Burden of Community-Acquired Pneumonia and Unmet Clinical Needs

AbstractCommunity-acquired pneumonia (CAP) is the leading cause of death among infectious diseases and an important health problem, having considerable implications for healthcare systems worldwide. Despite important advances in prevention through vaccines, new rapid diagnostic tests and antibiotics, CAP management still has significant drawbacks. Mortality remains very high in severely ill patients presenting with respiratory failure or shock but is also high in the elderly. Even after a CAP episode, higher risk of death remains during a long period, a risk mainly driven by inflammation and patient-related co-morbidities. CAP microbiology has been altered by new molecular diagnostic tests that have turned viruses into the most identified pathogens, notwithstanding uncertainties about the specific role of each virus in CAP pathogenesis. Pneumococcal vaccines also impacted CAP etiology and thus had changedStreptococcus pneumoniae circulating serotypes. Pathogens from specific regions should also be kept in mind when treating CAP. New antibiotics for CAP treatment were not tested in severely ill patients and focused on multidrug-resistant pathogens that are unrelated to CAP, limiting their general use and indications for intensive care unit (ICU) patients. Similarly, CAP management could be personalized through the use of adjunctive therapies that showed outcome improvements in particular patient groups. Although pneumococcal vaccination was only convincingly shown to reduce in...
Source: Advances in Therapy - Category: Drugs & Pharmacology Source Type: research

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Conclusion. This study shows that macrolide resistance among S. pneumoniae isolated in Tunisia is mainly related to target site modification. Our observations demonstrate a high degree of genetic diversity and capsular types among strains resistant to macrolides. PMID: 32159507 [PubMed - as supplied by publisher]
Source: Journal of Medical Microbiology - Category: Microbiology Authors: Tags: J Med Microbiol Source Type: research
This study was performed to investigate the serotype distribution and antimicrobial susceptibility of Streptococcus pneumoniae in Asian countries. A prospective surveillance study on S. pneumoniae collected from adult patients (≥50 years old) with invasive pneumococcal disease or community-acquired pneumonia was performed at 66 hospitals in Asian countries (Korea, China, Malaysia, Singapore, the Philippines, and Thailand) in 2012-2017. Serotyping and antimicrobial susceptibility tests of 850 pneumococcal isolates were performed. The proportions of isolates with serotypes covered by 13-valent pneumococcal conjugate vac...
Source: Vaccine - Category: Allergy & Immunology Authors: Tags: Vaccine Source Type: research
Conclusions: Serotype changes and emerging multidrug-resistant international clones were found in current study. lytA, ply, psaA, pavA, spxB, htrA and clpP may be good protein vaccine candidates. Long-term high-quality surveillance should be conducted to assess impact and effectiveness brought by vaccines, and provide a foundation for prevention strategies and vaccine policies.
Source: Frontiers in cellular and infection microbiology - Category: Microbiology Source Type: research
Abstract Nosocomial infections have become alarming with the increase of multidrug-resistant bacterial strains of Acinetobacter baumannii. Being the causative agent in ~80% of the cases, these pathogenic gram-negative species could be deadly for hospitalized patients, especially in intensive care units utilizing ventilators, urinary catheters, and nasogastric tubes. Primarily infecting an immuno-compromised system, they are resistant to most antibiotics and are the root cause of various types of opportunistic infections including but not limited to septicemia, endocarditis, meningitis, pneumonia, skin, and wound s...
Source: Genomics Proteomics ... - Category: Genetics & Stem Cells Authors: Tags: Front Cell Infect Microbiol Source Type: research
Nosocomial infections have become alarming with the increase of multidrug resistant bacterial strains of Acinetobacter baumannii. Being the causative agent in approximately 80% of the cases, these pathogenic gram-negative species could be deadly for hospitalized patients, especially in intensive care units utilizing ventilators, urinary catheters and nasogastric tubes. Primarily infecting an immuno-compromised system, they are resistant to most antibiotics and are the root cause of various types of opportunistic infections including but not limited to septicemia, endocarditis, meningitis, pneumonia, skin and wound sepsis a...
Source: Frontiers in cellular and infection microbiology - Category: Microbiology Source Type: research
Emergent resistance to antibiotics among Streptococcus pneumoniae isolates is a severe problem worldwide. Antibiotic resistance profiles for S pneumoniae isolates identified from pediatric patients in mainland China remains to be established. The clinical features, antimicrobial resistance, and multidrug resistance patterns of S pneumoniae were retrospectively analyzed at 10 children's hospitals in mainland China in 2016. Among the collected 6132 S pneumoniae isolates, pneumococcal diseases mainly occurred in children younger than 5 years old (85.1%). The resistance rate of S pneumoniae to clindamycin, erythromycin, tetr...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
In this study, a “species” is defined as a unique AMR profile, including the profile corresponding to susceptibility to all tested antimicrobials. The AMR profile (or antibiogram) of an isolate is the combination of AMR phenotype (susceptible or non-susceptible) to each drug tested. SR reflects the richness of AMR profiles without weighting of abundance. SE and SD are measures in which both SR and relative abundance are taken into account. The BP diversity index is related to the proportion of isolates with the most common AMR profile. Changes in antimicrobial testing protocol could impact upon results, partic...
Source: Frontiers in Microbiology - Category: Microbiology Source Type: research
In conclusion, we demonstrated that the selective boosting of lung innate immunity is a conceptually advantageous approach for improving the effectiveness of antibiotic treatment and fighting antibiotic-resistant bacteria. Introduction Pneumonia constitutes a major cause of death, morbidity and health resource use worldwide. The main causative agents identified in adult patients hospitalized for community-acquired pneumonia (CAP) are viruses (in 27–30% of cases, the most common being rhinovirus, influenza and coronavirus) and bacteria (14–23% of cases, with a marked predominance of Streptococcus pneumonia...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
Purpose of review Despite the improvements in its management, community-acquired pneumonia (CAP) still exhibits high global morbidity and mortality rates, especially in elderly patients. This review focuses on the most recent findings on the epidemiology, cause, diagnosis and management of CAP. Recent findings There is consistent evidence that the trend in CAP mortality has declined over time. However, the mortality of pneumococcal CAP has not changed in the last two decades, with an increase in the rate of hospitalization and more severe forms of CAP. Streptococcus pneumoniae remains the most frequent cause of CAP in...
Source: Current Opinion in Critical Care - Category: Nursing Tags: EMERGENCIES IN CRITICAL CARE: Edited by Wesley H. Self Source Type: research
Abstract Community-acquired pneumonia is one of the most common infections seen in emergency department patients. There is a wide spectrum of disease severity and viral pathogens are common. After a careful history and physical examination, chest radiographs may be the only diagnostic test required. The first step in management is risk stratification, using a validated clinical decision rule and serum lactate, followed by early antibiotics and fluid resuscitation when indicated. Antibiotics should be selected with attention to risk factors for multidrug-resistant respiratory pathogens. Broad use of pneumococcal va...
Source: The Medical Clinics of North America - Category: General Medicine Authors: Tags: Emerg Med Clin North Am Source Type: research
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