RT Journal Article
SR Electronic
T1 PES in CAP: An acronym to identify "problematic pathogens" in community-acquired pneumonia
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P2471
VO 40
IS Suppl 56
A1 Elena Prina
A1 Miquel Ferrer
A1 Eva Polverino
A1 Catia Cilloniz
A1 Josep Mensa
A1 Encarnación Moreno
A1 Erika Cuenca
A1 Roberto Cosentini
A1 Antoni Torres
YR 2012
UL http://erj.ersjournals.com/content/40/Suppl_56/P2471.abstract
AB Background: Nosocomial and Multidrug-resistant pathogens have been emerging as a cause of community-acquired infections. Recently, Rice has introduced the acronym ESKAPE for the identification of the principle pathogens responsible for nosocomial infection that frequently can “escape” the effect of antibiotic treatment. In order to translate this idea to community-acquired pneumonia (CAP), we purpose the adapted acronym PES: Pseudomonas aeruginosa, Enterobacteriaceae and Staphylococcus aureus.The aim of our study is to compare clinical characteristics and outcomes of patients with CAP/HCAP due to PES pathogens respect patients with pneumonia due to other pathogens.Methods: Among 4549 patients evaluated for CAP/HCAP, we analyzed 1470 patients which presented an etiologic diagnosis. We excluded patients with immunosuppression, neoplasm and active tuberculosis.Results: Pneumonia due to PES was identified in 136 (9%) patients (n=64 P. aeruginosa n=44 Enterobacteriaceae n=35 S. aureus). These patients were older, had more frequently received previous antibiotics and presented a reduced autonomy with higher rate of aspiration episodes (p<0.001) but not a higher number of nursing-home (p=0.125). PES pathogens were more commonly identified in patients with many comorbidities (especially neurologic and chronic respiratory disease, p<0.001). PES group had more severe pneumonia by PSI score (p<0.001), longer hospital length-of-stay and 30-days mortality (p<0.001).Conclusions: PES pathogens are responsible for CAP with high mortality. The attendant physician should be worried to empirically cover PES pathogens in patients with lower autonomy, many comorbidities and previous antibiotic treatment.