Growing importance of Gram-negative isolates in respiratory samples

Méndez, Lucía; Pedrosa, Adriana; Caneiras, Cátia

doi:10.1183/13993003.congress-2020.2027

Cited by 3 publications

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“…A previous study performed by the authors at the same hospital showed an increase in isolates of Gram-negative microorganisms in the last 5 years, an important factor when selecting empirical antibiotic therapy [24]. However, of relevance, the H. alvei is intrinsically resistant to amoxicillin/clavulanic acid and the piperacillin/tazobactam combination was not tested.…”

Section: Discussionmentioning

confidence: 98%

Hafnia alvei Pneumonia: A Rare Cause of Infection in a Patient with COVID-19

2021

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Herein, we describe a case report of a critically ill patient, a 48-year-old man without comorbidities admitted to the hospital with a serious type 1 (hypoxemic) respiratory insufficiency and confirmed diagnosis of COVID-19. After 5 days with invasive mechanical ventilation, the patient developed a bacterial co-infection, namely a pneumonia by Hafnia alvei, requiring the last line of respiratory support: extracorporeal membrane oxygenation (ECMO). Subsequently, his clinical situation gradually stabilized, until he was discharged from the hospital on day 61, being accompanied in ambulatory consultation by the physical medicine and pulmonology department during the post-COVID-19 recovery. H. alvei is a Gram-negative bacterium that is rarely isolated from human specimens and is rarely considered to be pathogenic. However, COVID-19 disease can cause substantial organ dysfunction and can be associated with bacterial secondary infections which can favor the emergence of rare infectious diseases by uncommon microorganisms.

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Section: Discussionmentioning

confidence: 98%

Hafnia alvei Pneumonia: A Rare Cause of Infection in a Patient with COVID-19

2021

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“…Klebsiella pneumoniae is a member of the Enterobacteriaceae family and is a common pathogen in lower urinary tract, soft tissue and pulmonary infections. Thereby, pulmonary pathogenicity of virulent KP species has been recently emphasized by increasing isolation frequencies in respiratory samples over the past decade (Mendez et al, 2020 ; Braeken et al, 2021 ). Typically, if rarely, hyper virulent, hypermucoviscous KP species have been interlinked with systemic infection and sequential involvement of multiple organ sites (Fang et al, 2004 ; Chang et al, 2021 ), which is likely to have occurred in our patient despite absent genetic in depth characterization of the detected KP isolate.…”

Section: Discussionmentioning

confidence: 99%

A Case Report and Review of the Literature: Infectious Aneurysm Formation in the Pulmonary Arteries—A Rare but Perilous Sequela of Persisting Infection With Klebsiella pneumoniae

et al. 2022

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Septic aneurysms of the pulmonary artery are rare conditions, with few cases having been reported worldwide. They are assumed to result from septic emboli that cause a local inflammatory reaction of the arterial wall, ultimately leading to degenerative changes. We report the case of a 63-year-old female patient presenting with Klebsiella pneumoniae urosepsis and first diagnosis of diabetes mellitus, who developed a life-threatening infectious pulmonary artery aneurysm secondary to bacteremia with Klebsiella pneumoniae. The patient required a lobectomy due to pulmonary hemorrhage. We review the clinical hallmarks of Klebsiella pneumoniae related septic pulmonary embolic disease and summarize currently known risk factors for the development of infectious aneurysmatic disease including diabetes mellitus and other states of immunosuppression. The featured case aims to increase the awareness for this seldom but life-threatening complication of infectious diseases such as Klebsiella pneumoniae urosepsis.

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“…Worryingly, most pneumonia (>95%) are treated empirically considering that only in few situations the infectious agent is isolated. At the top of the list of isolations we find Klebsiella pneumoniae , which can indicate that the trend of respiratory isolations has changed in the last years and we can highlight the increase of relevance of Gram-negative microorganisms [ 41 ]. However, this results should be interpreted with caution regarding that only 2% of the clinical situations have a microorganism identified.…”

Section: Discussionmentioning

confidence: 99%

Epidemiological Characterization and the Impact of Healthcare-Associated Pneumonia in Patients Admitted in a Northern Portuguese Hospital

Méndez

Castro

Ferreira

et al. 2021

JCM

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Pneumonia is one of the main causes of hospitalization and mortality. It’s the fourth leading cause of death worldwide. Healthcare-associated infections are the most frequent complication of healthcare and affect hundreds of millions of patients around the world, although the actual number of patients affected is unknown due to the difficulty of reliable data. The main goal of this manuscript is to describe the epidemiological characteristics of patients admitted with pneumonia and the impact of healthcare-associated pneumonia (HCAP) in those patients. It is a quantitative descriptive study with retrospective analysis of the clinical processes of 2436 individuals for 1 year (2018) with the diagnosis of pneumonia. The individuals with ≤5 years old represented 10.4% (n = 253) and ≥65 were 72.6% (n = 1769). 369 cases resulted in death, which gives a sample lethality rate of 15.2%. The severity and mortality index were not sensitive to the death event. We found 30.2% (n = 735) individuals with HCAP and 0.41% (n = 59) with ventilator-associated pneumonia (VAP). In only 59 individuals (2.4%) the agent causing pneumonia was isolated. The high fatality rate obtained shows that pneumonia is a major cause of death in vulnerable populations. Moreover, HCAP is one of the main causes of hospital admissions from pneumonia and death and the most pneumonias are treated empirically. Knowledge of the epidemiology characterization of pneumonia, especially associated with healthcare, is essential to increase the skills of health professionals for the prevention and efficient treatment of pneumonia.

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Growing importance of Gram-negative isolates in respiratory samples

Cited by 3 publications

References 0 publications

Hafnia alvei Pneumonia: A Rare Cause of Infection in a Patient with COVID-19

Hafnia alvei Pneumonia: A Rare Cause of Infection in a Patient with COVID-19

A Case Report and Review of the Literature: Infectious Aneurysm Formation in the Pulmonary Arteries—A Rare but Perilous Sequela of Persisting Infection With Klebsiella pneumoniae

Epidemiological Characterization and the Impact of Healthcare-Associated Pneumonia in Patients Admitted in a Northern Portuguese Hospital

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