TY - JOUR. T1 - Community-acquired methicillin-resistant staphylococcus aureus in children with no identified predisposing risk. AU - Herold, Betsy C.. AU - Immergluck, Lilly C.. AU - Maranan, Melinda C.. AU - Lauderdale, Diane S.. AU - Gaskin, Ryan E.. AU - Boyle-Vavra, Susan. AU - Leitch, Cindy D.. AU - Daum, Robert S.. N1 - Copyright: Copyright 2007 Elsevier B.V., All rights reserved.. PY - 1998/2/25. Y1 - 1998/2/25. N2 - Context.-Community-acquired methicillin-resistant Staphylococcus aureus (MRSA) infections in children have occurred primarily in individuals with recognized predisposing risks. Community-acquired MRSA infections in the absence of identified risk factors have been reported infrequently. Objectives.-To determine whether community-acquired MRSA infections in children with no identified predisposing risks are increasing and to define the spectrum of disease associated with MRSA isolation. Design.-Retrospective review of medical records. Patients.-Hospitalized children with S ...

TY - JOUR. T1 - Commercially distributed meat as a potential vehicle for community-acquired methicillin-resistant Staphylococcus aureus. AU - Ogata, Kikuyo. AU - Narimatsu, Hiroshi. AU - Suzuki, Masahiro. AU - Higuchi, Wataru. AU - Yamamoto, Tatsuo. AU - Taniguchi, Hatsumi. PY - 2012/4. Y1 - 2012/4. N2 - The incidence of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infection has been increasing; however, the sources of infection remain unclear. Therefore, we investigated the involvement of meat as a possible mediator of CA-MRSA infection.Weexamined the distribution ofMRSAstrains in commercially distributed raw meat samples (n=197) and diarrheal stool samples of outpatients (n=1,287) that were collected in Oita Prefecture, Japan, between 2003 and 2009 for routine legal inspections. FourteenMRSAstrains were isolated from three meat and 11 stool samples. Among these, seven isolates from three meat and four stool samples exhibited the same epidemiological marker profiles ...

TY - JOUR. T1 - Community-acquired methicillin-resistant staphylococcus aureus among patients with puerperal mastitis requiring hospitalization. AU - Stafford, Irene. AU - Hernandez, Jennifer. AU - Laibl, Vanessa. AU - Sheffield, Jeanne. AU - Roberts, Scott. AU - Wendel, George. PY - 2008/9/1. Y1 - 2008/9/1. N2 - OBJECTIVE: To estimate the incidence of puerperal mastitis requiring hospital admission and to describe demographic and obstetric risk factors for this condition. We also sought to identify trends in bacteriology among isolates obtained from breast abscesses and breast-milk aspirates, with a focus on treatment strategies used for community-acquired methicillin-resistant Staphylococcus aureus (MRSA). METHODS: Patients with puerperal mastitis who were admitted to a county-based teaching hospital between January 1997 and December 2005 were identified by International Classification of Diseases, 9th Revision, codes (675.1, 675.2). Data collected included demographic characteristics, ...

Methicillin-resistant Staphylococcus aureus (MRSA) is a frequent cause for patients to present to a physicians office or emergency department. We observed increasing numbers of community-acquired MRSA infections in patients admitted to the hand surgery service at our suburban academic center. It is an important issue as unsuspected community-acquired MRSA hand infections can be admitted to the hospital, inadequately treated, and allowed for nosocomial spread. This study was performed to examine the trend in the incidence of community-acquired MRSA infections in patients admitted to the hand surgery service in order to sensitize practitioners to have a high index of suspicion for this entity and promote early recognition and treatment of this organism. A multihospital retrospective chart review was undertaken to compare the total number of community-acquired MRSA infections in our hospital as well as the number in patients admitted to the hand surgery service with community-acquired MRSA from 2000

BioAssay record AID 529821 submitted by ChEMBL: Bactericidal activity against community-acquired methicillin-resistant Staphylococcus aureus by broth microdilution method in presence of 50% human serum.

