Prospective study of aetiology and outcome of adult lower-respiratory-tract infections in the community

Macfarlane, John; Macfarlane, R.M.; Rose, D H; Colville, A.; Guion, A

doi:10.1016/0140-6736(93)90275-l

Cited by 356 publications

(243 citation statements)

References 13 publications

Supporting

Mentioning

206

Contrasting

Unclassified

Order By: Relevance

“…The incidence of community-acquired pneumonia is higher in elderly than in young adults [3,16]. This period of life is characterized by the occurrence of chronic and debilitating conditions, which tend to be more frequent in males and have been found to be a major risk factor for community-acquired pneumonia [7].…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of community-acquired pneumonia in adults: a population-based study

Almirall¹,

Bolíbar²,

Vidal³

et al. 2000

Eur Respir J

372

232

View full text Add to dashboard Cite

a study was performed in a mixed residential-industrial urban population of the "Maresme" region in Barcelona, Spain. All subjects $14 yrs of age (annual average population size 74,368 inhabitants) with clinically suspected community-acquired pneumonia were registered. All cases were re-evaluated by chest radiographs on the 5th day of illness and at monthly intervals until complete recovery. Urine and blood samples were obtained for culture and antigen detection. When lower respiratory tract secretions were obtained, these were also cultured.There were 241 patients with community-acquired pneumonia, with an annual incidence rate of 1.62 cases (95% confidence interval, 1.42±1.82) per 1,000 inhabitants. Incidence rates increased by age groups and were higher in males than in females. Of 232 patients with aetiological data, 104 had an identifiable aetiology. A total of 114 pathogens were found (single pathogen 94, two pathogens 10). There were 81 episodes of bacterial infection and 33 of viral infection. The most common pathogens were Streptococcus pneumoniae, Chlamydia pneumoniae, and influenza A and B viruses. No case of Hantavirus infection was found. The rate of hospital admission was 61.4% with a mean SD length of 11.7 10.1 days, a mean period of 23.0 14.3 days inactivity, and an overall mortality rate of 5%.The high rate of hospital admission, prolonged stay in hospital, and long period of inactivity all continue to constitute a social and health care burden of communityacquired pneumonia. Eur Respir J 2000; 15: 757±763.

show abstract

Section: Discussionmentioning

confidence: 99%

Epidemiology of community-acquired pneumonia in adults: a population-based study

Almirall¹,

Bolíbar²,

Vidal³

et al. 2000

Eur Respir J

372

232

View full text Add to dashboard Cite

show abstract

“…Chest radiographs are also only of limited value in the imaging of mild infiltrates [12,13]. Moreover, since only every 10th or 20th patient with LRTI is expected to have true pneumonia [14], thus resulting in a low prevalence, the positive predictive value of any diagnostic rule will be low. Thus, a sharp distinction will not be possible in every case of mild LRTI.…”

Section: Detecting Mild Pneumoniamentioning

confidence: 99%

Severity assessment in community-acquired pneumonia

Ewig¹,

Schäfer²,

Torres³

2000

Eur Respir J

View full text Add to dashboard Cite

In current guidelines for the management of adults with community‐acquired pneumonia (CAP), the triaging decision about hospitalization or intensive care unit (ICU) admission, and, as a consequence, selection of initial antimicrobial treatment is largely based on the assessment of pneumonia severity. The proposed severity criteria are mainly derived from studies determining pre‐dictors of adverse outcome. These include age, male sex, comorbidity, acute respira‐tory failure, severe sepsis and septic shock, extension of radiographic infiltrates, bacteraemia and CAP through several different pathogens such as Streptococcus pneumoniae, Staphylococcus aureus, Gram‐negative enteric bacilli (GNEB), and signs of disease progression within the first 48–72 h. In addition, prediction rules and need for a complicated course in ambulatory and hospitalized patients, for the individual risk of death have been developed which may be helpful in determining the patient who might require hospitalization or intensive care, respectively. Risk classifications such as the scores developed by F ineet al. [40] are not only useful for identifying low risk patients who might safely be treated as outpatients, but apparently they will also play a major role in the evaluation of processes and outcomes of care for patients with CAP. Recent investigations have provided objective criteria for the definition of severe CAP requiring ICU admission. Whether the detection of infiltrates in the chest radiographs of patients with acute lower respiratory tract infection (LRTI) suggestive of mild pneumonia has an independent prognostic impact which fundamentally affects the concept of mild LRTI remains to be seen. Based on objective criteria for severity assessment it will be possible to define interventions aimed at reducing hospital admission rates, define a risk‐adapted anti‐microbial treatment regimen, reduce costs for antimicrobial treatment and supportive measures, shorten hospital stay, and, thereby, improve the quality of care for patients with community‐acquired pneumonia.

show abstract

“…[16][17][18] En nuestro estudio, los casos de NAC fueron identificados en base a los códigos CIE-9 registrados como diagnóstico en las historias clínicas electrónicas de atención primaria y/o listados de altas hospitalarias y de los servicios de urgencia de referencia de la cohorte de estudio. Sin embargo, todos los casos fueron radiológicamente confirmados y validados mediante revisión de la historia clínica; por lo tanto, es improbable una sobreestimación de la incidencia.…”

Section: Discussionunclassified

Incidencia y características clínicas de las neumonías tratadas ambulatoriamente en las personas mayores de 65 años del área de Tarragona-Valls, 2002-2005

Vila-Córcoles¹,

Blanco²,

Ochoa-Gondar³

et al. 2009

Rev. Esp. Salud Publica

View full text Add to dashboard Cite

Prospective study of aetiology and outcome of adult lower-respiratory-tract infections in the community

Cited by 356 publications

References 13 publications

Epidemiology of community-acquired pneumonia in adults: a population-based study

Epidemiology of community-acquired pneumonia in adults: a population-based study

Severity assessment in community-acquired pneumonia

Incidencia y características clínicas de las neumonías tratadas ambulatoriamente en las personas mayores de 65 años del área de Tarragona-Valls, 2002-2005

Contact Info

Product

Resources

About