Community acquired polymicrobial pneumonia in the intensive care unit: aetiology and prognosis
Introduction: The frequency and clinical significance of polymicrobial aetiology in community-acquired pneumonia (CAP) patients admitted to the ICU have been poorly studied. The aim of the present study was to describe the prevalence, clinical characteristics and outcomes of severe CAP of polymicrob...
| Authors: | ; ; ; ; ; ; ; |
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| Format: | Article |
| Status: | Published version |
| Publication date: | 2011 |
| Country: | España |
| Institution: | Universidad de Barcelona |
| Repository: | Dipòsit Digital de la UB |
| OAI Identifier: | oai:diposit.ub.edu:2445/144626 |
| Online Access: | https://hdl.handle.net/2445/144626 |
| Access Level: | Open access |
| Keyword: | Pneumònia Unitats de cures intensives Pneumonia Intensive care units |
| _version_ | 1878741652746534912 |
|---|---|
| author | Cillóniz, Catia |
| author2 | Ewig, Santiago Ferrer Monreal, Miquel Polverino, Eva Gabarrús, Albert Puig de la Bellacasa, Jordi Mensa Pueyo, Josep Torres Martí, Antoni |
| author2_role | author author author author author author author |
| author_browse | Cillóniz, Catia Ewig, Santiago Ferrer Monreal, Miquel Gabarrús, Albert Mensa Pueyo, Josep Polverino, Eva Puig de la Bellacasa, Jordi Torres Martí, Antoni |
| author_facet | Cillóniz, Catia Ewig, Santiago Ferrer Monreal, Miquel Polverino, Eva Gabarrús, Albert Puig de la Bellacasa, Jordi Mensa Pueyo, Josep Torres Martí, Antoni |
| author_role | author |
| collection | Dipòsit Digital de la UB |
| description | Introduction: The frequency and clinical significance of polymicrobial aetiology in community-acquired pneumonia (CAP) patients admitted to the ICU have been poorly studied. The aim of the present study was to describe the prevalence, clinical characteristics and outcomes of severe CAP of polymicrobial aetiology in patients admitted to the ICU. Methods: The prospective observational study included 362 consecutive adult patients with CAP admitted to the ICU within 24 hours of presentation; 196 (54%) patients had an established aetiology. Results: Polymicrobial infection was present in 39 (11%) cases (20% of those with defined aetiology): 33 cases with two pathogens, and six cases with three pathogens. The most frequently identified pathogens in polymicrobial infections were Streptococcus pneumoniae (n = 28, 72%), respiratory viruses (n = 15, 39%) and Pseudomonas aeruginosa (n = 8, 21%). Chronic respiratory disease and acute respiratory distress syndrome criteria were independent predictors of polymicrobial aetiology. Inappropriate initial antimicrobial treatment was more frequent in the polymicrobial aetiology group compared with the monomicrobial aetiology group (39% vs. 10%, P < 0.001), and was an independent predictor of hospital mortality (adjusted odds ratio = 10.79, 95% confidence interval = 3.97 to 29.30; P < 0.001). The trend for higher hospital mortality of the polymicrobial aetiology group compared with the monomicrobial aetiology group (n = 8, 21% versus n = 17, 11%), however, was not significantly different (P = 0.10). Conclusions: Polymicrobial pneumonia occurs frequently in patients admitted to the ICU. This is a risk factor for inappropriate initial antimicrobial treatment, which in turn independently predicts hospital mortality. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | ES_e8f852b97d4407b50c3d6efd13b3b6cc |
| institution | Universidad de Barcelona |
| instname_str | Universidad de Barcelona |
| network_acronym_str | ES |
| network_name_str | España |
| oai_identifier_str | oai:diposit.ub.edu:2445/144626 |
| publishDate | 2011 |
| publishDateSort | 2011 |
| publisher | BioMed Central |
| publisherStr | BioMed Central |
| reponame_str | Dipòsit Digital de la UB |
| spelling | Community acquired polymicrobial pneumonia in the intensive care unit: aetiology and prognosis Cillóniz, Catia Ewig, Santiago Ferrer Monreal, Miquel Polverino, Eva Gabarrús, Albert Puig de la Bellacasa, Jordi Mensa Pueyo, Josep Torres Martí, Antoni Pneumònia Unitats de cures intensives Pneumonia Intensive care units Introduction: The frequency and clinical significance of polymicrobial aetiology in community-acquired pneumonia (CAP) patients admitted to the ICU have been poorly studied. The aim of the present study was to describe the prevalence, clinical characteristics and outcomes of severe CAP of polymicrobial aetiology in patients admitted to the ICU. Methods: The prospective observational study included 362 consecutive adult patients with CAP admitted to the ICU within 24 hours of presentation; 196 (54%) patients had an established aetiology. Results: Polymicrobial infection was present in 39 (11%) cases (20% of those with defined aetiology): 33 cases with two pathogens, and six cases with three pathogens. The most frequently identified pathogens in polymicrobial infections were Streptococcus pneumoniae (n = 28, 72%), respiratory viruses (n = 15, 39%) and Pseudomonas aeruginosa (n = 8, 21%). Chronic respiratory disease and acute respiratory distress syndrome criteria were independent predictors of polymicrobial aetiology. Inappropriate initial antimicrobial treatment was more frequent in the polymicrobial aetiology group compared with the monomicrobial aetiology group (39% vs. 10%, P < 0.001), and was an independent predictor of hospital mortality (adjusted odds ratio = 10.79, 95% confidence interval = 3.97 to 29.30; P < 0.001). The trend for higher hospital mortality of the polymicrobial aetiology group compared with the monomicrobial aetiology group (n = 8, 21% versus n = 17, 11%), however, was not significantly different (P = 0.10). Conclusions: Polymicrobial pneumonia occurs frequently in patients admitted to the ICU. This is a risk factor for inappropriate initial antimicrobial treatment, which in turn independently predicts hospital mortality. BioMed Central https://hdl.handle.net/2445/144626 |
| spellingShingle | Community acquired polymicrobial pneumonia in the intensive care unit: aetiology and prognosis Cillóniz, Catia Pneumònia Unitats de cures intensives Pneumonia Intensive care units |
| status_str | publishedVersion |
| title | Community acquired polymicrobial pneumonia in the intensive care unit: aetiology and prognosis |
| title_full | Community acquired polymicrobial pneumonia in the intensive care unit: aetiology and prognosis |
| title_fullStr | Community acquired polymicrobial pneumonia in the intensive care unit: aetiology and prognosis |
| title_full_unstemmed | Community acquired polymicrobial pneumonia in the intensive care unit: aetiology and prognosis |
| title_short | Community acquired polymicrobial pneumonia in the intensive care unit: aetiology and prognosis |
| title_sort | Community acquired polymicrobial pneumonia in the intensive care unit: aetiology and prognosis |
| topic | Pneumònia Unitats de cures intensives Pneumonia Intensive care units |
| topic_facet | Pneumònia Unitats de cures intensives Pneumonia Intensive care units |
| url | https://hdl.handle.net/2445/144626 |