www.lung.org/assets/documents/research/pi-trend-report.pdf.. 5. Arnold FW, Wiemken TL, Peyrani P, et al. Mortality differences among hospitalized patients with community-acquired pneumonia in three world regions: results from the Community-Acquired Pneumonia Organization (CAPO) International Cohort Study. Respir Med 2013;107:1101-11.. 6. Mortensen EM, Coley CM, Singer DE, et al. Causes of death for patients with community-acquired pneumonia: results from the Pneumonia Patient Outcomes Research Team cohort study. Arch Intern Med 2002;162:1059-64.. 7. Bordon J, Wiemken T, Peyrani P, et al. Decrease in long-term survival for hospitalized patients with community-acquired pneumonia. Chest 2010;138:279-83.. 8. Mortensen EM, Halm EA, Pugh MJ, et al. Association of azithromycin with mortality and cardiovascular events among older patients hospitalized with pneumonia. JAMA 2014;311:2199-208.. 9. Aliberti S, Ramirez JA. Cardiac diseases complicating community-acquired pneumonia. Curr Opin Infect Dis ...

SUPPLEMENT ARTICLE Infectious Diseases Society of America/American Thoracic Society Consensus Guidelines on the Management of Community-Acquired Pneumonia in Adults Lionel A. Mandell, 1,a Richard G. Wunderink,

Klebsiella pneumoniae is the major cause of community-acquired pyogenic infections in Taiwan. This retrospective study evaluated the clinical and microbiological characteristics of bacteremic community-acquired pneumonia due to K. pneumoniae in Taiwanese adults. The clinical characteristics of bacteremic community-acquired pneumonia (CAP) in adults due to K. pneumoniae were compared to those of adults with bacteremic CAP due to Streptococcus pneumoniae at a tertiary medical center in Taiwan from 2001-2008. Risk factors for mortality of bacteremic CAP due to K. pneumoniae were analyzed. All clinical isolates of K. pneumoniae were examined for capsular serotypes, hypermucoviscosity phenotype, aerobactin and rmpA gene. K. pneumoniae was the dominant cause of bacteremic CAP and was associated with a more fulminant course and a worse prognosis than bacteremic CAP due to Streptococcus pneumoniae. Initial presentation with septic shock and respiratory failure were independent risk factors for both early and

Oxidative stress is an important part of host innate immune response to foreign pathogens. However, the impact of vitamin C on oxidative stress and inflammation remains unclear in community-acquired pneumonia (CAP). We aimed to determine the effect of vitamin C on oxidative stress and inflammation. CAP patients were enrolled. Reactive oxygen species (ROS), DNA damage, superoxide dismutases (SOD) activity, tumor necrosis factor-alpha (TNF-α), and IL-6 were analyzed in CAP patients and LPS-stimulated macrophages cells. MH-S cells were transfected with RFP-LC3 plasmids. Autophagy was measured in LPS-stimulated macrophages cells. Severe CAP patients showed significantly increased ROS, DNA damage, TNF-α, and IL-6. SOD was significantly decreased in severe CAP. Vitamin C significantly decreased ROS, DNA damage, TNF-α, and IL-6. Vitamin C inhibited LPS-induced ROS, DNA damage, TNF-α, IL-6, and p38 in macrophages cells. Vitamin C inhibited autophagy in LPS-induced macrophages cells.

References 1. Bartlett JG, Dowell SF, Mandell LA, et al; Infectious Diseases Society of America. Practice guidelines for the management of community-acquired pneumonia. Clin Infect Dis. 2000;31:347-382. 2. National Center for Health Statistics. Health, United States, 2006. Available at: www.cdc.gov/nchs/data/hus/hus06.pdf. Accessed June 6, 2007.3. DeFrances CJ, Podgornik MN. 2004 National hospital discharge survey. Adv Data. 2006;317:1-19. 4. Division of Epidemiology. National Heart Lung and Blood Institute. Morbidity and mortality: 2004 chartbook on cardiovascular, lung and blood diseases. May 2004. 5. Mandell LA, Wunderink RG, Anzueto A, et al. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis. 2007;44(suppl 2):S27-S72. 6. Mandell GL, Bennett JE, Dolin R. Principles and Practice of Infectious Diseases. 6th ed. Philadelphia, PA: Churchill Livingstone; 2005:819-845. 7. Marrie TJ, ...

