Risk factors for immunosuppression in hospitalized patients coming from the community with pneumonia: a worldwide perspective

Pasquale, Marta Francesca Di; Sotgiu, Giovanni; Gramegna, Andrea; Radovanovic, Dejan; Terraneo, Silvia; Reyes, Luis Felipe; Blasi, Francesco; Restrepo, Marcos I.; Aliberti, Stefano

doi:10.1183/13993003.congress-2018.pa2039

Cited by 6 publications

(10 citation statements)

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“…47 Despite the fact that immunocompromised patients are often exposed to previous hospitalization, the incidence of these pathogens is relatively low (around 10%). 13 However, an empirical therapy against these pathogens is mandatory in specific settings. 48 History of colonization or infection with a drug-resistant gram-negative bacillus in the previous 12 months, previous hospitalization with exposure to broad-spectrum antibiotics, a history of pulmonary comorbidity, and the presence of a tracheostomy are risk factors for the development of pulmonary infection with resistant gram-negative bacilli.…”

Section: Therapeuticmentioning

confidence: 99%

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Severe Community-Acquired Pneumonia in Immunocompromised Patients

Chean,

Windsor,

Lafarge

et al. 2024

Semin Respir Crit Care Med

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Due to higher survival rates with good quality of life, related to new treatments in the fields of oncology, hematology, and transplantation, the number of immunocompromised patients is increasing. But these patients are at high risk of intensive care unit admission because of numerous complications. Acute respiratory failure due to severe community-acquired pneumonia is one of the leading causes of admission. In this setting, the need for invasive mechanical ventilation is up to 60%, associated with a high hospital mortality rate of around 40 to 50%. A wide range of pathogens according to the reason of immunosuppression is associated with severe pneumonia in those patients: documented bacterial pneumonia represents a third of cases, viral and fungal pneumonia both account for up to 15% of cases. For patients with an undetermined etiology despite comprehensive diagnostic workup, the hospital mortality rate is very high. Thus, a standardized diagnosis strategy should be defined to increase the diagnosis rate and prescribe the appropriate treatment. This review focuses on the benefit-to-risk ratio of invasive or noninvasive strategies, in the era of omics, for the management of critically ill immunocompromised patients with severe pneumonia in terms of diagnosis and oxygenation.

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Section: Therapeuticmentioning

confidence: 99%

“…Indeed, almost 20% of patients hospitalized for community-acquired pneumonia (CAP) are immunocompromised. 13 14 The rate of ICU hospitalization in severe pneumonia is high for immunocompromised patients. 9 Acute respiratory failure (ARF) due to pulmonary infection is the leading cause of ICU admission in immunocompromised patients.…”

mentioning

confidence: 99%

Severe Community-Acquired Pneumonia in Immunocompromised Patients

Chean,

Windsor,

Lafarge

et al. 2024

Semin Respir Crit Care Med

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“…The study did not show an increased prevalence of severe CAP in patients with immunocompromise. 54 The challenge is that patients with immunocompromise represent a heterogeneous group. The probability of opportunistic infections varies according to the risk factor for immunocompromise.…”

Section: Epidemiologymentioning

confidence: 99%

Definition, Epidemiology, and Pathogenesis of Severe Community-Acquired Pneumonia

Cavallazzi,

Ramirez

2024

Semin Respir Crit Care Med

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The clinical presentation of community-acquired pneumonia (CAP) can vary widely among patients. While many individuals with mild symptoms can be managed as outpatients with excellent outcomes, there is a distinct subgroup of patients who present with severe CAP. In these cases, the mortality rate can reach approximately 25% within 30 days and even up to 50% within a year. It is crucial to focus attention on these patients who are at higher risk.Among the various definitions of severe CAP found in the literature, one commonly used criterion is the requirement for admission to intensive care unit. Notable epidemiological characteristics of these patients include the impact of acute cardiovascular diseases on clinical outcomes and the enduring, independent effect of pneumonia on long-term outcomes. Factors such as pathogen virulence, the presence of comorbidities, and the host response are important contributors to the pathogenesis of severe CAP. In these patients, the host response may be dysregulated and compartmentalized. Gaining a better understanding of the epidemiology and pathogenesis of severe CAP will provide a foundation for the development of new therapies for this condition.This manuscript aims to review the definition, epidemiology, and pathogenesis of severe CAP, shedding light on important aspects that can aid in the improvement of patient care and outcomes.

