in the current epidemic season of 2020–2021 worldwide. This fact is particularly important now because of the need for differential diagnosis between mild COVID-19 and respiratory infection caused by M. pneumoniae, as well as for timely administration of causal therapy. Materials and methods. In this study, we analyzed the frequency of pneumonia caused by M. pneumoniae detected among children admitted to the Pediatric Department for Infectious Diseases of Khimki Hospital over the last 5 years. Results. We observed an increase in the proportion of patients hospitalized with community-acquired pneumonia, primarily between October 2017 and April 2018, as well as in the spring of 2020. In 31% to 67% of children treated in 2020–2021 (depending on the month and season), community-acquired pneumonia was caused by M. pneumoniae. We also analyzed clinical characteristics of community-acquired pneumonia caused by M. pneumoniae and other pathogens. In addition to that, we report a case of mixed infection (M. pneumoniae plus Epstein-Barr virus) and provide a rationale for administration of meglumine acridone acetate (Cycloferon) as a part of comprehensive treatment for this pathology. Key words: community-acquired pneumonia, children, infection caused by Mycoplasma pneumoniae, meglumine acridone acetate

Особенности внебольничной пневмонии у пациентов, госпитализированных в пульмонологическое отделение

Особенности внебольничной пневмонии у пациентов, госпитализированных в пульмонологическое отделение

Etiology and characteristics of community-acquired pneumonia in an influenza epidemic period

PurposeThe etiology of community-acquired pneumonia (CAP) in hospital patients is often ambiguous due to the limited pathogen detection. Lack of a microbiological diagnosis impairs precision treatment in CAP. MethodsSpecimens collected from the lower respiratory tract of 195 CAP patients, viruses were measured by the Single-plex real-time PCR assay and the conventional culture method was exploited for bacteria. ResultsAmong the 195 patients, there were 46 (23.59%) pure bacterial infections, 20 (10.26%) yeast infections, 32 (16.41%) pure viral infections, 8 (4.10%) viral-yeast co-infections, and 17 (8.72%) viral-bacterial co-infections. The two most abundant bacteria were Acinetobacter baumannii and klebsiella pneumoniae, whereas the most common virus was influenza A. ConclusionsNon-influenza respiratory microorganisms frequently co-circulated during the epidemic peaks of influenza, which easily being ignored in CAP therapy. In patients with bacterial and viral co-infections, identifying the etiologic agent is crucial for patient’s therapy.

Особенности внебольничной пневмонии у детей с детским церебральным параличом

Особенности внебольничной пневмонии у детей с детским церебральным параличом

CLINICAL AND CHEST X-RAY FEATURES OF PNEUMONIA IN INJECTING-DRUG USERS

On an example of a clinical case in a patient with drug addiction, the reviewed clinical and chest X-ray features of community-acquired pneumonia, the diagnostic algorithms and the differential diagnostics are based on the recommendations of the Ukrainian Association of Pulmonology. The treatment strategy of the patient in the conditions of an ambulatory are described. Community-Acquired pneumonia acquired by intravenous drug use is characterized by a severe course, febrile body temperature, severe specific lung disease. On the example of this clinical case, the importance of express diagnostics of pneumonia at the ambulatory stage wasconfirmed to determine the correct tactics of patient management.

ЭПИДЕМИОЛОГИЧЕСКИЕ ОСОБЕННОСТИ ВНЕБОЛЬНИЧНЫХ ПНЕВМОНИЙ В ЭКСТРЕМАЛЬНЫХ ПРИРОДНО-КЛИМАТИЧЕСКИХ УСЛОВИЯХ

The authors evaluated epidemiological features of community-acquired pneumonia (CAP) in organized groups under hot and wet conditions of Black Sea climate as well as under maritime climate conditions of Kamchatka. Persons of first group were not adapted to activity conditions and not acclimatized, but persons of second group were acclimatized and adapted to activity conditions. It was established that environmental factors caused incidence rate, seasonal prevalence, phase of ascent during period of adaptation, prevalence of causative agents. CAP incidence among persons with body weight deficiency, its onset in stress situations, high associativity of opportunistic microorganisms in etiological structure provided evidence about a role of natural resistance of human body. It was found a necessity of application of means of non-specific and specific prevention taking into consideration etiological role of causative agents both in different times during period of adaptation and taking into account season.