Distinguishing bacterial pneumonia from viral pneumonia is critical to providing effective treatment but remains a significant challenge. This issue provides guidance for the management of pediatric community-acquired pneumonia as well as associated complications including pleural effusion/empyema

Press Release Date: March 1, 2004. The Agency for Healthcare Research and Quality today announced its first clinical decision-support tool for personal digital assistants (PDAs) that is designed to help clinicians deliver evidence-based medicine at the point of care. AHRQs new Pneumonia Severity Index Calculator (which is available for download from the AHRQ Web site at http://pda.ahrq.gov), is an interactive application for Palm Pilots and other PDAs to help doctors quickly and easily determine whether patients with community-acquired pneumonia should be treated at home or in a hospital.. This new Pneumonia Severity Index Calculator is an example of how technology can support and facilitate the delivery of evidence-based medicine, said AHRQ Director Carolyn M. Clancy, M.D. AHRQ is striving to make decision support tools such as this available to clinicians. Community-acquired pneumonia contracted outside of a hospital or nursing home environment affects approximately 4 million Americans ...

There is no evidence supporting the use of de-escalation therapy (DET) among patients with community-acquired pneumonia (CAP). We assessed the outcomes associated with DET among bacteraemic CAP patients. We performed a secondary analysis of the Community-Acquired Pneumonia Organization database, which contains data on 660 bacteraemic patients hospitalized because of CAP in 35 countries (2001-2013). Exclusion criteria were death within 72h from admission and an inappropriate empirical antibiotic regimen. DET was defined as changing an appropriate empirical broad-spectrum regimen to a narrower-spectrum regimen according to culture results within 7 days from hospital admission. Two study groups were identified: patients whose antibiotic therapy was de-escalated (the DET group), and patients whose antibiotic therapy was not de-escalated (the N-DET group). The primary study outcome was 30-day mortality. Two hundred and sixty-one bacteraemic CAP patients were included. Gram-positive bacteria were ...

...WALTHAM Mass. Dec. 8 /- Decision Resources one of the ...The new Pharmacor report entitled Community-Acquired Pneumonia ... Two of the most clinically and commercially promising antibiotics in ...The report also finds that the community-acquired pneumonia market is ...,Patent,Expiries,of,Blockbuster,Antibiotics,Will,Fuel,a,Decline,of,More,Than,15,Percent,in,the,Community-Acquired,Pneumonia,Drug,Market,medicine,advanced medical technology,medical laboratory technology,medical device technology,latest medical technology,Health

Community-acquired pneumonia (CAP) has significant morbidity and mortality. The Infectious Diseases Society of America/American Thoracic Society (IDSA/ATS) guidelines recommend two antimicrobial regimens for hospitalized patients with CAP, one of which includes a macrolide, and one of which does not. Both regimens have antimicrobial properties, but macrolides also possess immunomodulatory properties. Macrolides, however, may also have potential arrhythmia adverse effects. The purpose of this review is to provide an update of studies evaluating outcomes for patients with CAP treated with or without a macrolide-based regimen. Two recent randomized controlled trials conflict with each other regarding the benefit versus noninferiority of including a macrolide for the treatment for CAP. Each have their respective limitations. Most prior observational studies and meta-analyses favor using a regimen with a macrolide. We do not recommend any different treatment strategy than the current IDSA/ATS guidelines for

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A study to assess the frequency of CRB65 scoring in patients diagnosed with community-acquired pneumonia (CAP) in primary care has been recently published in the Dove Press journal Pragmatic and Observational Research[1].. Community-acquired pneumonia (CAP) is a leading infectious cause of death worldwide.[2] CAP requires a severity assessment for diagnosis and treatment, particularly in hospital admission decisions. As an increased mortality rate is associated with a delay in admissions to the intensive care unit in severe CAP cases, it is critical that treatment is based on the severity of CAP to improve treatment outcomes. Both the British Thoracic Society (BTS) and the National Institute for Health and Care Excellence (NICE) recommend that the CRB65 scoring system to be used for this purpose due to its high levels of accuracy. The score assigns one score for each component of confusion, respiratory rate, blood pressure and age of 65 years or more, up to a maximum of 4. However, not much is ...

