Abstract:
:The aim of the study was to determine risk factors for severe community-acquired pneumonia (CAP) as well as to compare microbial patterns of severe CAP to a previous study from our respiratory intensive care unit (ICU) originating from 1984 to 1987. Patients admitted to the ICU according to clinical judgment were defined as having severe CAP. For the study of risk factors, a hospital-based case-control design was used, matching each patient with severe CAP to a patient hospitalized with CAP but not requiring ICU admission. Microbial investigation included noninvasive and invasive techniques. Overall, 89 patients with severe CAP were successfully matched to a control patient. The presence of an alcohol ingestion of >/= 80 g/d (odds ratio [OR] 3.9, 95% confidence interval [CI] 1.4 to 10.6, p = 0.008) was found to be an independent risk factor for severe CAP and prior ambulatory antimicrobial treatment (OR 0.37, 95% CI 0.17 to 0.79, p = 0.009) to be protective. Streptococcus pneumoniae (24%) continued to be the most frequent pathogen; however, 48% of strains were drug-resistant. "Atypical" bacterial pathogens were significantly more common (17% versus 6%, p = 0.006) and Legionella spp. less common (2% versus 14%, p = 0.004) than in our previous study, whereas gram-negative enteric bacilli (GNEB) and Pseudomonas aeruginosa continued to represent important pathogens (6% and 5%, respectively). Our findings provide additional evidence for the importance of the initiation of early empiric antimicrobial treatment for a favorable outcome of CAP. Variations of microbial patterns are only in part due to different epidemiological settings. Therefore, initial empiric antimicrobial treatment will also have to take into account local trends of changing microbial patterns.
journal_name
Am J Respir Crit Care Medauthors
Ruiz M,Ewig S,Torres A,Arancibia F,Marco F,Mensa J,Sanchez M,Martinez JAdoi
10.1164/ajrccm.160.3.9901107keywords:
subject
Has Abstractpub_date
1999-09-01 00:00:00pages
923-9issue
3eissn
1073-449Xissn
1535-4970journal_volume
160pub_type
杂志文章abstract::The frequency and determinants of exogenous reinfection and of endogenous reactivation of tuberculosis in patients previously treated are poorly understood. In Gran Canaria Island, Spain, between 1991 and 1996, 962 tuberculosis cases were confirmed by culture. Drug susceptibility testing was performed on available bac...
journal_title:American journal of respiratory and critical care medicine
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更新日期:2001-03-01 00:00:00
abstract::The gender-and race-specific effects of asthma/wheeze on pulmonary function level and annual growth velocity were studied in a cohort of 10,792 white and 944 black children 6 to 18 yr of age, examined annually between 1974 and 1989 in six U.S. cities. In comparison with white boys who never reported asthma or wheeze, ...
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doi:10.1164/ajrccm.149.5.8173760
更新日期:1994-05-01 00:00:00
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journal_title:American journal of respiratory and critical care medicine
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更新日期:1997-09-01 00:00:00
abstract::An imbalance of proinflammatory cytokines such as TNF-alpha, IL-1 beta, and the neutrophil chemotactic factor IL-8 and inhibitors (e.g., soluble TNF receptors and IL-1ra) in the lung during the first week of life may contribute to prolonged pulmonary inflammation and fibrosis in bronchopulmonary dysplasia (BPD). Disod...
journal_title:American journal of respiratory and critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1997-11-01 00:00:00
abstract::To determine the status of activation of lymphocytes and the role of cytokines on the inflammatory response of the bronchial mucosa in toluene diisocyanate (TDI) asthma, we performed a quantitative analysis of bronchial biopsies obtained from 15 subjects with TDI-induced asthma and seven normal control subjects. Marke...
journal_title:American journal of respiratory and critical care medicine
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更新日期:1995-03-01 00:00:00
abstract:RATIONALE:Sublingual allergen-specific immunotherapy is gaining popularity for treatment of allergic diseases, but underlying immunological mechanisms are unresolved. OBJECTIVES:To perform detailed immunological investigation of sublingual house dust mite (HDM) immunotherapy. METHODS:A 12-month randomized double-blin...
journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章,随机对照试验
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更新日期:2009-11-15 00:00:00
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journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1164/ajrccm.162.1.9905006
更新日期:2000-07-01 00:00:00
abstract:RATIONALE:5-Hydroxytryptamine (5-HT) is involved in the pathogenesis of allergic airway inflammation (AAI). It is unclear, however, how 5-HT contributes to AAI and whether this depends on tryptophan hydroxylase (TPH) 1, the critical enzyme for peripheral 5-HT synthesis. OBJECTIVES:To elucidate the role of TPH1 and the...
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更新日期:2013-03-01 00:00:00
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journal_title:American journal of respiratory and critical care medicine
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doi:10.1164/ajrccm.159.6.9807060
更新日期:1999-06-01 00:00:00
abstract::In order to examine the dose-dependence of the airway response to animal allergens we performed environmental challenges on 17 workers with documented IgE-mediated allergic reactions to laboratory rats. The 1-h environmental challenges were conducted in a vivarium during cage cleaning (high-allergen challenge), quiet ...
journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1164/ajrccm.151.3.7881650
更新日期:1995-03-01 00:00:00
abstract::Alkaline phosphatase (ALP) in lung lavage fluids is a marker of tissue damage and type II cell proliferation. Type II pneumocytes are extensively involved in fibrosis. The aim of our study was to verify whether local ALP activity can be held as a marker of fibrosis in chronic interstitial lung disorders. ALP was deter...
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更新日期:1997-01-01 00:00:00
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更新日期:2018-03-01 00:00:00
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journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章,多中心研究
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更新日期:2013-03-01 00:00:00
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journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章,评审
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更新日期:2015-12-01 00:00:00
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journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1164/ajrccm.155.6.9196090
更新日期:1997-06-01 00:00:00
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journal_title:American journal of respiratory and critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1994-10-01 00:00:00
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更新日期:2004-06-15 00:00:00
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更新日期:2012-05-15 00:00:00
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更新日期:2006-06-15 00:00:00
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journal_title:American journal of respiratory and critical care medicine
pub_type: 临床试验,杂志文章
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更新日期:1997-06-01 00:00:00
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更新日期:2011-10-15 00:00:00
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更新日期:2000-02-01 00:00:00
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更新日期:2004-04-15 00:00:00
abstract:RATIONALE:In San Francisco, 70% of the tuberculosis cases occur among foreign-born persons, mainly from China, the Philippines, and Mexico. We postulate that there are differences in the characteristics and risk factors for tuberculosis among these populations. OBJECTIVES:To determine the clinical, epidemiological and...
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更新日期:2013-05-01 00:00:00
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journal_title:American journal of respiratory and critical care medicine
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更新日期:2002-09-15 00:00:00
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更新日期:2011-08-15 00:00:00
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journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章
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更新日期:2004-03-01 00:00:00