Severe community-acquired pneumonia: assessment of microbial aetiology as mortality factor

Paganin, F.

doi:10.1183/09031936.04.00119503

Cited by 141 publications

(105 citation statements)

References 45 publications

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“…K. pneumoniae is rarely the underlying cause of CAPs in North America, Europe, and Australia, as it is estimated to be the causative agent in only ϳ3 to 5% of CAPs in these regions. It is, however, a more common etiological agent of CAPs in Asia and Africa, where K. pneumoniae is second only to Streptococcus pneumoniae as the underlying agent, causing about 15% of infections (32,42,(60)(61)(62). While both classical and HV strains can cause CAPs, the comparatively increased prevalence of K. pneumoniae as the etiological agent of CAPs in Asia and Africa is likely due, at least in part, to the increased prevalence of hypervirulent strains in these areas (42).…”

Section: Infections Caused By K Pneumoniaementioning

confidence: 99%

Klebsiella pneumoniae: Going on the Offense with a Strong Defense

Paczosa

Mecsas

2016

Microbiol Mol Biol Rev

1,293

1,345

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SUMMARYKlebsiella pneumoniaecauses a wide range of infections, including pneumonias, urinary tract infections, bacteremias, and liver abscesses. Historically,K. pneumoniaehas caused serious infection primarily in immunocompromised individuals, but the recent emergence and spread of hypervirulent strains have broadened the number of people susceptible to infections to include those who are healthy and immunosufficient. Furthermore,K. pneumoniaestrains have become increasingly resistant to antibiotics, rendering infection by these strains very challenging to treat. The emergence of hypervirulent and antibiotic-resistant strains has driven a number of recent studies. Work has described the worldwide spread of one drug-resistant strain and a host defense axis, interleukin-17 (IL-17), that is important for controlling infection. Four factors, capsule, lipopolysaccharide, fimbriae, and siderophores, have been well studied and are important for virulence in at least one infection model. Several other factors have been less well characterized but are also important in at least one infection model. However, there is a significant amount of heterogeneity inK. pneumoniaestrains, and not every factor plays the same critical role in all virulentKlebsiellastrains. Recent studies have identified additionalK. pneumoniaevirulence factors and led to more insights about factors important for the growth of this pathogen at a variety of tissue sites. Many of these genes encode proteins that function in metabolism and the regulation of transcription. However, much work is left to be done in characterizing these newly discovered factors, understanding how infections differ between healthy and immunocompromised patients, and identifying attractive bacterial or host targets for treating these infections.

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Section: Infections Caused By K Pneumoniaementioning

confidence: 99%

Klebsiella pneumoniae: Going on the Offense with a Strong Defense

Paczosa

Mecsas

2016

Microbiol Mol Biol Rev

1,293

1,345

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“…A colony count of ≥104 CFU/ml was considered to be significant for sputum (Paganin, 2004) while for other specimens ≥105 CFU/ml was suggestive for infection (CLSI. 2012).…”

Section: Identification Of Isolated Organismsmentioning

confidence: 99%

Current Trend of Antibiotic Resistance in Lower Respiratory Tract Infections (LRTIs): An Experience in a Teaching Hospital in Bangladesh

et al. 2016

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Lower respiratory tract infections (LTRIs) are responsible for the vital causes of morbidity and mortality in all ages. In recent years, antibiotic resistance among respiratory pathogens is increasing emergently. The present study aimed to find out the bacterial etiology of LRTIs in Bangladesh and to update the clinicians about the current scenario of antibiotic resistance in lower respiratory tract infections. A total 64 bacterial pathogens from 100 patients with LRTIs were isolated from sputum specimens from a teaching hospital in Savar, Bangladesh between July-2014 to June-2015. The sputum specimens received within this year were subjected to analysis with microscopy, culture and susceptibility testing using conventional bacteriologic methods. Out of 100 processed sputum samples 64 (64%) cases had established bacterial etiology. Staphylococcus aureus (57.81%) was found to be the predominant organism in LRTIs followed by Streptococcus pneumonia (25%), Klebsiella and Pseudomonas species. Males (64.06%) were found to be more susceptible to LRTIs than that of females (35.93%). In antimicrobial susceptibility testing, grampositive organisms showed maximum sensitivity to imipenem (94.6%), meropenem (97.3%) and cefotaxime (75%). The resistance pattern varied for different organisms. Staphylococcus aureus isolates were mostly resistant to amoxicillin and ceftazidime (89.2%), whereas, Streptococcus pneumonia was to ceftazidime, amoxicillin and cotrimoxazole (81.2%). In case of gram negative isolates, Klebsiella sp. was mostly resistant to ceftriaxone, ceftazidime and amoxicillin (100%). Escherichia coli were resistant to amoxicillin, cotrimoxazole and vancomycin (100%). Therefore, appropriate identification of the causative organisms and their antibiotic resistance is crucial for right choice of antibiotic therapy in LRTIs.

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“…A colony count of ≥10 4 CFU/ml was considered to be significant for bronchial washing 7 while for other specimens, ≥10 5 CFU/ml was suggestive for infection 8 . …”

Section: Identification Of Isolated Organismsmentioning

confidence: 99%

Recent trend of bacterial aetiology of lower respiratory tract infection in a tertiary care centre of Nepal

Mishra

Kattel

Acharya

et al. 2012

Int J Infection & Microbiol

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INTRODUCTION:Lower respiratory tract infections (LRTIs) are among the most common infectious diseases of humans. This study focused on determining the recent trend of bacterial aetiology of LRTIs among the patients attending Tribhuvan University Teaching Hospital (TUTH) in Kathmandu. MATERIALS AND METHODS:This was a prospective study conducted over a period of six months in the bacteriology laboratory of TUTH. A total of 1120 specimens representing lower respiratory tract were received from patients with suspected LRTIs. The specimens were collected and processed according to standard methodology. RESULTS:Respiratory pathogens were recovered from 44.4% cases (n=497). Gram-negative bacteria were recovered in 84.1% (n=488). Bacteria were more commonly recovered from endotracheal secretion (41/61, 67.2%) than in sputum (454/1039, 43.7%) and bronchial washing (2/20, 10%). Ninety-one percent (n=454) growth was monomicrobial while the rest accounted for mixed growth. Among the organisms isolated, Haemophilus influenzae (112, 21%) was the most predominant pathogen followed by Klebsiella pneumoniae (102, 19.1%), Pseudomonads (91, 17.1%), Acinetobacter baumannii calcoaceticus complex (60, 10.9%), Streptococcus pneumoniae (46, 8.6%), Escherichia coli (37, 6.9%).CONCLUSIONS: H. influenzae and S. pneumoniae were the most common Gram-negative and Grampositive bacterial isolates recovered, respectively from LRTIs urging for monitoring and surveillance of these pathogens.

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Severe community-acquired pneumonia: assessment of microbial aetiology as mortality factor

Cited by 141 publications

References 45 publications

Klebsiella pneumoniae: Going on the Offense with a Strong Defense

Klebsiella pneumoniae: Going on the Offense with a Strong Defense

Current Trend of Antibiotic Resistance in Lower Respiratory Tract Infections (LRTIs): An Experience in a Teaching Hospital in Bangladesh

Recent trend of bacterial aetiology of lower respiratory tract infection in a tertiary care centre of Nepal

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