Background: Streptococcus pneumoniae (S. pneumoniae) is a major cause of morbidity and mortality in children worldwide, and its evolving serotype distribution and antibiotic resistance patterns are of global health concern. This meta-analysis aims to investigate the serotype distribution and antimicrobial resistance of S. pneumoniae after the introduction of pneumococcal conjugate vaccine 13-valent (PCV13) as a self-funded vaccine in Chinese pediatric populations.
Methods: We systematically reviewed studies published between 2017 and 2024 that focused on S. pneumoniae serotypes isolated from children under 14 years old in mainland China. Data sources included PubMed, Embase, Web of Science, CNKI, Wanfang, and SinoMed. The findings were synthesized using either a fixed-effects or random-effects model.
Results: Our meta-analysis included 12 studies, identifying the most common serotypes of S. pneumoniae were 19 F, 19 A, 23 F, 14, 6B and 6 A. Vaccine serotype coverage rates were 52.17% (95%CI: 44.91-59.42%) for PCV10, 74.77% (95%CI: 71.53-78.01%) for PCV13, 76.72% (95%CI: 75.37-78.07%) for PCV15 and 92.90% (95%CI: 92.09-93.71%) for PPSV23. Antimicrobial resistance was most pronounced for erythromycin at 93.73% (95%CI: 90.58-96.88%), followed by azithromycin, tetracycline, clindamycin, and sulfamethoxazole. Serotype prevalence and vaccine coverage varied regionally and by strain type.
Conclusion: The distribution of S. pneumoniae serotypes and their antibiotic resistance profiles in children under 14 years in mainland China have remained relatively stable post-PCV13 introduction as a self-funded vaccine. The results support continued use and possible expansion of PCV13 immunization and highlight the importance of ongoing surveillance and vaccine development to cover all prevalent serotypes in China.
{"title":"Serotype distribution and antimicrobial resistance of Streptococcus pneumoniae in China among children under 14 years of age post-implementation of the PCV13: a systematic review and meta-analysis (2017-2024).","authors":"Yue Li, Sijie Wang, Liang Hong, Lijing Xin, Fei Wang, Yibin Zhou","doi":"10.1186/s41479-024-00141-z","DOIUrl":"10.1186/s41479-024-00141-z","url":null,"abstract":"<p><strong>Background: </strong>Streptococcus pneumoniae (S. pneumoniae) is a major cause of morbidity and mortality in children worldwide, and its evolving serotype distribution and antibiotic resistance patterns are of global health concern. This meta-analysis aims to investigate the serotype distribution and antimicrobial resistance of S. pneumoniae after the introduction of pneumococcal conjugate vaccine 13-valent (PCV13) as a self-funded vaccine in Chinese pediatric populations.</p><p><strong>Methods: </strong>We systematically reviewed studies published between 2017 and 2024 that focused on S. pneumoniae serotypes isolated from children under 14 years old in mainland China. Data sources included PubMed, Embase, Web of Science, CNKI, Wanfang, and SinoMed. The findings were synthesized using either a fixed-effects or random-effects model.</p><p><strong>Results: </strong>Our meta-analysis included 12 studies, identifying the most common serotypes of S. pneumoniae were 19 F, 19 A, 23 F, 14, 6B and 6 A. Vaccine serotype coverage rates were 52.17% (95%CI: 44.91-59.42%) for PCV10, 74.77% (95%CI: 71.53-78.01%) for PCV13, 76.72% (95%CI: 75.37-78.07%) for PCV15 and 92.90% (95%CI: 92.09-93.71%) for PPSV23. Antimicrobial resistance was most pronounced for erythromycin at 93.73% (95%CI: 90.58-96.88%), followed by azithromycin, tetracycline, clindamycin, and sulfamethoxazole. Serotype prevalence and vaccine coverage varied regionally and by strain type.</p><p><strong>Conclusion: </strong>The distribution of S. pneumoniae serotypes and their antibiotic resistance profiles in children under 14 years in mainland China have remained relatively stable post-PCV13 introduction as a self-funded vaccine. The results support continued use and possible expansion of PCV13 immunization and highlight the importance of ongoing surveillance and vaccine development to cover all prevalent serotypes in China.</p>","PeriodicalId":45120,"journal":{"name":"Pneumonia","volume":"16 1","pages":"18"},"PeriodicalIF":8.5,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11453009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-25DOI: 10.1186/s41479-024-00146-8
Catia Cilloniz, Amedeo Guzzardella, Davide Calabretta, Albert Gabarrus, Maria Angeles Marcos, Antoni Torres
Aim: The objective of this study was to assess the therapeutic effects of corticosteroids in adult patients hospitalized with viral community-acquired pneumonia.
