Community-acquired pneumonia in hospitalised patients : changes in aetiology, clinical presentation, and severity outcomes in a 10-year period
Sellarès-Nadal, Júlia (Universitat Autònoma de Barcelona. Departament de Medicina)
Burgos, Joaquín (Universitat Autònoma de Barcelona. Departament de Medicina)
Martin-Gomez, M. Teresa (Hospital Universitari Vall d'Hebron)
Antón, Andrés (Hospital Universitari Vall d'Hebron)
Sordé, Roger (Hospital de Trauma Manuel Giagni (Uruguay))
Bosch-Nicolau, Pau (Hospital Universitari Vall d'Hebron)
Falcó-Roget, Anna (Universitat Autònoma de Barcelona. Departament de Medicina)
Kirkegaard, Cristina (Hospital Universitari Vall d'Hebron)
Rodriguez-Pardo, Dolors (Hospital Universitari Vall d'Hebron)
Len, Oscar (Hospital Universitari Vall d'Hebron)
Falcó, Vicenç (Hospital Universitari Vall d'Hebron)

Data:	2022
Resum:	Community-acquired pneumonia (CAP) is a frequent cause of hospitalisation. Several factors, such as pandemics, vaccines and globalisation may lead to changes in epidemiology, clinical presentation, and outcomes of CAP, which oblige to a constant actualisation. We performed this study to analyse how these factors have evolved over a 10-year period. Patients diagnosed with CAP for two 1-year periods that were 10 years apart (2007-2008 and 2017-2018) were included. We compared microbiological information, clinical data and evolutive outcomes in the two periods. A mortality analysis was performed. 1043 patients were included: 452 during the first period (2007- 2008), and 591 during the second period (2017-2018). Bacterial aetiology did not change during the 10-year period, besides a slight increase in Staphylococcus aureus (0. 9% vs 2. 9%, p = 0. 026). There was a decline in the proportion of bacteraemia in the second period (14. 8% vs 9. 6%, p = 0. 012). The incidence of complicated pleural effusion and septic shock declined too (6. 4% vs 3. 6%, p = 0. 04 and 15. 5% vs 6. 3%, p < 0. 001). Respiratory failure and Intensive care unit (ICU) admission were similar in both periods. Variables independently associated with mortality were age and septic shock. Influenza vaccine was a protective factor against mortality in the second period. We have not found relevant differences in the bacterial aetiology of CAP over this 10-year period. There has been a decline in septic complications of CAP such as septic shock, bacteraemia, and complicated pleural effusion. Influenza vaccination is an important tool to reduce mortality.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Pneumonia ; Virology ; Staphylococcus aureus ; MRSA ; Mortality
Publicat a:	Annals of Medicine, Vol. 54 (november 2022) , p. 3052-3059, ISSN 1365-2060

DOI: 10.1080/07853890.2022.2138529
PMID: 36331267

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