Characteristics of Community-Acquired Pneumonia in Hospitalized Lebanese Children and their Correlation

Aim To study the radiological findings of community acquired pneumonia in correlation with clinical signs and symptoms as well as laboratory findings in children and adolescents hospitalized Material and methods We retrospectively reviewed the medical records of children who were hospitalized for community acquired pneumonia A descriptive study was followed by a correlation study of patients rsquo clinical signs and symptoms physical examination and laboratory studies with the patients rsquo radiologic finding Results We reviewed the medical records of pediatric patients who met criteria The most common symptoms were cough and fever Crackles heard and focal infiltrate were the most common findings on physical exam and radiologic imaging respectively Among the laboratory studies performed only C reactive protein was found to be elevated with prolonged duration of symptoms p lt With the exception of abdominal pain p there were no significant differences relating patient symptoms with radiologic findings Conclusion In this study no clinical or laboratory finding could be sufficient for the diagnosis and therapeutic decision as found in previous studies Newer laboratory tests and etiologic search methods should be made available until then a high clinical index of suspicion is useful in our developing country Aim To study the radiological findings of community acquired pneumonia in correlation with clinical signs and symptoms as well as laboratory findings in children and adolescents hospitalized Material and methods We retrospectively reviewed the medical records of children who were hospitalized for community acquired pneumonia A descriptive study was followed by a correlation study of patients rsquo clinical signs and symptoms physical examination and laboratory studies with the patients rsquo radiologic finding Results We reviewed the medical records of pediatric patients who met criteria The most common symptoms were cough and fever Crackles heard and focal infiltrate were the most common findings on physical exam and radiologic imaging respectively Among the laboratory studies performed only C reactive protein was found to be elevated with prolonged duration of symptoms p lt With the exception of abdominal pain p there were no significant differences relating patient symptoms with radiologic findings Conclusion In this study no clinical or laboratory finding could be sufficient for the diagnosis and therapeutic decision as found in previous studies Newer laboratory tests and etiologic search methods should be made available until then a high clinical index of suspicion is useful in our developing country

Study on common symptoms and characteristics of community acquired pneumonia in elderly patients

Objective To summarize the common syndromes and characteristics of community acquired pneumonia in elderly patients.Method 38 cases were diagnosed from October 2009 to October 2010 in the elderly patients as community-acquired pneumonia,the clinical data were retrospectively analyzed and summarized.Results Among all patients,7 cases of lung-qi deficiency (18.42％),pulmonary stagnation of phlegm syndrome in 6 cases (15.79％),phlegm and blood stasis obstructing lung in 5 cases (13.16％),spleen qi deficiency syndrome in 4 cases (10.53％),4 cases of Qi and yin deficiency syndrome (10.53％),lung spleen qi deficiency syndrome in 3 cases (7.89％),kidney-qi deficiency syndrome in 3 cases (7.89％),3 cases of lung qi deficiency syndrome (7.89％),1 case of deficiency of kidney yin deficiency syndrome (2.63％),1 eases (2.63％),lung and kidney in 1 case (2.63％).The onset of fever in 18 cases,the incidence was 47.37％; the appearance of chest pain in 10 cases,the incidence was 26.32％; onset of haemoptysis in 2 cases,the incidence was 5.26％;1 case appeared dyspnea,cough and incidence rate was 2.63％; in 28 cases,the incidence was 73.68％; pneumococcus sputum culture was positive in 3 cases,the positive rate was 7.89％.Gonclusion The fever,chest pain is not apparent as clinical features in community acquired pneumonia in elderly patients,the pneumococcus sputum culture positive rate decreased.When there is some unexplained symptoms in older patients without obvious causes,we should carefully distinguish the relevant examination,to early detect the occurrence of community acquired pneumonia. Key words: Community acquired pneumonia; Syndrome; Elderly patients; Characteristics

Clinical features of community-acquired pneumonia in servicemen after pneumococcal vaccination

