Risk factors for community-acquired pneumonia in adults in Europe: a literature review

Abstract

BackgroundCommunity-acquired pneumonia (CAP) causes considerable morbidity and mortality in adults, particularly in the elderly.MethodsStructured searches of PubMed were conducted to identify up-to-date information on the incidence of CAP in adults in Europe, as well as data on lifestyle and medical risk factors for CAP.ResultsThe overall annual incidence of CAP in adults ranged between 1.07 to 1.2 per 1000 person-years and 1.54 to 1.7 per 1000 population and increased with age (14 per 1000 person-years in adults aged ≥65 years). Incidence was also higher in men than in women and in patients with chronic respiratory disease or HIV infection. Lifestyle factors associated with an increased risk of CAP included smoking, alcohol abuse, being underweight, having regular contact with children and poor dental hygiene. The presence of comorbid conditions, including chronic respiratory and cardiovascular diseases, cerebrovascular disease, Parkinson's disease, epilepsy, dementia, dysphagia, HIV or chronic renal or liver disease all increased the risk of CAP by twofold to fourfold.ConclusionA range of lifestyle factors and underlying medical conditions are associated with an increased risk of CAP in European adults. Understanding of the types of individual at greatest risk of CAP can help to ensure that interventions to reduce the risk of infection and burden of disease are targeted appropriately.

Association between monovalent influenza A (H1N1) pdm09 vaccine and pneumonia among the elderly in the 2009–2010 season in Japan: A case-control study

“…10 Old age, underlying respiratory system disease, hypertension, hypercholesterolemia, heart disease, cerebral hemorrhage, cerebral infarction, stroke, diabetes mellitus, kidney disease, smoking, and low ADL status are associated with an increased risk of hospitalization due to pneumonia or influenza. 11 On the other hand, the vaccination rate typically is higher in healthy elderly than in weak elderly. Pneumococcus is cited as the major pathogenic bacterium in community-acquired pneumonia in the Japanese, 12 and the 23-valent pneumococcal polysaccharide vaccine has reduced the prevalence of pneumococcal pneumonia.…”

Amoxicillin is associated with a lower risk of further antibiotic prescriptions for lower respiratory tract infections in primary care – A database analysis spanning over 30 years

“…These findings appear to be clinically relevant and plausible as, for example older patients are at higher risk of adverse outcomes from community acquired pneumonia [11]. Patients with previous smoking history are at risk of abnormal lung architecture, COPD and hence atypical bacterial infections [12,13].…”

Predictors of Mortality Among U.S. Veterans With Streptococcus Pneumoniae Infections

“…A recent literature review demonstrated that epilepsy, Parkinson disease, and multiple sclerosis were all risk factors for the development of community-acquired pneumonia, increasing risk by twofold to fourfold. 34 Neurologic disorders are believed to increase the risk of developing pneumococcal disease owing to a higher likelihood of aspiration. 2 As neurologic disorders were also independent predictors of mortality in this study, and considering the infection and potential mortality prevention afforded by pneumococcal vaccination, further studies assessing the impact of pneumococcal vaccination on outcomes in patients with a history of neurologic disorders are warranted.…”

“…Dementia has been shown to increase risk of developing pneumococcal infection as well as increased disease severity, likely due to an increased risk of aspiration similar to neurologic disorders. 2,34,38 A retrospective study of more than 1,000 patients with a mean age of 64 years showed that dementia was an independent predictor of increased pneumococcal infection severity (OR=4.23, 95% CI=1.24, 14.4), but was not a significant predictor of mortality. 38 However, severe infection, which was assessed in the aforementioned study as well as in this study via invasive disease and intensive care unit treatment, was predictive of mortality.…”