Community-acquired pneumonia as an emergency condition

Abstract

Purpose of review Despite the improvements in its management, community-acquired pneumonia (CAP) still exhibits high global morbidity and mortality rates, especially in elderly patients. This review focuses on the most recent findings on the epidemiology, cause, diagnosis and management of CAP. Recent findings There is consistent evidence that the trend in CAP mortality has declined over time. However, the mortality of pneumococcal CAP has not changed in the last two decades, with an increase in the rate of hospitalization and more severe forms of CAP. Streptococcus pneumoniae remains the most frequent cause of CAP in all settings, age groups and regardless of comorbidities. However, the implementation of molecular diagnostic tests in the last years has identified respiratory viruses as a common cause of CAP too. The emergency of multidrug-resistance pathogens is a worldwide concern. An improvement in our ability to promptly identify the causative cause of CAP is required in order to provide pathogen-directed antibiotic therapy, improve antibiotic stewardship programs and implement appropriate vaccine strategies. Summary It is time to apply all the knowledge generated in the last decade in order to optimize the management of CAP.

One year after ICU admission for severe community-acquired pneumonia of bacterial, viral or unidentified etiology. What are the outcomes?

“…However, our sensitivity analysis showed no difference in one-year mortality between the viral and the unidentified etiology groups when the 17/37 patients with viruses different from RSV or influenza and not obtained from a distal sampling were reclassified into the unidentified etiology group (p = 0.72). The 22% overall hospital mortality rate of severe CAP observed in our study is close to the rates classically reported, which range between 25% and 50% [23][24][25]. In our study, the mortality rates in the viral and unidentified etiology groups are consistent with those of previously published studies.…”

Challenges in severe community-acquired pneumonia: a point-of-view review

“…A large populationbased surveillance study on hospitalized CAP patients found that 21% of patients required intensive care unit (ICU) admission, with 26% of them needing mechanical ventilation [2]. SCAP hospital mortality is still high, ranging from 25% to more than 50% [3,4]. Since delays from hospitalization to ICU admission have been related to increased mortality [5], several scoring systems have been evaluated in order to promptly identify patients requiring intensive care management and to guide empiric antibiotic therapy [6].…”

Plasma Soluble Urokinase-Type Plasminogen Activator Receptor Level as a Predictor of the Severity of Community-Acquired Pneumonia

“…Community-acquired pneumonia (CAP) is the most common infectious disease with high mortality [11,12]. The CAP mortality rate remains high despite numerous treatment options.…”