Methods: This is a retrospective analysis of data collected prospectively from November 1996 to June 2024. All adult patients with viral community-acquired pneumonia were enrolled. The primary outcome was 30-day mortality. Secondary outcomes included all-cause in-hospital mortality, ICU admission, length of ICU and hospital stay, mechanical ventilation, and 1-year mortality. Propensity score matching (PSM) was used to obtain balance among the baseline variables in the two groups.
Results: Of the 524 patients with viral pneumonia, 30 (6%) received corticosteroids and 494 (94%) did not. Patients were primarily male (n = 299, 57%), with a median [Q1-Q3] age of 66.9 [55-81] years. The 3:1 propensity matching procedure identified 90 patients not treated with corticosteroid (CS-) as controls. After PSM, no difference in 30-day mortality was found [7% (95%CI 1 to 22%) vs. 4% (95%CI 1 to 11%), p = 0.639]. The risk of death at 30 days did not differ significantly in unmatched and matched cohorts [Hazard Ratio (HR) 1.33 (0.32-5.63), p = 0.695 vs. HR 1.51 (0.28-8.27), p = 0.632, respectively]. Nor were differences found in hospital length of stay, ICU admission and length of stay, or mechanical ventilation requirement and duration between matched and unmatched CS + and CS-.
Conclusions: There were no significant differences in the primary and secondary outcomes regarding the use of corticosteroids in patients with viral pneumonia.
{"title":"Outcomes of corticosteroid therapy in patients with viral community-acquired pneumonia.","authors":"Catia Cilloniz, Amedeo Guzzardella, Davide Calabretta, Albert Gabarrus, Maria Angeles Marcos, Antoni Torres","doi":"10.1186/s41479-024-00146-8","DOIUrl":"https://doi.org/10.1186/s41479-024-00146-8","url":null,"abstract":"<p><strong>Aim: </strong>The objective of this study was to assess the therapeutic effects of corticosteroids in adult patients hospitalized with viral community-acquired pneumonia.</p><p><strong>Methods: </strong>This is a retrospective analysis of data collected prospectively from November 1996 to June 2024. All adult patients with viral community-acquired pneumonia were enrolled. The primary outcome was 30-day mortality. Secondary outcomes included all-cause in-hospital mortality, ICU admission, length of ICU and hospital stay, mechanical ventilation, and 1-year mortality. Propensity score matching (PSM) was used to obtain balance among the baseline variables in the two groups.</p><p><strong>Results: </strong>Of the 524 patients with viral pneumonia, 30 (6%) received corticosteroids and 494 (94%) did not. Patients were primarily male (n = 299, 57%), with a median [Q1-Q3] age of 66.9 [55-81] years. The 3:1 propensity matching procedure identified 90 patients not treated with corticosteroid (CS-) as controls. After PSM, no difference in 30-day mortality was found [7% (95%CI 1 to 22%) vs. 4% (95%CI 1 to 11%), p = 0.639]. The risk of death at 30 days did not differ significantly in unmatched and matched cohorts [Hazard Ratio (HR) 1.33 (0.32-5.63), p = 0.695 vs. HR 1.51 (0.28-8.27), p = 0.632, respectively]. Nor were differences found in hospital length of stay, ICU admission and length of stay, or mechanical ventilation requirement and duration between matched and unmatched CS + and CS-.</p><p><strong>Conclusions: </strong>There were no significant differences in the primary and secondary outcomes regarding the use of corticosteroids in patients with viral pneumonia.</p>","PeriodicalId":45120,"journal":{"name":"Pneumonia","volume":"16 1","pages":"21"},"PeriodicalIF":8.5,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11423511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142356068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-25DOI: 10.1186/s41479-024-00138-8
Sha Huang, Lanlan Chen, Ning Yang, Jiao Zhang, Yan Wang, Xiaoyan Chen
Objective: This retrospective cohort identified the association of human serum albumin (HSA) with adverse outcomes (septic shock, in-hospital and out-of-hospital mortality) in elderly hospitalized patients who have community-acquired pneumonia (CAP) and specific body mass index (BMI).
