Acquired pneumonia

BACKGROUND: Computed tomography angiography (CTA) of the head and neck during acute ischemic stroke (AIS) usually includes visualization of lung apices. The possibility to evaluate for pulmonary changes, e.g. peripheral ground-glass and consolidative opacities suggestive of coronavirus disease 2019 (COVID-19)-related pneumonia, depends on the area of the lung covered by CTA. METHODS: We performed an analysis of a real-world scenario assessing the variability of lung coverage on CTA in patients presenting with AIS to a comprehensive stroke center (CSC) or to one of eight primary stroke centers (PSC) within a teleradiological network covered by the comprehensive stroke center in 2019...

The ESKAPE pathogens ( Enterococcus faecium , Staphylococcus aureus , Klebsiella pneumoniae , Acinetobacter baumannii , Pseudomonas aeruginosa , and Enterobacter cloacae ) represent clinically important bacterial species that are responsible for most hospital-acquired drug-resistant infections; hence, the need for rapid identification is of high importance. Previous work has demonstrated the suitability of liquid extraction surface analysis mass spectrometry (LESA MS) for the direct analysis of colonies of two of the ESKAPE pathogens ( Staphylococcus aureus and Pseudomonas aeruginosa ) growing on agar...

BACKGROUND: The effect of workflow factors, such as timing of admission and changes in treating team, on patient outcomes remains inconclusive. AIMS: We aimed to investigate the impact of weekend admission and changes in treating team on four pre-defined outcomes in patients admitted to hospital with community acquired pneumonia (CAP). METHODS: We performed an observational cohort study by utilizing prospective longitudinal data collected during the IMPROVE-GAP trial, a stepped-wedge randomised study investigating an evidence-based bundle of care in the management of CAP...

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BACKGROUND: Hospital-acquired pneumonia (HAP) is a common problem in intensive care medicine and the patient outcome depends on the fast beginning of adequate antibiotic therapy. Until today pathogen identification is performed using conventional microbiological methods with turnaround times of at least 24 h for the first results. It was the aim of this study to investigate the potential of headspace analyses detecting bacterial species-specific patterns of volatile organic compounds (VOCs) for the rapid differentiation of HAP-relevant bacteria...

INTRODUCTION: Ketoacidosis is a metabolic condition caused by the buildup of ketone bodies. The most common causes are diabetes, alcoholism, and starvation. This is a case of a lactating mother on a ketogenic diet who developed a community-acquired pneumonia and then went into life-threatening ketoacidosis. CASE PRESENTATION: A 32-year-old, lactating, 8-week-postpartum woman presented to the hospital complaining of nausea, vomiting, rhinorrhea, and cough. She had no history of diabetes or of alcohol or drug use but reported following a ketogenic diet and was found to have a pneumonia...

RATIONALE: Computerized severity assessment for community-acquired pneumonia (CAP), could improve consistency and reduce clinician burden. OBJECTIVES: Develop and compare 30-day mortality prediction models using electronic health record data including a computerized Pneumonia Severity Index (PSI) versus models with additional variables. METHODS: Among adults presenting to Emergency Departments (EDs) at 117 VA Medical Centers EDs between 1/1/2006-12/31/2016 with CAP, we compared a computerized score with all variables from the PSI except confusion and pleural effusion ("ePSI score") to 10 novel models employing logistic regression, spline, and machine learning (ml) methods using PSI variables (PSI), age, sex and 26 physiologic variables (PSI-28), and all 69 variables (PSI-69)...

We report the case of a 36-year-old man with cirrhosis who presented with recurrent infection of his right-sided hepatic hydrothorax in the form of fever, dyspnea, and cough. The pleural fluid analysis showed transudative fluid with normal pH, lactic acid dehydrogenase, and glucose, but with Escherichia coli growth. An uncommon diagnosis of high mortality, spontaneous bacterial empyema was made. Criteria for chest tube drainage were met, but he was managed without one. He developed hospital-acquired pneumonia during his stay, but his pleural fluid showed the same characteristics...

OBJECTIVE: To characterize the pediatric patients presenting at the two pediatric centers in Bogotá, with first isolate urine culture of community-acquired extended-spectrum b-lactamase (ESBL)-producing enterobacteriaceae. METHODS: Review of microbiological data of children between January, 2012 and December, 2018, obtained using the WHONET software. RESULTS: A total of 2657 Escherichia coli, Klebsiella spp and Proteus mirabilis - positive urine cultures were obtained within a 6-year period; data of 132 patients were finally selected...

BACKGROUND: Klebsiella pneumoniae (K. pneumoniae) is a common pathogen associated with hospital and community-onset infections. This study aimed to compare the clinical and microbiological characteristics of nosocomial, healthcare-associated (HCA), and community-acquired (CA) K. pneumoniae infections. METHODS: Clinical data were extracted from electronic medical records and analyzed retrospectively. Antimicrobial susceptibility and extended-spectrum beta-lactamase (ESBL) production were determined for all identified strains...

