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dc.contributor.authorGramegna, Andrea
dc.contributor.authorSotgiu, Giovanni
dc.contributor.authorPasquale, Marta Di
dc.contributor.authorRadovanovic, Dejan
dc.contributor.authorTerraneo, Silvia
dc.contributor.authorReyes, Luis F.
dc.contributor.authorVendrell, Ester
dc.contributor.authorNeves, Joao
dc.contributor.authorMenzella, Francesco
dc.contributor.authorBlasi, Francesco
dc.contributor.authorAliberti, Stefano
dc.contributor.authorRestrepo, Marcos I.
dc.identifier.citationBMC Infectious Diseases (2018) 18:677es_CO
dc.description11 páginases_CO
dc.description.abstractBackground: Empirical antibiotic coverage for atypical pathogens in community-acquired pneumonia (CAP) has long been debated, mainly because of a lack of epidemiological data. We aimed to assess both testing for atypical pathogens and their prevalence in hospitalized patients with CAP worldwide, especially in relation with disease severity. Methods: A secondary analysis of the GLIMP database, an international, multicentre, point-prevalence study of adult patients admitted for CAP in 222 hospitals across 6 continents in 2015, was performed. The study evaluated frequency of testing for atypical pathogens, including L. pneumophila, M. pneumoniae, C. pneumoniae, and their prevalence. Risk factors for testing and prevalence for atypical pathogens were assessed through univariate analysis. Results: Among 3702 CAP patients 1250 (33.8%) underwent at least one test for atypical pathogens. Testing varies greatly among countries and its frequency was higher in Europe than elsewhere (46.0% vs. 12.7%, respectively, p < 0. 0001). Detection of L. pneumophila urinary antigen was the most common test performed worldwide (32.0%). Patients with severe CAP were less likely to be tested for both atypical pathogens considered together (30.5% vs. 35.0%, p = 0.009) and specifically for legionellosis (28.3% vs. 33.5%, p = 0.003) than the rest of the population. Similarly, L. pneumophila testing was lower in ICU patients. At least one atypical pathogen was isolated in 62 patients (4.7%), including M. pneumoniae (26/251 patients, 10.3%), L. pneumophila (30/1186 patients, 2.5%), and C. pneumoniae (8/228 patients, 3.5%). Patients with CAP due to atypical pathogens were significantly younger, showed less cardiovascular, renal, and metabolic comorbidities in comparison to adult patients hospitalized due to non-atypical pathogen CAP. Conclusions: Testing for atypical pathogens in patients admitted for CAP in poorly standardized in real life and does not mirror atypical prevalence in different settings. Further evidence on the impact of atypical pathogens, expecially in the low-income countries, is needed to guidelines implementation.eng
dc.publisherEnfermedades infecciosas BMCes_CO
dc.relation.ispartofseriesBMC Infectious Diseases (2018) 18:677
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 International*
dc.sourceinstname:Universidad de La Sabanaes_CO
dc.sourcereponame:Intellectum Repositorio Universidad de La Sabanaes_CO
dc.subjectAtypical pathogenses_CO
dc.titleAtypical pathogens in hospitalized patients with community-acquired pneumonia: a worldwide perspectivees_CO
dc.title.alternativePatógenos atípicos en pacientes hospitalizados con neumonía adquirida en la comunidad: una perspectiva mundiales_CO

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Attribution-NonCommercial-NoDerivatives 4.0 InternationalExcept where otherwise noted, this item's license is described as Attribution-NonCommercial-NoDerivatives 4.0 International