Materials and methods: This research included hospitalized CAP individuals (≥ 60 years) and was conducted at a teaching hospital in western China. All the patients were categorized into three populations based on two BMI cutoff values (18.5 kg/m2 and 24 kg/m2). The data was acquired from medical records, local government mortality databases, and telephone interviews. Binomial logistic regression analysis was used to explore the associations between low HSA and septic shock and in-hospital mortality, and Cox regression analysis was used to explore the association between low HSA and out-of-hospital mortality.
Results: A total of 627 patients were included in the analysis of in-hospital death and septic shock, and 431 patients were included in the analysis of out-of-hospital death. The study showed that 120 elderly patients with CAP (19.14%) died in the hospital, while 141 patients (32.71%) died out of the hospital, and 93 patients (14.83%) developed septic shock. No differences in in-hospital and out-of-hospital mortality were observed for BMI values < 18.5 kg/m2 or BMI ≥ 24 kg/m2, regardless of whether HSA was ≥ 40 g/l or < 40 g/l. When 18.5 kg/m2 ≤ BMI < 24 kg/m2, patients with HSA < 40 g/l had both higher in-hospital and out-of-hospital mortality compared with those with HSA ≥ 40 g/l (in-hospital death: 26.13% vs. 11.46%, p < 0.001; out-of-hospital death: 46.15% vs. 19.17%, p < 0.001). No significant differences were observed in the incidence of septic shock between patients with HSA < 40 g/l and those with HSA ≥ 40 g/l either in the overall population or when the BMI values were divided according to the cutoff values of 18.5 kg/m2 and 24 kg/m2. After further logistic regression analysis and adjustment for potential confounders, the results showed that when 18.5 kg/m2 ≤ BMI < 24 kg/m2, elderly CAP patients with HSA < 40 g/l had a higher risk of in-hospital and out-of-hospital mortality compared with those with HSA ≥ 40 g/l (in-hospital death: HR = 1.964, 95%CI = 1.08-3.573; out-of-hospital death: HR = 2.841, 95%CI = 1.745-4.627).
Conclusions: HSA levels can predict the risk of in-hospital and out-of-hospital mortality in elderly patients with CAP and normal BMI values. However, HSA cannot predict the risk of septic shock in elderly patients hospitalized with CAP, irrespective of their BMI classification.