Plasma YKL-40 level has been reported as playing a significant role in community-acquired pneumonia (CAP). However, the correlation between plasma level of YKL-40 and the severity of CAP has not been reported. This study identifies the relationship between plasma level changes of the YKL-40 gene in adult patients hospitalized with CAP. The ELISA was used to measure the plasma YKL-40 level from 61 adult CAP patients before and after antibiotic treatment and from 60 healthy controls. The plasma YKL-40 levels were significantly increased in patients with CAP compared to normal controls. Moreover, the plasma concentration of YKL-40 correlated with the severity of CAP based on the pneumonia severity index (PSI) score (r = 0.630, p < 0.001), the CURB-65 (confusion, uremia, respiratory rate, BP, age 65 years) score (r = 0.640, p < 0.001), the Acute Physiology And Chronic Health Evaluation II (APACHE II) score (r = 0.539, p < 0.001) and length of hospital stay (r = 0.321, p = 0.011), respectively. In

Abdel-Rahman EM, 2000, DIAGN MICR INFEC DIS, V36, P203, DOI 10.1016-S0732-8893(99)00142-X; Ahmad S, 2009, JCPSP-J COLL PHYSICI, V19, P264, DOI 04.2009-JCPSP.264265; Ahmed K, 2000, EPIDEMIOL INFECT, V125, P573, DOI 10.1017-S0950268800004751; AHMED K, 1999, J INFECT CHEMOTHER, V5, P217, DOI 10.1007-s101560050039; Akala FA, 2006, LANCET, V367, P961, DOI 10.1016-S0140-6736(06)68402-X; Akbar DH, 2001, ACTA DIABETOL, V38, P77; ALALI MK, 2007, SAUDI MED J, V28, P813; Al-Ghamdi SM, 2003, SAUDI MED J, V24, P1073; Al-Ghizawi G. J., 2007, Eastern Mediterranean Health Journal, V13, P230; Al-Moyed K A, 2003, East Mediterr Health J, V9, P279; Al-Muhairi S, 2006, Monaldi Arch Chest Dis, V65, P13; Al-Muhairi SS, 2006, SAUDI MED J, V27, P1044; Alzeer A, 1998, J INFECTION, V36, P303, DOI 10.1016-S0163-4453(98)94315-8; Babay HA, 2000, SAUDI MED J, V21, P860; Balkhy HH, 2006, INT J INFECT DIS, V10, P326, DOI 10.1016-j.ijid.2005.06.013; Behbehani N, 2005, MED PRIN PRACT, V14, P235, DOI 10.1159-000085741; BISHAY FK, ...

Methicillin-resistant Staphylococcus aureus (MRSA) is an emerging community-acquired pathogen among patients without established risk factors for MRSA infection (e.g., recent hospitalization, recent surgery, residence in a long-term-care facility [LTCF], or injecting-drug use [IDU]) (1). Since 1996, the Minnesota Department of Health (MDH) and the Indian Health Service (IHS) have investigated cases of community-acquired MRSA infection in patients without established risk factors. This report describes four fatal cases among children with community-acquired MRSA; the MRSA strains isolated from these patients appear to be different from typical nosocomial MRSA strains in antimicrobial susceptibility patterns and pulsed-field gel electrophoresis (PFGE) characteristics.. Case Reports. Case 1. In July 1997, a 7-year-old black girl from urban Minnesota was admitted to a tertiary-care hospital with a temperature of 103 F (39.5 C) and right groin pain. An infected right hip joint was diagnosed; she ...

TY - JOUR. T1 - Ampicillin and penicillin concentration in serum and pleural fluid of hospitalized children with community-acquired pneumonia. AU - Giachetto, Gustavo. AU - Pirez, María Catalina. AU - Nanni, Luciana. AU - Martínez, Adriana. AU - Montano, Alicia. AU - Algorta, Gabriela. AU - Kaplan, Sheldon L.. AU - Ferrari, Ana María. PY - 2004/7/1. Y1 - 2004/7/1. N2 - Background: Optimal therapeutic efficacy of β-lactam antibiotics for treatment of pneumococcal pneumonia is thought to be associated with the serum concentration greater than the minimum inhibitory concentration for 40-50% of the interdose interval at site of infection. Objective: Establish whether intravenous administration of ampicillin 400 mg/kg/day or penicillin 200,000 IU/kg/day in 6 divided doses reaches serum and or pleural concentrations above 4 μg/ml for at least 40% of the interdose interval. Materials and Methods: Hospitalized healthy children 1 month-14 years old with community-acquired bacterial pneumonia and ...

