Global and Local Epidemiology of Community-Acquired Pneumonia: The Experience of the CAPNETZ Network

Welte, Tobias; Köhnlein, Thomas

doi:10.1055/s-0029-1202941

Cited by 104 publications

(69 citation statements)

References 30 publications

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“…Ewig et al reported the incidence of communityacquired pneumonia requiring hospitalization by age group based [58]. It was estimated that approximately 40% of communityacquired pneumonia cases were attributable to pneumococcal infection, based on the German Competence Network for Community-Acquired Pneumonia study [59]. Case-fatality rates also came from the Competence Network for CommunityAcquired Pneumonia study [59].…”

Section: Natural History Of Ipd Complications and Other Pneumococcal DImentioning

confidence: 99%

Cost–effectiveness of vaccinating adults with the 23-valent pneumococcal polysaccharide vaccine (PPV23) in Germany

Jiang

Gauthier

Annemans

et al. 2012

Expert Review of Pharmacoeconomics & Outcomes Research

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Section: Natural History Of Ipd Complications and Other Pneumococcal DImentioning

confidence: 99%

Cost–effectiveness of vaccinating adults with the 23-valent pneumococcal polysaccharide vaccine (PPV23) in Germany

Jiang

Gauthier

Annemans

et al. 2012

Expert Review of Pharmacoeconomics & Outcomes Research

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“…The ratio of C-reactive protein to procalcitonin significantly distinguished between the groups. High procalcitonin levels were associated with an adverse clinical course.Community-acquired pneumonia (CAP) may be caused by either Streptococcus pneumoniae or Legionella pneumophila (5,19). The initiation of adequate empirical antimicrobial therapy can be challenging, since S. pneumoniae and L. pneumophila have partly contrasting antimicrobial susceptibility patterns (11).…”

mentioning

confidence: 99%

“…Community-acquired pneumonia (CAP) may be caused by either Streptococcus pneumoniae or Legionella pneumophila (5,19). The initiation of adequate empirical antimicrobial therapy can be challenging, since S. pneumoniae and L. pneumophila have partly contrasting antimicrobial susceptibility patterns (11).…”

mentioning

confidence: 99%

Clinical Potential of C-Reactive Protein and Procalcitonin Serum Concentrations To Guide Differential Diagnosis and Clinical Management of Pneumococcal and Legionella Pneumonia

et al. 2010

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We retrospectively analyzed the records of 61 hospitalized patients with community-acquired pneumonia (CAP) caused by Streptococcus pneumoniae or Legionella pneumophila. We found that serum procalcitonin and sodium concentrations were significantly lower, and ferritin levels were significantly higher, in patients infected with L. pneumophila than in those infected with S. pneumoniae. The ratio of C-reactive protein to procalcitonin significantly distinguished between the groups. High procalcitonin levels were associated with an adverse clinical course.Community-acquired pneumonia (CAP) may be caused by either Streptococcus pneumoniae or Legionella pneumophila (5,19). The initiation of adequate empirical antimicrobial therapy can be challenging, since S. pneumoniae and L. pneumophila have partly contrasting antimicrobial susceptibility patterns (11). We thus questioned whether the determination of C-reactive protein (CRP) and procalcitonin (PCT) levels in serum could be helpful for the differential diagnosis of S. pneumoniae or L. pneumophila infection. While determination of CRP levels can be helpful for the differentiation between viral and bacterial pulmonary infections (7), elevated PCT levels have been linked to a poor prognosis in CAP and specifically in Legionella pneumonia (9, 15). However, while PCT was linked to the severity of the underlying cause, CRP was more closely linked to the presence of infections in a prospective study (8).We retrospectively analyzed the records of 61 patients admitted to the University Hospital of Innsbruck (Innsbruck, Austria) between 2005 and 2008 with CAP caused either by S. pneumoniae (n ϭ 37) or by L. pneumophila (n ϭ 24). Pneumonia was diagnosed on the basis of clinical criteria and laboratory evidence of infection and was confirmed by radiographic evidence. For species diagnosis, urinary antigen tests for S. pneumoniae or L. pneumophila, the latter detecting serotype 1 (BinaxNOW; Inverness Medical, ME), were used (1,4,5,10,17).Baseline laboratory parameters were determined by routine automated tests, and data were available from day 1 (admission) and days 5 to 7. PCT levels were determined by a timeresolved amplified cryptate emission technology assay (Brahms AG, Henningsdorf, Germany) (2).All statistical analyses were performed with the SPSS statistical package (version 11.5; SPSS, Chicago, IL). For nonnormally distributed data. nonparametric tests were applied (Mann-Whitney test). The Spearman rank correlation technique was used for analysis of associations. All tests were two-sided, and a P value of Ͻ0.05 indicated statistical significance. Binary logistic regression analysis was used to identify parameters predictive of the patient outcomes. The ratio of CRP concentrations to PCT concentrations was calculated, and the logarithmic values were used to identify cutoffs for discrimination between L. pneumophila and S. pneumoniae infections. The diagnostic value of these cutoffs was evaluated by calculating sensitivity, specificity, and positive and negative predictive ...

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“…A recent review by Welte and Kohnlein (in 2009) showed a mortality of patients hospitalized with CAP of 5 to 20% (20). Treatment failure due to antimicrobial resistance may account for at least a part of that.…”

mentioning

confidence: 99%

International Pneumococcal Clones Match or Exceed the Fitness of Other Strains despite the Accumulation of Antibiotic Resistance

Rudolf

Michaylov

Linden

et al. 2011

Antimicrob Agents Chemother

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A few international pneumococcal clones dominate the population of antibiotic-resistant pneumococci. Despite the scientific paradigm that a loss in fitness is the price for acquisition of resistance, these clones spread successfully. One hundred fifty-four isolates from adult patients with community-acquired pneumonia (CAP) were analyzed. Thirty percent showed a close relationship to international clones and had fitness equal to or exceeding that of other strains (P ‫؍‬ 0.015); these factors may result in the endurance of these strains despite a reduction of antibiotic usage.

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Global and Local Epidemiology of Community-Acquired Pneumonia: The Experience of the CAPNETZ Network

Cited by 104 publications

References 30 publications

Cost–effectiveness of vaccinating adults with the 23-valent pneumococcal polysaccharide vaccine (PPV23) in Germany

Cost–effectiveness of vaccinating adults with the 23-valent pneumococcal polysaccharide vaccine (PPV23) in Germany

Clinical Potential of C-Reactive Protein and Procalcitonin Serum Concentrations To Guide Differential Diagnosis and Clinical Management of Pneumococcal and Legionella Pneumonia

International Pneumococcal Clones Match or Exceed the Fitness of Other Strains despite the Accumulation of Antibiotic Resistance

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