目的这项回顾性队列研究确定了患有社区获得性肺炎（CAP）的老年住院患者的人血清白蛋白（HSA）与不良结局（脓毒性休克、院内和院外死亡率）以及特定体重指数（BMI）之间的关系：研究对象包括住院的 CAP 患者（≥ 60 岁），研究在中国西部的一家教学医院进行。根据两个 BMI 临界值（18.5 kg/m2 和 24 kg/m2）将所有患者分为三个群体。数据来源于医疗记录、当地政府的死亡数据库和电话访谈。二项式逻辑回归分析用于探讨低HSA与脓毒性休克和院内死亡率之间的关系，Cox回归分析用于探讨低HSA与院外死亡率之间的关系：共有 627 例患者纳入院内死亡和脓毒性休克分析，431 例患者纳入院外死亡分析。研究显示，120 名老年 CAP 患者（19.14%）在院内死亡，141 名患者（32.71%）在院外死亡，93 名患者（14.83%）出现脓毒性休克。无论HSA是否≥40 g/l或2≤BMI 2、HSA为2和24 kg/m2的患者，BMI值为2或BMI≥24 kg/m2的患者院内和院外死亡率均无差异。在进一步进行逻辑回归分析并调整潜在的混杂因素后，结果显示，当 18.5 kg/m2 ≤ BMI 2 时，老年 CAP 患者的 HSA 结论：HSA 水平可以预测 BMI 值正常的老年 CAP 患者的院内和院外死亡风险。然而，无论 BMI 分级如何，HSA 都无法预测 CAP 住院老年患者发生脓毒性休克的风险。
{"title":"Relationships between human serum albumin levels and septic shock, in-hospital, and out-of-hospital mortality in elderly patients with pneumonia in different BMI ranges.","authors":"Sha Huang, Lanlan Chen, Ning Yang, Jiao Zhang, Yan Wang, Xiaoyan Chen","doi":"10.1186/s41479-024-00138-8","DOIUrl":"https://doi.org/10.1186/s41479-024-00138-8","url":null,"abstract":"<p><strong>Objective: </strong>This retrospective cohort identified the association of human serum albumin (HSA) with adverse outcomes (septic shock, in-hospital and out-of-hospital mortality) in elderly hospitalized patients who have community-acquired pneumonia (CAP) and specific body mass index (BMI).</p><p><strong>Materials and methods: </strong>This research included hospitalized CAP individuals (≥ 60 years) and was conducted at a teaching hospital in western China. All the patients were categorized into three populations based on two BMI cutoff values (18.5 kg/m<sup>2</sup> and 24 kg/m<sup>2</sup>). The data was acquired from medical records, local government mortality databases, and telephone interviews. Binomial logistic regression analysis was used to explore the associations between low HSA and septic shock and in-hospital mortality, and Cox regression analysis was used to explore the association between low HSA and out-of-hospital mortality.</p><p><strong>Results: </strong>A total of 627 patients were included in the analysis of in-hospital death and septic shock, and 431 patients were included in the analysis of out-of-hospital death. The study showed that 120 elderly patients with CAP (19.14%) died in the hospital, while 141 patients (32.71%) died out of the hospital, and 93 patients (14.83%) developed septic shock. No differences in in-hospital and out-of-hospital mortality were observed for BMI values < 18.5 kg/m<sup>2</sup> or BMI ≥ 24 kg/m<sup>2</sup>, regardless of whether HSA was ≥ 40 g/l or < 40 g/l. When 18.5 kg/m<sup>2</sup> ≤ BMI < 24 kg/m<sup>2</sup>, patients with HSA < 40 g/l had both higher in-hospital and out-of-hospital mortality compared with those with HSA ≥ 40 g/l (in-hospital death: 26.13% vs. 11.46%, p < 0.001; out-of-hospital death: 46.15% vs. 19.17%, p < 0.001). No significant differences were observed in the incidence of septic shock between patients with HSA < 40 g/l and those with HSA ≥ 40 g/l either in the overall population or when the BMI values were divided according to the cutoff values of 18.5 kg/m<sup>2</sup> and 24 kg/m<sup>2</sup>. After further logistic regression analysis and adjustment for potential confounders, the results showed that when 18.5 kg/m<sup>2</sup> ≤ BMI < 24 kg/m<sup>2</sup>, elderly CAP patients with HSA < 40 g/l had a higher risk of in-hospital and out-of-hospital mortality compared with those with HSA ≥ 40 g/l (in-hospital death: HR = 1.964, 95%CI = 1.08-3.573; out-of-hospital death: HR = 2.841, 95%CI = 1.745-4.627).