Ekloef and Schmidt Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine2012, 20(Suppl 2):P10http://www.sjtrem.com/content/20/S2/P10 Community-acquired pneumonia: a comparisonof clinical treatment failure in patients treatedwith either penicillin or cefuroximeJosefin Ekloef*, Thomas A Schmidt From 4th Danish Emergency Medicine ConferenceRoskilde, Denmark. 25-26 November 2011 cefuroxime. Forty percent of the patients treated with National and local guidelines in the Emergency depart- penicillin experienced CTF compared to 17% in the ment (ED) at Holbaek hospital recommend penicillin as group treated with cefuroxime (p=0.347). Patients were first-line treatment of community-acquired pneumonia followed for 9 days. At 5 days, a survival rate without (CAP). Nevertheless, the use of cefuroxime seem to be CTF was estimated to 0,75 for cefuroxime and 0.54 for substantial when admitting patients with CAP ...

Our comprehensive search strategy identified 14 studies describing an association between kidney disease and acute community-acquired infection. Although between-study heterogeneity precluded meta-analysis, all studies were consistent with a positive direction of association. Four studies which reported estimates on more than one category of kidney disease found a graded association in which risk of infection increased with greater severity of CKD. These four studies excluded patients with ESRD, and three were at low risk of bias in all categories of quality assessment.22 ,23 ,26 ,27. To the best of our knowledge, this is the first review to address this research question systematically. We used a sensitive search strategy, with a broad definition of kidney disease, for a thorough and inclusive search. The results are consistent with the conclusion of previous narrative reviews: that an association between CKD and infection incidence is likely, but that there is a paucity of ...

TABLE: Emerging Therapies in Development for Community-Acquired Pneumonia, 2004 summarizes emerging antibacterial agents in late-stage development and their expected sales potential in the community-acquired pneumonia market.

Community-acquired pneumonia (CAP) is a common infection. Approximately 20 percent of all episodes of pneumonia result in hospitalization. It is the leading cause of community-acquired infection requiring intensive care unit (ICU) admission. In pulmonary infections, the release of cytokines and other inflammatory mediators from alveolar macrophages serves as a mechanism by which invading pathogens are eliminated. However, this reaction of the innate immune system can be potentially harmful when excessive release of circulating inflammatory cytokines causes damage to the patient, particularly the lung. Interest in the role of corticosteroids in the pathophysiology of critical illness has existed since the early part of the 20th century. On ICU, early treatment with corticosteroids to attenuate systemic inflammation is widespread. At the same time, outside the ICU little evidence is available on the effect of treatment with corticosteroids in patients diagnosed with CAP. Theoretically, early ...

OBJECTIVE: The 2007 American Thoracic Society/Infectious Diseases Society of America (ATS/IDSA) guidelines recommend that community-acquired pneumonia (CAP) patients admitted to hospital wards initially receive respiratory fluoroquinolone monotherapy or beta-lactam plus macrolide combination therapy. There is little evidence as to which regimen is preferred, or if differences in medical resource utilization exist between therapies. Thus, the authors compared length of hospital stay (LOS) and length of intravenous antibiotic therapy (LOIV) for patients who received initial levofloxacin 750 mg daily versus ceftriaxone 1000 mg plus azithromycin 500 mg daily (combination therapy).. RESEARCH DESIGN AND METHODS: Adult hospital CAP cases from January 2005 to December 2007 were identified by principal discharge diagnosis code. Patients with a chest infiltrate and medical notes indicative of CAP were included. Direct intensive care unit admits and healthcare-associated cases were excluded. A propensity ...

Authors: Edberg M, Furebring M, Sjölin J, Enblad P.. BACKGROUND: Reports about neurointensive care of severe community-acquired meningitis are few. The aims of this retrospective study were to review the acute clinical course, management and outcome in a series of bacterial meningitis patients receiving neurointensive care.. METHODS: Thirty patients (median age 51, range 1-81) admitted from a population of 2 million people during 7 years were studied. The neurointensive care protocol included escalated stepwise treatment with mild hyperventilation, cerebrospinal fluid (CSF) drainage, continuous thiopentotal infusion and decompressive craniectomy. Clinical outcome was assessed using the Glasgow outcome scale.. RESULTS: Twenty-eight patients did not respond to commands on arrival, five were non-reacting and five had dilated pupils. Twenty-two patients had positive CSF cultures: Streptococcus pneumoniae (n=18), Neisseria meningitidis (n=2), β-streptococcus group A (n=1) and Staphylococcus aureus ...

