ERJ Open Research (Oct 2018)

Microbiological testing of adults hospitalised with community-acquired pneumonia: an international study

  • Manuela Carugati,
  • Stefano Aliberti,
  • Luis Felipe Reyes,
  • Ricardo Franco Sadud,
  • Muhammad Irfan,
  • Cristina Prat,
  • Nilam J. Soni,
  • Paola Faverio,
  • Andrea Gori,
  • Francesco Blasi,
  • Marcos I. Restrepo,
  • Patricia Karina Aruj,
  • Silvia Attorri,
  • Enrique Barimboim,
  • Juan Pablo Caeiro,
  • María I. Garzón,
  • Victor Hugo Cambursano,
  • Adrian Ceccato,
  • Julio Chertcoff,
  • Florencia Lascar,
  • Fernando Di Tulio,
  • Ariel Cordon Díaz,
  • Lautaro de Vedia,
  • Maria Cristina Ganaha,
  • Sandra Lambert,
  • Gustavo Lopardo,
  • Carlos M. Luna,
  • Alessio Gerardo Malberti,
  • Nora Morcillo,
  • Silvina Tartara,
  • Claudia Pensotti,
  • Betiana Pereyra,
  • Pablo Gustavo Scapellato,
  • Juan Pablo Stagnaro,
  • Florencio Varela,
  • Sonali Shah,
  • Felix Lötsch,
  • Florian Thalhammer,
  • Kurt Anseeuw,
  • Camille A. Francois,
  • Eva Van Braeckel,
  • Jean Louis Vincent,
  • Marcel Zannou Djimon,
  • Jules Bashi,
  • Roger Dodo,
  • Simone Aranha Nouér,
  • Peter Chipev,
  • Milena Encheva,
  • Darina Miteva,
  • Diana Petkova,
  • Adamou Dodo Balkissou,
  • Eric Walter Pefura Yone,
  • Bertrand Hugo Mbatchou Ngahane,
  • Ning Shen,
  • Jin-fu Xu,
  • Carlos Andres Bustamante Rico,
  • Ricardo Buitrago,
  • Fernando Jose Pereira Paternina,
  • Jean-Marie Kayembe Ntumba,
  • Vesna Vladic Carevic,
  • Marko Jakopovic,
  • Mateja Jankovic,
  • Zinka Matkovic,
  • Ivan Mitrecic,
  • Marie-Laure Bouchy Jacobsson,
  • Anette Bro Christensen,
  • Uffe Christian Heitmann Bødtger,
  • Christian Niels Meyer,
  • Andreas Vestergaard Jensen,
  • Gertrud Baunbæk-Knudsen,
  • Pelle Trier Petersen,
  • Stine Andersen,
  • Ibrahim El-Said Abd El-Wahhab,
  • Nesreen Elsayed Morsy,
  • Hanaa Shafiek,
  • Eman Sobh,
  • Kedir Abdella Abdulsemed,
  • Fabrice Bertrand,
  • Christian Brun-Buisson,
  • Etienne de Montmollin,
  • Muriel Fartoukh,
  • Jonathan Messika,
  • Pierre Tattevin,
  • Abdo Khoury,
  • Bernard Ebruke,
  • Michael Dreher,
  • Martin Kolditz,
  • Matthias Meisinger,
  • Mathias W. Pletz,
  • Stefan Hagel,
  • Jan Rupp,
  • Tom Schaberg,
  • Marc Spielmanns,
  • Petra Creutz,
  • Norton Suttorp,
  • Beatrice Siaw-Lartey,
  • Katerina Dimakou,
  • Dimosthenis Papapetrou,
  • Evdoxia Tsigou,
  • Dimitrios Ampazis,
  • Evangelos Kaimakamis,
  • Mina Gaga,
  • Mohit Bhatia,
  • Raja Dhar,
  • George D'Souza,
  • Rajiv Garg,
  • Parvaiz A. Koul,
  • P.A. Mahesh,
  • B.S. Jayaraj,
  • Kiran Vishnu Narayan,
  • Hirennappa B. Udnur,
  • Shashi Bhaskara Krishnamurthy,
  • Surya Kant,
  • Rajesh Swarnakar,
  • Sneha Limaye,
  • Sundeep Salvi,
  • Keihan Golshani,
  • Vera M. Keatings,
  • Ignacio Martin-Loeches,
  • Yasmin Maor,
  • Jacob Strahilevitz,
  • Salvatore Battaglia,
  • Maria Carrabba,
  • Piero Ceriana,
  • Marco Confalonieri,
  • Antonella d'Arminio Monforte,
  • Bruno Del Prato,
  • Marino De Rosa,
  • Riccardo Fantini,
  • Giuseppe Fiorentino,
  • Maria Antonia Gammino,
  • Francesco Menzella,
  • Giuseppe Milani,
  • Stefano Nava,
  • Gerardo Palmiero,
  • Roberta Petrino,
  • Barbra Gabrielli,
  • Paolo Rossi,
  • Claudio Sorino,
  • Gundi Steinhilber,
  • Alessandro Zanforlin,
  • Fabio Franzetti,
  • Manuela Carugati,
  • Manuela Morosi,
  • Elisa Monge,
  • Mauro Carone,
  • Vincenzo Patella,
  • Simone Scarlata,
  • Andrea Comel,
  • Kiyoyasu Kurahashi,
  • Zeina Aoun Bacha,
  • Daniel Barajas Ugalde,
  • Omar Ceballos Zuñiga,
  • José F. Villegas,
  • Milic Medenica,
  • E.M.W. van de Garde,
  • Deebya Raj Mihsra,
  • Poojan Shrestha,
  • Elliott Ridgeon,
  • Babatunde Ishola Awokola,
  • Ogonna N.O. Nwankwo,
  • Adefuye Bolanle Olufunlola,
  • Segaolu Olumide,
  • Kingsley N. Ukwaja,
  • Muhammad Irfan,
  • Lukasz Minarowski,
  • Skoczyński Szymon,
  • Felipe Froes,
  • Pedro Leuschner,
  • Mariana Meireles,
  • Sofia B Ravara,
  • Victoria Brocovschii,
  • Chesov Ion,
  • Doina Rusu,
  • Cristina Toma,
  • Daniela Chirita,
  • Carmen Mihaela Dorobat,
  • Alexei Birkun,
  • Anna Kaluzhenina,
  • Abdullah Almotairi,
  • Zakeya Abdulbaqi Ali Bukhary,
  • Jameela Edathodu,
  • Amal Fathy,
  • Abdullah Mushira Abdulaziz Enani,
  • Nazik Eltayeb Mohamed,
  • Jawed Ulhadi Memon,
  • Abdelhaleem Bella,
  • Nada Bogdanović,
  • Branislava Milenkovic,
  • Dragica Pesut,
  • Charles Feldman,
  • Ho Kee Yum,
  • Luis Borderìas,
  • Noel Manuel Bordon Garcia,
  • Hugo Cabello Alarcón,
  • Catia Cilloniz,
  • Antoni Torres,
  • Vicens Diaz-Brito,
  • Xavier Casas,
  • Alicia Encabo González,
  • Maria Luisa Fernández-Almira,
  • Miguel Gallego,
  • Inmaculada Gaspar-GarcÍa,
  • Juan González del Castillo,
  • Patricia Javaloyes Victoria,
  • Elena Laserna Martínez,
  • Rosa Malo de Molina,
  • Pedro J. Marcos,
  • Rosario Menéndez,
  • Ana Pando-Sandoval,
  • Cristina Prat Aymerich,
  • Jordi Rello,
  • Silvia Moyano,
  • Francisco Sanz,
  • Oriol Sibila,
  • Ana Rodrigo-Troyano,
  • Jordi Solé-Violán,
  • Ane Uranga,
  • Job F.M. van Boven,
  • Ester Vendrell Torra,
  • Jordi Almirall Pujol,
  • Arnauld Attannon Fiogbe,
  • Ferdaous Yangui,
  • Semra Bilaceroglu,
  • Levent Dalar,
  • Ufuk Yilmaz,
  • Artemii Bogomolov,
  • Naheed Elahi,
  • Devesh J. Dhasmana,
  • Andrew Feneley,
  • Rhiannon Ions,
  • Julie Skeemer,
  • Gerrit Woltmann,
  • Carole Hancock,
  • Adam T. Hill,
  • Banu Rudran,
  • Silvia Ruiz-Buitrago,
  • Marion Campbell,
  • Paul Whitaker,
  • Alexander Youzguin,
  • Anika Singanayagam,
  • Karen S. Allen,
  • Veronica Brito,
  • Jessica Dietz,
  • Claire E. Dysart,
  • Susan M. Kellie,
  • Ricardo A. Franco-Sadud,
  • Garnet Meier,
  • Thomas L. Holland,
  • Stephen P. Bergin,
  • Fayez Kheir,
  • Mark Landmeier,
  • Manuel Lois,
  • Girish B. Nair,
  • Hemali Patel,
  • Katherine Reyes,
  • William Rodriguez-Cintron,
  • Shigeki Saito,
  • Nilam J. Soni,
  • Julio Noda,
  • Cecilia I. Hinojosa,
  • Stephanie M. Levine,
  • Luis F. Angel,
  • Antonio Anzueto,
  • K. Scott Whitlow,
  • John Hipskind,
  • Kunal Sukhija,
  • Vicken Totten,
  • Richard G. Wunderink,
  • Ray D. Shah,
  • Kondwelani John Mateyo,
  • Lorena Noriega,
  • Ezequiel Alvarado,
  • Mohamed Aman,
  • Lucía Labra