</p><p><strong>Conclusions: </strong>HSA levels can predict the risk of in-hospital and out-of-hospital mortality in elderly patients with CAP and normal BMI values. However, HSA cannot predict the risk of septic shock in elderly patients hospitalized with CAP, irrespective of their BMI classification.</p>","PeriodicalId":45120,"journal":{"name":"Pneumonia","volume":"16 1","pages":"17"},"PeriodicalIF":8.5,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11423505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142356069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-05DOI: 10.1186/s41479-024-00142-y
Giovanni Sotgiu
{"title":"A scientific manifesto for a new 5-year period: a new horizon for Pneumonia.","authors":"Giovanni Sotgiu","doi":"10.1186/s41479-024-00142-y","DOIUrl":"10.1186/s41479-024-00142-y","url":null,"abstract":"","PeriodicalId":45120,"journal":{"name":"Pneumonia","volume":"16 1","pages":"19"},"PeriodicalIF":8.5,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11375841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-05DOI: 10.1186/s41479-024-00137-9
Johannes Rukyaa, Martha F Mushi, Vitus Silago, Prisca Damiano, Katherine Keenan, Wilber Sabiiti, Matthew T G Holden, Jeremiah Seni, Stephen E Mshana
Background: Bacterial pneumonia is among the leading causes of morbidity and mortality worldwide. The extensive misuse and overuse of antibiotics observed during the Corona Virus Disease 2019 (COVID-19) pandemic may have changed the patterns of pathogens causing bacterial pneumonia and their antibiotic susceptibility profiles. This study was designed to establish the prevalence of culture-confirmed bacterial pneumonia and describe their antimicrobial susceptibility profile in adult patients who presented with signs and symptoms of lower respiratory tract infections (LRTIs) during the COVID-19 pandemic.
Methodology: This hospital-based cross-sectional study was conducted from July 2021 to July 2022 at a zonal referral hospital and two district hospitals in Mwanza, Tanzania. Demographic and clinical data were collected using a standardized questionnaire. Sputum samples were processed by conventional culture followed by the identification of isolates and antibiotic susceptibility testing. Descriptive data analysis was performed using STATA version 15.0.
Results: A total of 286 patients with a median age of 40 (IQR 29-60) years were enrolled in the study. More than half of the patients enrolled were females (52.4%, n = 150). The overall prevalence of bacterial pneumonia was 34.3% (n = 98). The majority of the bacterial pathogens isolated were Gram-negative bacteria (GNB) (61.2%, 60/98), with a predominance of Klebsiella spp., 38.8% (38/98), followed by Streptococcus pyogenes (21.4%, 21/98). Multi drug resistant (MDR) bacteria were detected in 72/98 (73.5%) of the isolates. The proportions of GNB-resistant strains were 60.0% (36/60) for ciprofloxacin, 60% (36/60) for amoxicillin, 60% (36/60) for amoxicillin, 68.3% (41/60) for trimethoprim-sulfamethoxazole and 58.3% (35/60) for ceftriaxone.
Conclusion: One-third of the patients with signs and symptoms of LRTIs had laboratory-confirmed bacterial pneumonia with a predominance of Gram negative MDR bacteria. This calls for continuous antimicrobial resistance (AMR) surveillance and antimicrobial stewardship programs in the study setting and other settings in developing countries as important strategies for tackling AMR.