4. Genomics to Combact Resistance against Antibiotics in Community-acquired Lower Respiratory Tract Infections in Europe [GRACE]. Network of Excellence, Contract nº LSHM-CT-2005-518226. Funding: European Commission. Principal Contractor: University Hospital Antwerp, Belgium. Participating Institutions: ITQB and 23 others. March 2006/April 2010.. 5. CONtrol of COmmunity-acquired MRSA: Rationale and Development of counteractions [CONCORD]. Project FP7-Health-F3-2008-222718. Funding: European Commission. Principal contractor: University Medical Centre Utrecht, The Netherlands. Participating institutions: ITQB and 8 others. January 2009/Junho 2012.. 6. Translational Research on Combating Antimicrobial Resistance [TROCAR]. Project FP7-Health-F3-2008-223031. Funding: European Commission. Principal contractor: Institut Dinvestigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain. Participating institutions: ITQB and 15 others. January 2009/Junho 2012.. 7. A comprehensive ...

Length of hospital stay (LOS) in patients with community-acquired pneumonia (CAP) is variable and directly related to medical costs. Accurate estimation of LOS on admission and during follow-up may result in earlier and more efficient discharge strategies. This is a prospective multicenter study including patients in emergency departments of 6 tertiary care hospitals in Switzerland between October 2006 and March 2008. Medical history, clinical data at presentation and health care insurance class were collected. We calculated univariate and multivariate cox regression models to assess the association of different characteristics with LOS. In a split sample analysis, we created two LOS prediction rules, first including only admission data, and second including also additional inpatient information. The mean LOS in the 875 included CAP patients was 9.8 days (95%CI 9.3-10.4). Older age, respiratory rate |20 pm, nursing home residence, chronic pulmonary disease, diabetes, multilobar CAP and the pneumonia

Background: In Western settings, community-acquired pneumonia (CAP) due to Gram-negative bacilli (GNB) is relatively rare. Previous studies from Asia, however, indicate a higher prevalence of GNB in CAP, but data, particularly from Southeast Asia, are limited. Methods: This is a prospective observational study of 1451 patients ≥15 y of age with CAP from two hospitals in Cambodia between 2007 and 2010. The proportion of GNB was estimated. Risk factors and clinical characteristics of CAP due to GNB were assessed using logistic regression models. Results: The prevalence of GNB was 8.6% in all CAP patients and 15.8% among those with a valid respiratory sample. GNB infection was independently associated with diabetes, higher leucocyte count and CAP severity. Mortality was higher in patients with CAP due to GNB. Conclusions: We found a high proportion of GNB in a population hospitalized for CAP in Cambodia. Given the complex antimicrobial sensitivity patterns of certain GNBs and the rapid

Community-acquired pneumonia (CAP) is a heterogeneous disease causing great morbidity, mortality and health care burden globally. Typing methods for discriminating different clinical conditions of the same disease are essential to a better management of CAP. Traditional typing systems based separately on clinical manifestations (such as PSI and CURB-65), pathogens(bacterial types, virulence, drug resistance, etc) or host immune state (immunocompetent, immunocompromised or immunodeficiency). Thus, they are barely able to represent the real disease status nor to precisely predict the mortality.. As the development of multi-omic technologies, the relatedness of different phenotypes at a molecular level have revolutionized our ability to differentiate among patients. Our study is aimed at establishing a novel molecular typing method of CAP. Multi-omic (including genomics, transcriptomes, and metabolisms) data obtained from enrolled CAP patients and isolated pathogens would be integrated analyzed and ...

Gatifloxacin is an 8-methoxy fluoroquinolone with broad activity against respiratory tract pathogens, including those commonly associated with community-acquired pneumonia (CAP). To evaluate the efficacy and safety of oral gatifloxacin 400 mg once daily for seven to 14 days, community-based physicians enrolled adult outpatients with confirmed or suspected CAP in a prospective, single-arm, open-label, noncomparative study. Of 1488 clinically evaluable patients with radiographically confirmed or clinically suspected CAP, 1417 (95.2%) were cured. All strains of Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis, the most commonly isolated pathogens, were susceptible to gatifloxacin. Penicillin nonsusceptibility was seen in 32.6% of S. pneumoniae isolates, and beta-lactamase production was detected in H. influenzae (26.9%) and M. catarrhalis (88%) isolates. Clinical cure rates of 91%, 94%, and 92% were achieved in patients with S. pneumoniae, H. influenzae, and M. catarrhalis,

