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Community-acquired pneumonia and Gram-negative bacilli in Cambodia-incidence, risk factors and clinical characteristics

Inghammar, Malin LU ; Borand, Laurence ; Goyet, Sophie ; Rammaert, Blandine ; Te, Vantha ; Try, Patrich Lorn ; Guillard, Bertrand ; Buchy, Philippe ; Vong, Sirenda and Chheng, Eap Tek , et al. (2018) In Transactions of the Royal Society of Tropical Medicine and Hygiene 112(2). p.57-63
Abstract

Background: In Western settings, community-acquired pneumonia (CAP) due to Gram-negative bacilli (GNB) is relatively rare. Previous studies from Asia, however, indicate a higher prevalence of GNB in CAP, but data, particularly from Southeast Asia, are limited. Methods: This is a prospective observational study of 1451 patients ≥15 y of age with CAP from two hospitals in Cambodia between 2007 and 2010. The proportion of GNB was estimated. Risk factors and clinical characteristics of CAP due to GNB were assessed using logistic regression models. Results: The prevalence of GNB was 8.6% in all CAP patients and 15.8% among those with a valid respiratory sample. GNB infection was independently associated with diabetes, higher leucocyte count... (More)

Background: In Western settings, community-acquired pneumonia (CAP) due to Gram-negative bacilli (GNB) is relatively rare. Previous studies from Asia, however, indicate a higher prevalence of GNB in CAP, but data, particularly from Southeast Asia, are limited. Methods: This is a prospective observational study of 1451 patients ≥15 y of age with CAP from two hospitals in Cambodia between 2007 and 2010. The proportion of GNB was estimated. Risk factors and clinical characteristics of CAP due to GNB were assessed using logistic regression models. Results: The prevalence of GNB was 8.6% in all CAP patients and 15.8% among those with a valid respiratory sample. GNB infection was independently associated with diabetes, higher leucocyte count and CAP severity. Mortality was higher in patients with CAP due to GNB. Conclusions: We found a high proportion of GNB in a population hospitalized for CAP in Cambodia. Given the complex antimicrobial sensitivity patterns of certain GNBs and the rapid emergence of multidrug-resistant GNB, microbiological laboratory capacity should be strengthened and prospective clinical trials comparing empiric treatment algorithms according to the severity of CAP are needed.

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published
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keywords
Cambodia, Community acquired, Epidemiology, Gram-negative bacilli, Pneumonia, Pseudomonas
in
Transactions of the Royal Society of Tropical Medicine and Hygiene
volume
112
issue
2
pages
7 pages
publisher
Elsevier
external identifiers
  • scopus:85050586998
ISSN
0035-9203
DOI
10.1093/trstmh/try022
language
English
LU publication?
yes
id
d54616d6-f297-4aa7-ac4b-0225d6abceb1
date added to LUP
2018-09-18 12:17:53
date last changed
2020-01-16 03:30:50
@article{d54616d6-f297-4aa7-ac4b-0225d6abceb1,
  abstract     = {<p>Background: In Western settings, community-acquired pneumonia (CAP) due to Gram-negative bacilli (GNB) is relatively rare. Previous studies from Asia, however, indicate a higher prevalence of GNB in CAP, but data, particularly from Southeast Asia, are limited. Methods: This is a prospective observational study of 1451 patients ≥15 y of age with CAP from two hospitals in Cambodia between 2007 and 2010. The proportion of GNB was estimated. Risk factors and clinical characteristics of CAP due to GNB were assessed using logistic regression models. Results: The prevalence of GNB was 8.6% in all CAP patients and 15.8% among those with a valid respiratory sample. GNB infection was independently associated with diabetes, higher leucocyte count and CAP severity. Mortality was higher in patients with CAP due to GNB. Conclusions: We found a high proportion of GNB in a population hospitalized for CAP in Cambodia. Given the complex antimicrobial sensitivity patterns of certain GNBs and the rapid emergence of multidrug-resistant GNB, microbiological laboratory capacity should be strengthened and prospective clinical trials comparing empiric treatment algorithms according to the severity of CAP are needed.</p>},
  author       = {Inghammar, Malin and Borand, Laurence and Goyet, Sophie and Rammaert, Blandine and Te, Vantha and Try, Patrich Lorn and Guillard, Bertrand and Buchy, Philippe and Vong, Sirenda and Chheng, Eap Tek and Cavailler, Philippe and Mayaud, Charles and Tarantola, Arnaud},
  issn         = {0035-9203},
  language     = {eng},
  month        = {02},
  number       = {2},
  pages        = {57--63},
  publisher    = {Elsevier},
  series       = {Transactions of the Royal Society of Tropical Medicine and Hygiene},
  title        = {Community-acquired pneumonia and Gram-negative bacilli in Cambodia-incidence, risk factors and clinical characteristics},
  url          = {http://dx.doi.org/10.1093/trstmh/try022},
  doi          = {10.1093/trstmh/try022},
  volume       = {112},
  year         = {2018},
}