TY - JOUR T1 - Enterobacteriaceae and <em>Pseudomonas aeruginosa</em> in community-acquired pneumonia: the reality after a decade of uncertainty? JF - European Respiratory Journal JO - Eur Respir J SP - 473 LP - 474 DO - 10.1183/09031936.00198109 VL - 35 IS - 3 AU - A. Torres AU - R. Menéndez Y1 - 2010/03/01 UR - http://erj.ersjournals.com/content/35/3/473.abstract N2 - Community-acquired pneumonia (CAP) is a frequent infectious respiratory disease that remains a major cause of morbidity and mortality in developed countries. The percentage of CAP patients requiring hospitalisation is not well known and probably varies from country to country, reflecting different criteria for hospitalisation and different resources available. In a very recent epidemiological study of a large series of hospitalised patients with CAP in Germany 1, the overall mortality was 14%, an apparently very high figure. When patients from nursing homes and those chronically bedridden (patients now considered as having healthcare-associated pneumonia (HCAP)) were excluded from the analyses, the overall mortality dropped to 8%, a figure more in line with other recent European studies that excluded nursing-home patients 2. Mortality in hospitalised CAP patients depends on several factors, including age, comorbidities, microbial aetiology, and early and adequate initial antibiotic treatment. The adequacy of initial antibiotic treatment is the only factor amenable to modification by medical intervention. Initial antibiotic treatment is frequently administered on an empirical basis. Gram-negative Enterobacteriaceae (GNEB) and Pseudomonas aeruginosa are a rare microbial cause of CAP. When these pathogens are involved, mortality increases 3. Antibiotic treatment for P. aeruginosa is completely different from the standard treatment to cover Streptococcus pneumoniae, Legionella pneumophila and atypical pathogens (the most common microorganisms causing CAP). For this reason, most of the current guidelines for CAP include recommendations to suspect and empirically treat P. aeruginosa 4. How frequent is this problem? 10 yrs ago, Ruiz et al. 5 reported an incidence of … ER -