{"title":"Etiology and antimicrobial susceptibility patterns of bacteria causing pneumonia among adult patients with signs and symptoms of lower respiratory tract infections during the COVID-19 pandemic in Mwanza, Tanzania: a cross-sectional study.","authors":"Johannes Rukyaa, Martha F Mushi, Vitus Silago, Prisca Damiano, Katherine Keenan, Wilber Sabiiti, Matthew T G Holden, Jeremiah Seni, Stephen E Mshana","doi":"10.1186/s41479-024-00137-9","DOIUrl":"10.1186/s41479-024-00137-9","url":null,"abstract":"<p><strong>Background: </strong>Bacterial pneumonia is among the leading causes of morbidity and mortality worldwide. The extensive misuse and overuse of antibiotics observed during the Corona Virus Disease 2019 (COVID-19) pandemic may have changed the patterns of pathogens causing bacterial pneumonia and their antibiotic susceptibility profiles. This study was designed to establish the prevalence of culture-confirmed bacterial pneumonia and describe their antimicrobial susceptibility profile in adult patients who presented with signs and symptoms of lower respiratory tract infections (LRTIs) during the COVID-19 pandemic.</p><p><strong>Methodology: </strong>This hospital-based cross-sectional study was conducted from July 2021 to July 2022 at a zonal referral hospital and two district hospitals in Mwanza, Tanzania. Demographic and clinical data were collected using a standardized questionnaire. Sputum samples were processed by conventional culture followed by the identification of isolates and antibiotic susceptibility testing. Descriptive data analysis was performed using STATA version 15.0.</p><p><strong>Results: </strong>A total of 286 patients with a median age of 40 (IQR 29-60) years were enrolled in the study. More than half of the patients enrolled were females (52.4%, n = 150). The overall prevalence of bacterial pneumonia was 34.3% (n = 98). The majority of the bacterial pathogens isolated were Gram-negative bacteria (GNB) (61.2%, 60/98), with a predominance of Klebsiella spp., 38.8% (38/98), followed by Streptococcus pyogenes (21.4%, 21/98). Multi drug resistant (MDR) bacteria were detected in 72/98 (73.5%) of the isolates. The proportions of GNB-resistant strains were 60.0% (36/60) for ciprofloxacin, 60% (36/60) for amoxicillin, 60% (36/60) for amoxicillin, 68.3% (41/60) for trimethoprim-sulfamethoxazole and 58.3% (35/60) for ceftriaxone.</p><p><strong>Conclusion: </strong>One-third of the patients with signs and symptoms of LRTIs had laboratory-confirmed bacterial pneumonia with a predominance of Gram negative MDR bacteria. This calls for continuous antimicrobial resistance (AMR) surveillance and antimicrobial stewardship programs in the study setting and other settings in developing countries as important strategies for tackling AMR.</p>","PeriodicalId":45120,"journal":{"name":"Pneumonia","volume":"16 1","pages":"16"},"PeriodicalIF":8.5,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11375869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-25DOI: 10.1186/s41479-024-00136-w
Linda Yamba Yamba, Karin Hansen, Lisa Wasserstrom, Yu-Ching Su, Jonas Ahl, Kristian Riesbeck
Background: Haemophilus influenzae community-acquired pneumonia (CAP) is common, and it is equally common to Streptococcus pneumoniae in some settings. The purpose of this study was to provide additional data on patients affected by H. influenzae CAP and their outcomes.
Methods: Streptococcus pneumoniae-caused CAP (111 cases) was compared to CAP with H. influenzae (53 cases). Patients were adults (≥ 18 years) from the prospective study "Etiology of community acquired pneumonia in Sweden" (ECAPS), which was established during the years 2016-2018.
Results: Cases with H. influenzae CAP were significantly older compared to S. pneumoniae CAP (median 77 vs 70 years, p = 0.037) albeit similar comorbidities. Haemophilus influenzae was generally absent in the bloodstream compared to S. pneumoniae (18% vs 2%, p = 0.01) but clinical presentations were comparable. Only a minority of patients, 34% with H. influenzae and 41% with S. pneumoniae CAP had underlying lung disease.
Conclusion: In the light of childhood immunization campaigns against S. pneumoniae and the increasing numbers of pneumococcal vaccinations among the elderly, coupled with an aging population, the incidence of CAP caused by H. influenzae may increase. Further research is needed to understand the impact of H. influenzae CAP and to a development of a vaccine against this emerging microbe.