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“…Original samples from these patients were collected and immediately placed in virus transport media tubes for analysis. Immunosuppressed patients were de ned as the presence at least one risk factor as follows: congenital/genetic immunocompromise, HIV infection, SOT, HSCT, malignancies receiving chemotherapy, aplastic anemia, chronic haemodialysis, chronic steroid use, immunosuppressive agents use and biological drug use [10,11,12]. A(H1N1)pdm09 and A(H3N2) were con rmed by reverse transcription-polymerase chain reaction (RT-PCR) method [23].…”

Section: Patients and Sample Collectionmentioning

confidence: 99%

“…The previous literatures and surveillances of the Centers for Disease Control and Prevention (CDC) of in uenza at the molecular level were mainly from immunocompetent patients [8,9]. With the progress of medical technology, immunosuppressed patients who have undergone haemopoietic stem cell transplantation (HSCT) or solid-organ transplantation (SOT), patients on chronic haemodialysis, and patients receiving systemic corticosteroids, immunosuppressants and biological reagents have increased each year [10,11,12]. Immunosuppressed patients accounted for 10.3% of the global multi-center cross-sectional study of 35,348 adult in uenza patients published in 2020 [13].…”

Section: Introductionmentioning

confidence: 99%

Phylogenetic analysis of HA and NA genes of influenza A viruses in immunosuppressed inpatients in Beijing during the 2018-2020 influenza seasons

Liu

Wang

et al. 2023

Preprint

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Background Influenza A viruses have undergone rapid evolution with virulent; however, complete and comprehensive data on gene evolution and amino acid variation of HA and NA in immunosuppressed patients was few. In this study, we analysed molecular epidemiology and evolution of influenza A viruses in immunosuppressed population, and immunocompetent population were used as controls. Methods A(H1N1)pdm09 and A(H3N2) were confirmed by reverse transcription-polymerase chain reaction (RT-PCR). HA and NA genes were sequenced using the Sanger method and phylogenetically analysed using ClustalW 2.10 and MEGA software version 11.0. Results During the 2018–2020 influenza seasons, 54 immunosuppressed and 46 immunocompetent inpatients were verified using RT–PCR. 27 immunosuppressed and 23 immunocompetent samples were randomly selected and sequenced using the Sanger method. A(H1N1)pdm09 were detected in 15 samples and the remaining 35 samples were A(H3N2) positive. By analyzing the HA and NA gene sequences of these virus strains, we found that all A(H1N1)pdm09 viruses shared high similarities to each other and the HA and NA genes of these viruses exclusively belonged to subclade 6B.1A.1. Some NA genes of A(H3N2) viruses were not in the same clade as those of A/Singapore/INFIMH-16-0019/2016 and A/Kansas/14/2017, which may have led to A(H3N2) being the dominant strain in the 2019–2020 influenza season. Both A(H1N1)pdm09 and A(H3N2) viruses showed similar evolutionary lineages patterns of HA and NA between immunosuppressed and immunocompetent patients. However, compared with the vaccine strains, the HA and NA nucleotide and amino acid sequences of influenza A viruses in immunosuppressed patients were less similar than those in immunocompetent patients. A total of 18 unreported substitutions were observed, 12 substitutions of which from immunosuppressed patients. Furthermore, the oseltamivir resistance substitution of NA-H275Y and R292K have been observed in immunosuppressed patients. Conclusions A(H1N1)pdm09 and A(H3N2) viruses showed similar evolutionary lineages patterns of HA and NA between immunosuppressed and immunocompetent patients. Compared with immunocompetent patients, immunosuppressed patients have more amino acid variations, which should be of note monitored, especially those with potential to affect the viral antigen.

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Risk factors for immunosuppression in hospitalized patients coming from the community with pneumonia: a worldwide perspective

Cited by 6 publications

References 0 publications

Severe Community-Acquired Pneumonia in Immunocompromised Patients

Severe Community-Acquired Pneumonia in Immunocompromised Patients

Definition, Epidemiology, and Pathogenesis of Severe Community-Acquired Pneumonia

Phylogenetic analysis of HA and NA genes of influenza A viruses in immunosuppressed inpatients in Beijing during the 2018-2020 influenza seasons

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