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

Carugati M.; Aliberti S.; Reyes L. F.; Sadud R. F.; Irfan M.; Prat C.; Soni N. J.; Faverio P.; Gori A.; Blasi F.; Restrepo M. I.; Aruj P. K.; Attorri S.; Barimboim E.; Caeiro J. P.; Garzon M. I.; Cambursano V. H.; Ceccato A.; Chertcoff J.; Diaz A. C.; De Vedia L.; Ganaha M. C.; Lambert S.; Lopardo G.; Luna C. M.; Malberti A. G.; Morcillo N.; Tartara S.; Pensotti C.; Pereyra B.; Scapellato P. G.; Stagnaro J. P.; Shah S.; Lotsch F.; Thalhammer F.; Anseeuw K.; Francois C. A.; Van Braeckel E.; Vincent J. L.; Djimon M. Z.; Bashi J.; Dodo R.; Nouer S. A.; Chipev P.; Encheva M.; Miteva D.; Petkova D.; Balkissou A. D.; Yone E. W. P.; Ngahane B. H. M.; Shen N.; Xu J. -F.; Rico C. A. B.; Buitrago R.; Paternina F. J. P.; Ntumba J. -M. K.; Carevic V. V.; Jakopovic M.; Jankovic M.; Matkovic Z.; Mitrecic I.; Jacobsson M. L. B.; Christensen A. B.; Bodtger U. C. H.; Meyer C. N.; Jensen A. V.; Baunbaek-Knudsen G.; Petersen P. T.; Andersen S.; Abd El-Wahhab I. E. -S.; Morsy N. E.; Shafiek H.; Sobh E.; Abdulsemed K. A.; Bertrand F.; Brun-Buisson C.; De Montmollin E.; Fartoukh M.; Messika J.; Tattevin P.; Khoury A.; Ebruke B.; Dreher M.; Kolditz M.; Meisinger M.; Pletz M. W.; Hagel S.; Rupp J.; Schaberg T.; Spielmanns M.; Creutz P.; Suttorp N.; Siaw-Lartey B.; Dimakou K.; Papapetrou D.; Tsigou E.; Ampazis D.; Kaimakamis E.; Gaga M.; Bhatia M.; Dhar R.; D'Souza G.; Garg R.; Koul P. A.; Mahesh P. A.; Jayaraj B. S.; Narayan K. V.; Udnur H. B.; Krishnamurthy S. B.; Kant S.; Swarnakar R.; Limaye S.; Salvi S.; Golshani K.; Keatings V. M.; Martin-Loeches I.; Maor Y.; Strahilevitz J.; Battaglia S.; Carrabba M.; Ceriana P.; Confalonieri M.; Monforte A. D.; Del Prato B.; De Rosa M.; Fantini R.; Fiorentino G.; Gammino M. A.; Menzella F.; Milani G.; Nava S.; Palmiero G.; Petrino R.; Gabrielli B.; Rossi P.; Sorino C.; Steinhilber G.; Zanforlin A.; Franzetti F.; Morosi M.; Monge E.; Carone M.; Patella V.; Scarlata S.; Comel A.; Kurahashi K.; Bacha Z. A.; Ugalde D. B.; Zuniga O. C.; Villegas J. F.; Medenica M.; Van De Garde E. M. W.; Mihsra D. R.; Medicine I.; Shrestha P.; Ridgeon E.; Awokola B. I.; Nwankwo O. N. O.; Olufunlola A. B.; Olumide S.; Ukwaja K. N.; Minarowski L.; Szymon S.; Froes F.; Leuschner P.; Meireles M.; Ferrao C.; Neves J.; De Medicina S.; Ravara S. B.; Brocovschii V.; Ion C.; Rusu D.; Tom C.; Chirita D.; Dorobat C. M.; Birkun A.; Kaluzhenina A.; Almotairi A.; Bukhary Z. A. A.; Edathodu J.; Fathy A.; Enani A. M. A.; Mohamed N. E.; Memon J. U.; Bella A.; Bogdanovic N.; Milenkovic B.; Pesut D.; Feldman C.; Yum H. K.; Borderias L.; Garcia N. M. B.; Alarcon H. C.; Cilloniz C.; Torres A.; Diaz-Brito V.; Casas X.; Gonzalez A. E.; Fernandez-Almira M. L.; Gallego M.; Gaspar-Garcia I.; Del Castillo J. G.; Victoria P. J.; Martinez E. L.; De Molina R. M.; Marcos P. J.; Menendez R.; Pando-Sandoval A.; Aymerich C. P.; Rello J.; Moyano S.; Sanz F.; Sibila O.; Rodrigo-Troyano A.; Sole-Violan J.; Uranga A.; Van Boven J. F. M.; Torra E. V.; Pujol J. A.; Fiogbe A. A.; Yangui F.; Bilaceroglu S.; Dalar L.; Yilmaz U.; Bogomolov A.; Elahi N.; Feneley A.; Ions R.; Skeemer J.; Woltmann G.; Hancock C.; Hill A. T.; Rudran B.; Ruiz-Buitrago S.; Campbell M.; Whitaker P.; Youzguin A.; Singanayagam A.; Allen K. S.; Brito V.; Dietz J.; Dysart C. E.; Kellie S. M.; Franco-Sadud R. A.; Meier G.; Holland T. L.; Bergin S. P.; Kheir F.; Landmeier M.; Lois M.; Nair G. B.; Patel H.; Reyes K.; Rodriguez-Cintron W.; Saito S.; Noda J.; Hinojosa C. I.; Levine S. M.; Angel L. F.; Anzueto A.; Whitlow K. S.; Hipskind J.; Sukhija K.; Totten V.; Wunderink R. G.; Shah R. D.; Mateyo K. J.; Dhasmana D. J.; Noriega L.; Alvarado E.; Aman M.; Labra L.

doi:10.1183/23120541.00096-2018

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.

Carugati M., Aliberti S., Reyes L.F., Sadud R.F., Irfan M., Prat C., et al. (2018). Microbiological testing of adults hospitalised with community-acquired pneumonia: An international study. ERJ OPEN RESEARCH, 4(4) [10.1183/23120541.00096-2018].