Summary. The study involved 2,000 army conscripts with community-acquired pneumonia (CAP). Clinical and laboratory features of CAP were studied in 693 patients who had been previously vaccinated with polyvalent polysaccharide pneumococcal vaccine "Pneumo-23" (Aventis Pasteur SA, France) and in 1307 patients of the control group. The incidence of severe CAP in vaccinated patients was 2.2-fold and the incidence of moderate CAP was 1.2-fold lower compared to unvaccinated patients. On the contrary, a mild CАP prevalence was 1.3-fold higher in vaccinated patients. The vaccinated patients had complication rate twice as lower and more rapid resolution of clinical and radiological signs of CAP.

Clinical and morphological features of community-acquired pneumonia during the A / H1N1 influenza epidemics

Summary. This article presents a retrospective comparative analysis of hospitalized cases of community-acquired pneumonia (CAP) during the 2007 to 2009 years in a pneumology department of a regional hospital, Penza. This period included 2009 A / H1N1 influenza epidemics. In 2009, the number of hospitalizations increased in 1.4 times, mortality increased in 5.7 times in comparison with 2007 and 2008 years. Severe and atypical course of CAP with dry cough, prolonged fever, severe respiratory failure, bilateral multi-segmental lesions, an absence of leukocytosis and severe complications (acute respiratory failure, phlebitis, sepsis) were noted in 60.9 % of patients. CAP associated with influenza A / H1N1 was more common in patients with cardiovascular disease, obesity and differed from CAP in previous years. In 2009, outcomes of CAP were fibrosis in 43.8 % (compared to 25 % in 2008 and 21.2 % in 2007) and death in 12.5 % of cases. Pathomorphological findings were hemorrhage and microthrombosis in respiratory system, brain, and other organs.

Characteristics of community-acquired pneumonia in patients with chronic obstructive pulmonary disease

Community-acquired pneumonia is a frequent event in the course of chronic obstructive pulmonary disease (COPD). The aim of the present study was to provide information on clinical and microbiological characteristics and outcome of community-acquired pneumonia in these patients, in a comparative study with the non-COPD population. Prospective study of cases. A university hospital in Lleida, Spain. During a 6 year-period, we prospectively studied the clinical and radiological manifestations, microbiological data and outcome of all patients with community-acquired pneumonia. A comparative analysis of characteristics of pneumonia between 132 patients with a definitive diagnosis of COPD and 575 patients who did not have this underlying disease was performed. COPD was associated with an older and predominantly male population. These patients frequently had concomitant comorbidities such as diabetes mellitus or chronic heart failure. Clinical presentation was more severe, manifested by septic shock, tachypnea, lower values of pH, pO(2) and oxygen saturation, and greater values of pCO(2). Purulent expectoration was also more frequent in this subset of patients. Admission was usually required for patients with COPD, and length of hospitalization was significantly increased; however, difference in the mortality rate was not observed. Although the spectrum of responsible microorganisms was very similar, the incidence of Pseudomonas aeruginosa and other Gram-negative bacilli was increased in COPD, particularly among patients with advanced situation and/or oral corticosteroid treatment. Community-acquired pneumonia in patients with COPD was associated with epidemiological and clinical particularities mainly related to the underlying disease but showed only minor differences in outcome parameters. Gram-negative bacilli and P. aeruginosa are potential pathogens that need to be considered.

Epidemiology of Community-Acquired Pneumonia in Children

To the Editor .— We read the recent article by Michelow et al,1 “Epidemiology and Clinical Characteristics of Community-Acquired Pneumonia in Hospitalized Children,” with great interest. One hundred fifty-four children were enrolled in this study, and blood or pleural fluid cultures, pneumolysin-based polymerase chain reaction assays, and serologic tests were used to clarify the epidemiology. The study indicated that Streptococcus pneumoniae , Mycoplasma pneumoniae , Chlamydia pneumoniae , and respiratory viruses were the major pathogens involved …

C10.3 Etiology and clinical features of community-acquired pneumonia in hospitalized adult patients at a medical center in Southern Taiwan

C10.3 Etiology and clinical features of community-acquired pneumonia in hospitalized adult patients at a medical center in Southern Taiwan