Community-acquired pneumonia (CAP) is one of the most common infections presenting to the emergency department (ED). Increasingly, antibiotic resistant bacteria have been identified as causative pathogens in patients treated for CAP, especially in patients with healthcare exposure risk factors. We retrospectively identified adult subjects treated for CAP in the ED requiring hospital admission (January 2003-December 2011). Inappropriate antibiotic treatment, defined as an antibiotic regimen that lacked in vitro activity against the isolated pathogen, served as the primary end point. Information regarding demographics, severity of illness, comorbidities, and antibiotic treatment was recorded. Logistic regression was used to determine factors independently associated with inappropriate treatment. The initial cohort included 259 patients, 72 (27.8%) receiving inappropriate antibiotic treatment. There was no difference in hospital mortality between patients receiving inappropriate and appropriate treatment

Community-acquired pneumonia (CAP) refers to pneumonia (any of several lung diseases) contracted by a person with little contact with the healthcare system. The chief difference between hospital-acquired pneumonia (HAP) and CAP is that patients with HAP live in long-term care facilities or have recently visited a hospital. CAP is common, affecting people of all ages, and its symptoms occur as a result of oxygen-absorbing areas of the lung (alveoli) filling with fluid. This inhibits lung function, causing dyspnea, fever, chest pains and cough. CAP, the most common type of pneumonia, is a leading cause of illness and death worldwide. Its causes include bacteria, viruses, fungi and parasites. CAP is diagnosed by assessing symptoms, making a physical examination and on x-ray. Other tests, such as sputum examination, supplement chest x-rays. Patients with CAP sometimes require hospitalization, and it is treated primarily with antibiotics, antipyretics and cough medicine. Some forms of CAP can be ...

Community-acquired pneumonia substantially affects patient morbidity and mortality, and has significant health care costs. This type of pneumonia has more impact on elderly patients, who tend to have longer hospital stays and a higher cost per stay compared with younger patients. Multiple published guidelines provide physicians with information about when to admit patients with community-acquired pneumonia, which antibiotic therapy is appropriate, how long to treat, and when it is suitable to discharge patients from the hospital. These treatment strategies do not take into account the emergence of resistant organisms and the poorly understood impact of community-acquired pneumonia on younger patients. Although various studies have looked at combination antibiotic therapy, they rarely have been comparative. Brown and colleagues examined the effect of initial antibiotic therapy for community-acquired pneumonia on selected clinical outcomes.. The authors analyzed a hospital database of adult ...

Community-acquired pneumonia is diagnosed by clinical features (e.g., cough, fever, pleuritic chest pain) and by lung imaging, usually an infiltrate seen on chest radiography. Initial evaluation should determine the need for hospitalization versus outpatient management using validated mortality or severity prediction scores. Selected diagnostic laboratory testing, such as sputum and blood cultures, is indicated for inpatients with severe illness but is rarely useful for outpatients. Initial outpatient therapy should include a macrolide or doxycycline. For outpatients with comorbidities or who have used antibiotics within the previous three months, a respiratory fluoroquinolone (levofloxacin, gemifloxacin, or moxifloxacin), or an oral beta-lactam antibiotic plus a macrolide should be used. Inpatients not admitted to an intensive care unit should receive a respiratory fluoroquinolone, or a beta-lactam antibiotic plus a macrolide. Patients with severe community-acquired pneumonia or who are ...

The Outpatient Community-Acquired Pneumonia in Adults GUIDELINES Pocket Card is based on the latest guidelines of the Infectious Diseases Society of America

Guidelines recommend blood culture sampling from hospitalized patients with suspected community-acquired pneumonia (CAP). However, the yield of true-positive results is low. We investigated the benefit of procalcitonin (PCT) on hospital admission to predict blood culture positivity in CAP ...

Community-acquired pneumonia (CAP) is defined as an acute infection of the pulmonary parenchyma in a patient who has acquired the infection in the community, as distinguished from hospital-acquired (nosocomial) pneumonia (HAP).CAP is a common and pot

ABSTRACTObjective:Community-acquired pneumonia (CAP) is a common presentation to the emergency department (ED) and has high mortality rates. The aim of our study is to investigate the risk stratification and prognostic prediction value of precalcitonin (PCT) and clinical severity scores on patients

Acute respiratory infections (ARIs) are responsible for high morbidity and mortality in pediatric patients, particularly in children less than five years old. Community-acquired pneumonia (CAP) is the most serious cause of ARI. Each year, from two to three million children die of pneumonia, predominantly in developing countries, and this is attributed to more severe clinical conditions, the involvement of bacteria as etiological agents, and less access to health care services and adequate therapy. This study aimed to compare clinical response to initial empirical treatment of Oxacillin associated with Ceftriaxone to Amoxicillin associated with Clavulanic Acid in children aged from two months to five years, diagnosed with severe community-acquired Pneumonia, who require hospitalization. It also aimed to evaluate the time for clinical recovery (fever and tachypnea) and the need for extending the antimicrobial spectrum in order to determine therapeutic failure in the proposed schemes. It is a ...