BACKGROUND: An outbreak of Legionella pneumonia occurred at a university hospital using copper-silver ionization for potable water disinfection. We present the epidemiological and laboratory investigation of the outbreak, and associated case-control study. METHODS: Cases were defined by syndrome compatible with Legionella pneumonia with laboratory-confirmed Legionella infection. The water circuit and disinfection system were assessed, and water samples collected for Legionella culture...

Imipenem/cilastatin/relebactam (Recarbrio™) is an intravenously administered combination of the carbapenem imipenem, the renal dehydropeptidase-I inhibitor cilastatin, and the novel β-lactamase inhibitor relebactam. Relebactam is a potent inhibitor of class A and class C β-lactamases, conferring imipenem activity against many imipenem-nonsusceptible strains. Imipenem/cilastatin/relebactam is approved in the USA and EU for the treatment of hospital-acquired bacterial pneumonia (HABP) and ventilator-associated bacterial pneumonia (VABP) in adults and other gram-negative infections, including complicated urinary tract infections (cUTIs) [including pyelonephritis] and complicated intra-abdominal infections (cIAIs), in adults with limited or no alternative treatment options...

Klebsiella pneumoniae is a frequent cause of nosocomial and severe community-acquired infections. Multidrug-resistant (MDR) and hypervirulent (hv) strains represent major threats, and tracking their emergence, evolution and the emerging convergence of MDR and hv traits is of major importance. We employed whole-genome sequencing (WGS) to study the evolution and epidemiology of a large longitudinal collection of clinical K. pneumoniae isolates from the H301 hospital in Beijing, China. Overall, the population was highly diverse, although some clones were predominant...

Objective: SARS-CoV-2 (originally named COVID-2019) pneumonia is currently prevalent worldwide. The number of cases has increased rapidly but the auscultatory characteristics of affected patients and how to use it to predict who is most likely to survive or die are not available. This study aims to describe the auscultatory characteristics and its clinical relativity of SARS-CoV-2 pneumonia by using a wireless stethoscope. Material and methods: A cross-sectional, observational, single-center case series of 30 consecutive hospitalized patients with confirmed SARS-CoV-2 pneumonia at Leishenshan Hospital in Wuhan, China, were enrolled from March 9 to April 5, 2020...

BACKGROUND: Due to high risk of mortality, children with comorbidities are typically excluded from trials evaluating pneumonia treatment. Understanding heterogeneity of outcomes among children with pneumonia and comorbidities is critical to ensuring appropriate treatment. METHODS: We explored whether the percentage of children with fast-breathing pneumonia cured at Day 14 was lower among those with selected comorbidities enrolled in a prospective observational study than among those enrolled in a concurrent randomized controlled trial evaluating treatment with amoxicillin in Lilongwe, Malawi...

Community-acquired pneumonia is the most common type of pneumonia and remains a leading cause of morbidity and mortality worldwide. Although many different pathogens can contribute to pneumonia, Streptococcus pneumoniae (S. pneumoniae) is one of the common bacterial pathogens that underlie community-acquired pneumonia [1]. Receptor-interacting protein kinase 3 (RIPK3) is widely recognized as a key modulator of inflammation and cell death. To elucidate a potential role of RIPK3 in pneumonia, we examined plasma from healthy controls and patients positive with streptococcal pneumonia...

Coronary pulmonary artery fistula (CPAF) is a rare entity in the population. It may present with multiple clinical settings and in various age ranges. Invasive coronary angiography (ICA), coronary computed tomography angiography (CCTA), and transthoracic echocardiography (TTE) have been reported as diagnostic tools for CPAF. Among them, TTE is rarely capable of identifying CPAF. There is no current treatment guideline as some of the interventional therapies are effective yet controversial. The therapy therefore should be individualized...

Background: Respiratory tract infections (RTIs) are a common reason for people to seek medical care. RTIs are associated with high short-term mortality. Inconsistent evidence exists in the association between the presence of kidney disease and the risk of death in patient with RTIs. Methods: We searched the PubMed, Cochrane Library and Embase databases from inception through April 2019 for cohort and case-control studies investigating the presence of kidney disease (defined as medical diagnosis of kidney disease, reduced estimated glomerular filtration rate or creatinine clearance, elevated serum creatinine and proteinuria) on mortality in adults with RTIs in different settings including community, inpatient and intensive care units...

BACKGROUND: Spinal deformity is frequently identified in patients with cerebral palsy (CP). As it progresses, tracheal stenosis often develops due to compression between the innominate artery and anteriorly deviated vertebrae at the apex of the cervicothoracic hyperlordosis. However, the treatment strategy for tracheal stenosis complicated by spinal deformity in patients with CP remains unknown. CASE PRESENTATION: This study reports two cases: a 19-year-old girl (case 1) and a 17-year-old girl (case 2), both with CP at Gross Motor Function Classification System V...

Background The aim of this study was to evaluate both positive outcomes, including reduction of respiratory support aid and duration of hospital stay, and negative ones, including mortality and a composite of invasive mechanical ventilation or death, in patients with COVID-19 pneumonia treated with or without oral darunavir/cobicistat (DRV/c, 800/150 mg/day) used in different treatment duration. Secondary objective was to evaluate the percentage of patients treated with DRV/c who were exposed to potentially severe drug-drug interactions (DDI) and died during hospitalization...