DOI
https://doi.org/10.1183/23120541.00096-2018
Journal volume & issue
Vol. 4, no. 4

Abstract

Read online

This study aimed to describe real-life microbiological testing of adults hospitalised with community-acquired pneumonia (CAP) and to assess concordance with the 2007 Infectious Diseases Society of America (IDSA)/American Thoracic Society (ATS) and 2011 European Respiratory Society (ERS) CAP guidelines. This was a cohort study based on the Global Initiative for Methicillin-resistant Staphylococcus aureus Pneumonia (GLIMP) database, which contains point-prevalence data on adults hospitalised with CAP across 54 countries during 2015. In total, 3702 patients were included. Testing was performed in 3217 patients, and included blood culture (71.1%), sputum culture (61.8%), Legionella urinary antigen test (30.1%), pneumococcal urinary antigen test (30.0%), viral testing (14.9%), acute-phase serology (8.8%), bronchoalveolar lavage culture (8.4%) and pleural fluid culture (3.2%). A pathogen was detected in 1173 (36.5%) patients. Testing attitudes varied significantly according to geography and disease severity. Testing was concordant with IDSA/ATS and ERS guidelines in 16.7% and 23.9% of patients, respectively. IDSA/ATS concordance was higher in Europe than in North America (21.5% versus 9.8%; p<0.01), while ERS concordance was higher in North America than in Europe (33.5% versus 19.5%; p<0.01). Testing practices of adults hospitalised with CAP varied significantly by geography and disease severity. There was a wide discordance between real-life testing practices and IDSA/ATS/ERS guideline recommendations.