Severe Community Acquired Pneumonia In Mumbai, India: Etiology And Predictive Value Of The Modified British Thoracic Society Rule

Dagaonkar, Rucha S; Udwadia, Zarir; Sen, Tiyas; Nene, Amita; Joshi, Jyotsna; Rastogi, Sarthak A.; Shah, Kushal D.; Shah, Hardik; Pandey, Kamlesh Kumar

doi:10.1164/ajrccm-conference.2012.185.1_meetingabstracts.a6060

Cited by 7 publications

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“…Streptococcus pneumoniae remains the most isolated bacterial pathogen in CAP worldwide in all treatment settings (outpatient, general ward and ICU) [37,39,40,[42][43][44][45][46]. S. pneumoniae resistance patterns remain different across countries.…”

Section: Cap Microbiologymentioning

confidence: 99%

Burden of Community-Acquired Pneumonia and Unmet Clinical Needs

2020

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Community-acquired pneumonia (CAP) is the leading cause of death among infectious diseases and an important health problem, having considerable implications for healthcare systems worldwide. Despite important advances in prevention through vaccines, new rapid diagnostic tests and antibiotics, CAP management still has significant drawbacks. Mortality remains very high in severely ill patients presenting with respiratory failure or shock but is Enhanced Digital Features To view enhanced digital features for this article go to https://doi.org/10.6084/ m9.figshare.11673588. J. Ferreira-Coimbra (

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Section: Cap Microbiologymentioning

confidence: 99%

Burden of Community-Acquired Pneumonia and Unmet Clinical Needs

2020

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“…The sparse data for adults come from tertiary care teaching hospitals using cross-sectional studies 5 . A study from Mumbai reported that severe CAP (SCAP) reached 19 per cent of all patients and Streptococcus pneumoniae and Gram-negative bacteria ( Pseudomonas aeruginosa and Klebsiella pneumoniae ) had increased occurrence in severe pneumonia 6 . A recent review underscores the importance of pneumococci in the invasive pneumococcal diseases in India 7 .…”

Section: Disease Burden Of Community-acquired Pneumonia In India and mentioning

confidence: 99%

Community-acquired bacterial pneumonia in adults: An update

2020

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Community-acquired pneumonia (CAP) is the prominent cause of mortality and morbidity with important clinical impact across the globe. India accounts for 23 per cent of global pneumonia burden with case fatality rates between 14 and 30 per cent, and Streptococcus pneumoniae is considered a major bacterial aetiology. Emerging pathogens like Burkholderia pseudomallei is increasingly recognized as an important cause of CAP in Southeast Asian countries. Initial management in the primary care depends on clinical assessment while the hospitalized patients require combinations of clinical scores, chest radiography and various microbiological and biomarker assays. This comprehensive diagnostic approach together with additional sampling and molecular tests in selected high-risk patients should be practiced. Inappropriate therapy in CAP in hospitalized patients lengthens hospital stay and increases cost and mortality. In addition, emergence of multidrug-resistant organisms poses tough challenges in deciding empirical as well as definitive therapy. Developing local evidence on the cause and management should be a priority to improve health outcomes in CAP.

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“…Through strict screening criteria, we finally included 75 studies (n=18 379) published between 1985 and 2022 in our meta-analysis (figure 1). Among the studies included, 53 studies reported data for adults (n=10 404),4 29 30 32–81 17 studies for children (n=6652)29 35 82–96 and 7 studies for mixed groups (n=1323)97–103 (online supplemental material 2 and table 1). Forty-eight reported data for Chlamydia (n=12 087)4 30 32–34 39–42 44 46 48–50 53 56 58 60–65 67–70 72 74 75 78–82 84–88 90 91 93 97–99 101 102, 61 for Mycoplasma (n=15 101)4 30 32–34 36 37 39–50 53–58 60–70 72 74 79–91 93–102 and 56 for Legionella (n=11 144) 4 30 32–34 36–50 52 55 56 58–65 67–70 72–81 84 86 87 92 93 97–101 103.…”

Section: Resultsmentioning

confidence: 99%

Prevalence of atypical pathogens in patients with severe pneumonia: a systematic review and meta-analysis

et al. 2023

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ObjectivesWe aimed to summarise the prevalence of atypical pathogens in patients with severe pneumonia to understand the prevalence of severe pneumonia caused by atypical pathogens, improve clinical decision-making and guide antibiotic use.DesignSystematic review and meta-analysis.Data sourcesPubMed, Embase, Web of Science and Cochrane Library were searched through November 2022.Eligibility criteriaEnglish language studies enrolled consecutive cases of patients diagnosed with severe pneumonia, with complete aetiological analysis.Data extraction and synthesisWe conducted literature retrieval on PubMed, Embase, Web of Science and The Cochrane Library to estimate the prevalence ofChlamydia,MycoplasmaandLegionellain patients with severe pneumonia. After double arcsine transformation of the data, a random-effects model was used for meta-analyses to calculate the pooled prevalence of each pathogen. Meta-regression analysis was also used to explore whether the region, different diagnostic method, study population, pneumonia categories or sample size were potential sources of heterogeneity.ResultsWe included 75 eligible studies with 18 379 cases of severe pneumonia. The overall prevalence of atypical pneumonia is 8.1% (95% CI 6.3% to 10.1%) In patients with severe pneumonia, the pooled estimated prevalence ofChlamydia,MycoplasmaandLegionellawas 1.8% (95% CI 1.0% to 2.9%), 2.8% (95% CI 1.7% to 4.3%) and 4.0% (95% CI 2.8% to 5.3%), respectively. We noted significant heterogeneity in all pooled assessments. Meta-regression showed that the pneumonia category potentially influenced the prevalence rate ofChlamydia. The mean age and the diagnostic method of pathogens were likely moderators for the prevalence ofMycoplasmaandLegionella, and contribute to the heterogeneity of their prevalence.ConclusionsIn severe pneumonia, atypical pathogens are notable causes, especiallyLegionella. The diagnostic method, regional difference, sample size and other factors contribute to the heterogeneity of prevalence. The estimated prevalence and relative heterogeneity factors can help with microbiological screening, clinical treatment and future research planning.PROSPERO registration numberCRD42022373950.

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Severe Community Acquired Pneumonia In Mumbai, India: Etiology And Predictive Value Of The Modified British Thoracic Society Rule

Cited by 7 publications

References 0 publications

Burden of Community-Acquired Pneumonia and Unmet Clinical Needs

Burden of Community-Acquired Pneumonia and Unmet Clinical Needs

Community-acquired bacterial pneumonia in adults: An update

Prevalence of atypical pathogens in patients with severe pneumonia: a systematic review and meta-analysis

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