To access the full text documents, please follow this link: http://hdl.handle.net/2445/136778

Title:	Prevalence and Etiology of Community-acquired Pneumonia in Immunocompromised Patients
Author:	Pasquale, Marta Francesca Di; Sotgiu, Giovanni; Gramegna, Andrea; Radovanovic, Dejan; Terraneo, Silvia; Reyes, Luis F.; Rupp, Jan; González del Castillo, Juan; Blasi, Francesco; Aliberti, Stefano; Restrepo, Marcos I.; Cillóniz, Catia; Torres Martí, Antoni; GLIMP Investigators
Notes:	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.
Subject(s):	-Pneumònia adquirida a la comunitat -Etiologia -Community-acquired pneumonia -Etiology
Rights:	(c) Pasquale et al., 2019
Document type:	Article Article - Published version
Published by:	Oxford University Press
Share:

Show full item record