Trends in Pathogens Among Patients Hospitalized for Pneumonia From 1993 to 2011

Smith, Sean B.; Ruhnke, Gregory W.; Weiss, Curtis H.; Waterer, Grant; Wunderink, Richard G.

doi:10.1001/jamainternmed.2014.4344

Cited by 37 publications

(29 citation statements)

References 6 publications

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“…Two factors likely explain this improvement in mortality-routine vaccination of children with the protein conjugate pneumococcal vaccine and public reporting of CAP process of care, mortality, and readmission rates. 20 NOS=not otherwise specified. Stars show two Centers for Disease Control sponsored, population based estimates 19 21 by a radiologist rather than interpreted by the clinician, and the 30 day follow-up studies were available for comparison.…”

Section: Incidencementioning

confidence: 99%

“…19 21 It also correlates fairly well with data on discharge diagnoses from the National Inpatient Sample. 20 In contrast, rates in other countries with different healthcare systems are very different; for example, 8.1 hospital admissions per 10 000 adults in Vietnam and 31.2 per 10 000 adults in the UK. 22 23 However, admissions for CAP have been increasing over the past 16 years in areas of England.…”

Section: Introductionmentioning

confidence: 99%

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Advances in the causes and management of community acquired pneumonia in adults

Wunderink

Waterer

2017

BMJ

158

112

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Community acquired pneumonia remains a common cause of morbidity and mortality. Usually, the causal organism is not identified and treatment remains empiric. Recent computed tomography and magnetic resonance imaging studies have challenged the accuracy of the clinical diagnosis of pneumonia, and epidemiologic studies are changing our perspective of what causes community acquired pneumonia, especially the role of viral pathogens and the frequent finding of multiple pathogens. The past decade has seen increasing overuse of empiric coverage of meticillin resistant and antibiotic resistant Gram negative pathogens owing to inappropriate application of guidelines for healthcare associated pneumonia. Optimal treatment remains a matter for debate, especially in very sick patients, including the role of combination antibiotic therapy and corticosteroids. Pneumonia care bundles are being defined to improve outcomes. Increased recognition of both acute and long term cardiac complications is shifting our concept of pneumonia from an acute lung disease to a multisystem problem with adverse chronic health consequences.

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Section: Incidencementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Advances in the causes and management of community acquired pneumonia in adults

Wunderink

Waterer

2017

BMJ

158

112

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“…Despite ongoing research and the development of newer antibiotics, this infection continues to be a major cause of patient morbidity and mortality. Although Streptococcus pneumoniae remains the most commonly identified cause in hospitalized patients with community-acquired bacterial pneumonia (CABP), its frequency has declined over the past 20 years while Staphylococcus aureus has increased [2]. Moreover, S. aureus is the most commonly isolated pathogen from respiratory cultures in patients with influenza and bacterial coinfection [3].…”

Section: Introductionmentioning

confidence: 99%

“…plus a macrolide or a respiratory fluoroquinolone [4]. Neither of these therapeutic regimens is ideal for the treatment of staphylococcal infections, especially with the emergence of methicillin-resistant strains in patients hospitalized with pneumonia [2]. Levofloxacin is the most commonly used respiratory fluoroquinolone in U.S. acute care hospitals for community-acquired lower respiratory tract infections [5].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Ceftaroline and Levofloxacin against Staphylococci Using Serum from Patients with Community-Acquired Pneumonia

Stein¹,

Smith²,

Scharmen³

et al. 2016

Clin Microbiol Infect Dis

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Purpose: Currently, no clinical data exists comparing ceftaroline to a "respiratory" fluoroquinolone in patients with community-acquired bacterial pneumonia (CABP). The purpose of this study was to compare time-kill assays of ceftaroline and levofloxacin against clinical isolates of Staphylococcus aureus using sera from hospitalized patients with a diagnosis CABP. Methods:A total of 12 patients were equally randomized to receive ceftaroline (600 mg q12h) or levofloxacin (750 mg q24h) for treatment of presumptive CABP. Blood samples were obtained on day 3 at 2, 6 and 12h after the initiation of the antibiotic infusion and serum levels were measured using a LC/MS/MS assay. Time-Kill curves were performed using these patient sera against selected clinical isolates of S. aureus with levofloxacin MICs ranging from 0.5 mg/L to 4 mg/L. Findings:Both agents exhibited bactericidal activity (≥3 log kill at 24h) against methicillin-sensitive S. aureus (MSSA) strains with levofloxacin MICs=0.5 and 1.0 mg/L. Only ceftaroline produced bactericidal activity against MSSA isolates with levofloxacin MICs=2.0 and 4.0 mg/L. Similar results were observed against methicillin-resistant S. aureus (MRSA) strains for levofloxacin but bactericidal activity was not observed for ceftaroline against all MRSA isolates. Bacterial regrowth was observed with 6 and 12h serum samples against MRSA strains with ceftaroline MICs > 0.25 mg/L. Implications:In summary, our study results found that clinical concentrations of ceftaroline exhibited bactericidal activity against strains of S. aureus that were both susceptible as well as non-susceptible to levofloxacin, but did not produce bactericidal activity against all strains of MRSA.

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“…The increased pneumococcal burden in the nasopharynx stimulated by influenza increases the likelihood of aspiration of pneumococci into the lungs [9]. This Although the trends may be shifting, S. pneumoniae and influenza A or B virus are among the most common pathogens of CAP requiring hospitalization, particularly in elderly patients [4,10]. The primary bacterial causes of influenzaa s s o c i a t e d p n e u m o n i a s a r e S .…”

Section: Introductionmentioning

confidence: 99%

The Influence of Influenza and Pneumococcal Vaccines on Community-Acquired Pneumonia (CAP) Outcomes Among Elderly Patients

Gubbins

2015

Curr Infect Dis Rep

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Elderly are at high risk for hospitalization for community-acquired pneumonia (CAP), especially due to Streptococcus pneumoniae, and seasonal influenza viruses. Data suggest PPV23's influence on various CAP-related outcomes among the elderly may depend upon how many years have elapsed since they received this vaccine. PPV23's protection against invasive pneumococcal disease and CAP hospitalizations are often limited to moderately ill elderly, who are less than 75 years old, or female. PCV13 demonstrates broad protection against a variety of CAPs, but ultimately, its influence on their outcomes among the elderly may be limited by herd immunity from PCV7 use. Influenza vaccine's indirect protective effect against all-cause and non-invasive pneumococcal CAP in the elderly is difficult to ascertain. The use of both PPV23 and influenza vaccine shortens length of stay in hospitalized elderly with CAP, but whether that benefit would be realized in the presence of herd immunity is unknown.

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Trends in Pathogens Among Patients Hospitalized for Pneumonia From 1993 to 2011

Cited by 37 publications

References 6 publications

Advances in the causes and management of community acquired pneumonia in adults

Advances in the causes and management of community acquired pneumonia in adults

Evaluation of Ceftaroline and Levofloxacin against Staphylococci Using Serum from Patients with Community-Acquired Pneumonia

The Influence of Influenza and Pneumococcal Vaccines on Community-Acquired Pneumonia (CAP) Outcomes Among Elderly Patients

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