In a randomized clinical trial of antibiotic treatments for community-acquired pneumonia, researchers did not find that monotherapy with β-lactam alone was worse than a combination therapy with a macrolide in patients hospitalized with moderately severe pneumonia.

Introduction: Data describing real-life management and treatment of community-acquired pneumonia (CAP) in Europe are limited. The REtrospective Study to Assess the Clinical Management of Patients With Moderate-to-severe cSSTI or CAP Infections in the Hospital Setting (REACH) (NCT01293435) was an observational retrospective study that collected data on the management of European patients hospitalized with CAP in order to review current clinical practices and outcomes related to initial treatment failure, and to assess intercountry differences. Methods: Patients were aged ≥18 years, hospitalized with CAP between March 2010 and February 2011, and required in-hospital management and treatment with intravenous antibiotics. An electronic Case Report Form was used to collect a number of patient, disease and treatment variables, including type of CAP, medical history, treatment setting, antibiotic treatments and clinical outcomes, particularly treatment failure. Results: Patients (N=2039) were ...

Pneumonia is a type of lung infection. It can cause breathing problems and other symptoms. In community-acquired pneumonia (CAP), you get infected in a community setting. It doesnt happen in a hospital, nursing home, or other healthcare center.

Objective: To investigate the pathogens and antibiotic resistance of Community-Acquired Pneumonia (CAP) in children under 5 y old in our hospital duri..

TY - JOUR. T1 - Diagnostic accuracy of a serotype-specific antigen test in community-acquired pneumonia. AU - Huijts, S.M.. AU - Pride, M.W.. AU - Vos, J.M.. AU - Jansen, K.U.. AU - Webber, C.. AU - Gruber, W.. AU - Boersma, W.G.. AU - Snijders, D.. AU - Kluijtmans, J.A.J.W.. AU - van der Lee, I.. AU - Kuipers, B.A.. AU - van den Ende, A.. AU - Bonten, M.J.M.. PY - 2013. Y1 - 2013. U2 - 10.1183/09031936.00137412. DO - 10.1183/09031936.00137412. M3 - Article. C2 - 23397295. VL - 42. SP - 1283. EP - 1290. JO - European Respiratory Journal. JF - European Respiratory Journal. SN - 0903-1936. IS - 5. ER - ...

Marion Giry, Marie Gueudin, Déborah Boyer, Adeline Baron, Gaetan Beduneau, et al.. Impact of respiratory viruses in intensive care unit patient with community-acquired pneumonia : a one-year retrospective single-centre study.. ECCMID, Apr 2019, Amsterdam, Netherlands. ⟨hal-02264276⟩ ...

Of the 224 episodes of community-acquired pneumonia, 8.5% were attended at private institutions, a datum that is difficult to compare with other studies since the use of private healthcare resources depends on the healthcare system of each study area. Despite the fact that primary care plays an important role in the management of community-acquired pneumonia, the low diagnostic yield (20% of cases) at this level is surprising. This may be explained by the lack of availability of chest radiography such that many patients are referred to the hospital emergency department, as well as for the tendency of patients in Maresme to seek care directly from the hospital emergency service 24. A study carried out in Spain in the primary care setting showed that 29.7% of cases of community-acquired pneumonia were diagnosed at hospital emergency services 25. In the study of Weingarten et al. 26, 55% of diagnoses of community-acquired pneumonia were established at the emergency department.. After discharge from ...

Given the dramatic advances in antimicrobials since penicillin was introduced, why has the mortality rate associated with community-acquired pneumonia (CAP) remained essentially unchanged?

C(U)RB-65 (confusion, (urea |7 mol · L(-1),) respiratory frequency ≥ 30 breaths · min(-1), systolic blood pressure |90 mmHg or diastolic blood pressure ≤60 mmHg and age ≥ 65 years) is now the generally accepted severity score for patients with community-acquired pneumonia (CAP) in Europe. In a …