背景：流感嗜血杆菌社区获得性肺炎（CAP）很常见，在某些情况下与肺炎链球菌同样常见。本研究旨在提供更多有关流感嗜血杆菌社区获得性肺炎患者及其治疗效果的数据：方法：将肺炎链球菌引起的 CAP（111 例）与流感嗜血杆菌引起的 CAP（53 例）进行比较。患者均为成人（≥ 18 岁），来自 2016-2018 年期间开展的前瞻性研究 "瑞典社区获得性肺炎病因学"（ECAPS）：结果：尽管合并症相似，但流感嗜血杆菌 CAP 病例的年龄明显高于肺炎链球菌 CAP 病例（中位数 77 岁 vs 70 岁，p = 0.037）。与肺炎双球菌相比，流感嗜血杆菌一般不出现在血流中（18% 对 2%，p = 0.01），但临床表现相似。只有34%的流感嗜血杆菌和41%的肺炎双球菌CAP患者有潜在的肺部疾病：结论：鉴于肺炎双球菌的儿童免疫接种活动和老年人接种肺炎球菌疫苗的人数不断增加，再加上人口老龄化，由流感嗜血杆菌引起的 CAP 发病率可能会增加。要了解流感嗜血杆菌 CAP 的影响，并开发出针对这种新出现微生物的疫苗，还需要进一步的研究。
{"title":"The importance of Haemophilus influenzae in community-acquired pneumonia: an emerging pathogen in the elderly regardless of comorbidities compared to Streptococcus pneumoniae.","authors":"Linda Yamba Yamba, Karin Hansen, Lisa Wasserstrom, Yu-Ching Su, Jonas Ahl, Kristian Riesbeck","doi":"10.1186/s41479-024-00136-w","DOIUrl":"10.1186/s41479-024-00136-w","url":null,"abstract":"<p><strong>Background: </strong>Haemophilus influenzae community-acquired pneumonia (CAP) is common, and it is equally common to Streptococcus pneumoniae in some settings. The purpose of this study was to provide additional data on patients affected by H. influenzae CAP and their outcomes.</p><p><strong>Methods: </strong>Streptococcus pneumoniae-caused CAP (111 cases) was compared to CAP with H. influenzae (53 cases). Patients were adults (≥ 18 years) from the prospective study \"Etiology of community acquired pneumonia in Sweden\" (ECAPS), which was established during the years 2016-2018.</p><p><strong>Results: </strong>Cases with H. influenzae CAP were significantly older compared to S. pneumoniae CAP (median 77 vs 70 years, p = 0.037) albeit similar comorbidities. Haemophilus influenzae was generally absent in the bloodstream compared to S. pneumoniae (18% vs 2%, p = 0.01) but clinical presentations were comparable. Only a minority of patients, 34% with H. influenzae and 41% with S. pneumoniae CAP had underlying lung disease.</p><p><strong>Conclusion: </strong>In the light of childhood immunization campaigns against S. pneumoniae and the increasing numbers of pneumococcal vaccinations among the elderly, coupled with an aging population, the incidence of CAP caused by H. influenzae may increase. Further research is needed to understand the impact of H. influenzae CAP and to a development of a vaccine against this emerging microbe.</p>","PeriodicalId":45120,"journal":{"name":"Pneumonia","volume":"16 1","pages":"15"},"PeriodicalIF":8.5,"publicationDate":"2024-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11344911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142056822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Ethiopia is one of those countries with higher burden of community acquired pneumonia among its people, under five children are the members of society that are highly affected by pneumonia particularly Severe Community Acquired Pneumonia. However, there are limited studies on time to recovery and its predictors in under-five children and most of them are retrospective which fails to address important variables that affect the time to recovery. Therefore, the aim of this study was to estimate the median time to recovery and its predictors among under five children admitted to South Wollo zone public hospitals, North East Ethiopia.
Methods: An institution-based prospective cohort study was conducted from March 10 to May 10, 2021, with 270 study subjects. A systematic random sampling technique was used. Data was collected by interview and chart review. The data were entered and analyzed using Epi Data version 3.1 and STATA version 14.0, respectively. Kaplan-Meier and Cox regression models were used to test the time and predictors of recovery from severe community-acquired pneumonia.
Results: The overall incidence of recovery rate (95% confidence interval) from Severe Community-Acquired Pneumonia was 20.45(17.84-23.46) per 100 person days observation with median (IQR) time to recovery of [3, 5] days. The predictors of time to recovery from Severe Community-Acquired Pneumonia were having comorbidities on admission [AHR = 0.49 (95%CI: 0.32,0.75)], reaching hospitals after 5 days of onset of symptoms [AHR = 0.35 (95%CI: 0.20,0.60)], having Middle Upper Arm Circumference < = 12.5 cm [AHR = 0.21 (95%CI: 0.12,0.37)], the presence of smoker in the house [AHR = 0.21 (95%CI: 0.10,0.42)] and being not fully immunized for age [AHR = 0.35 (95%CI: 0.24,0.53)].
Conclusion and recommendations: Generally the recovery time of children with Severe Community Acquired Pneumonia in the study area was within the recommended national standards. Due attention should be given to children with the identified predictors while treating them.
{"title":"Time to recovery from severe community-acquired pneumonia and its predictors among 6 to 59 months of age children admitted to South Wollo zone public hospitals, North East Ethiopia: a prospective follow-up study.","authors":"Mekonnen Teferi, Elsabeth Addisu, Shambel Wodajo, Amare Muche, Abel Endawekie, Bezawit Adane, Tilahun Dessie, Natnael Kebede","doi":"10.1186/s41479-024-00135-x","DOIUrl":"10.1186/s41479-024-00135-x","url":null,"abstract":"<p><strong>Introduction: </strong>Ethiopia is one of those countries with higher burden of community acquired pneumonia among its people, under five children are the members of society that are highly affected by pneumonia particularly Severe Community Acquired Pneumonia. However, there are limited studies on time to recovery and its predictors in under-five children and most of them are retrospective which fails to address important variables that affect the time to recovery. Therefore, the aim of this study was to estimate the median time to recovery and its predictors among under five children admitted to South Wollo zone public hospitals, North East Ethiopia.</p><p><strong>Methods: </strong>An institution-based prospective cohort study was conducted from March 10 to May 10, 2021, with 270 study subjects. A systematic random sampling technique was used. Data was collected by interview and chart review. The data were entered and analyzed using Epi Data version 3.1 and STATA version 14.0, respectively. Kaplan-Meier and Cox regression models were used to test the time and predictors of recovery from severe community-acquired pneumonia.</p><p><strong>Results: </strong>The overall incidence of recovery rate (95% confidence interval) from Severe Community-Acquired Pneumonia was 20.45(17.84-23.46) per 100 person days observation with median (IQR) time to recovery of [3, 5] days. The predictors of time to recovery from Severe Community-Acquired Pneumonia were having comorbidities on admission [AHR = 0.49 (95%CI: 0.32,0.75)], reaching hospitals after 5 days of onset of symptoms [AHR = 0.35 (95%CI: 0.20,0.60)], having Middle Upper Arm Circumference < = 12.5 cm [AHR = 0.21 (95%CI: 0.12,0.37)], the presence of smoker in the house [AHR = 0.21 (95%CI: 0.10,0.42)] and being not fully immunized for age [AHR = 0.35 (95%CI: 0.24,0.53)].</p><p><strong>Conclusion and recommendations: </strong>Generally the recovery time of children with Severe Community Acquired Pneumonia in the study area was within the recommended national standards. Due attention should be given to children with the identified predictors while treating them.</p>","PeriodicalId":45120,"journal":{"name":"Pneumonia","volume":"16 1","pages":"14"},"PeriodicalIF":8.5,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11299310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-25DOI: 10.1186/s41479-024-00134-y
Mercy Wendy Wanyana, Richard Migisha, Patrick King, Abraham Kibaba Muhesi, Benon Kwesiga, Daniel Kadobera, Lilian Bulage, Alex Riolexus Ario
Background: Pneumonia is one of the leading causes of infant mortality globally, particularly in sub-Saharan Africa. In Uganda, pneumonia was the fourth leading cause of death in children <5 years in 2018. Analysis of 2013-2022 data for children <5 years from the District Health Information System indicated a high incidence of severe pneumonia in Kasese District, Uganda. We investigated to identify factors associated with severe pneumonia among children <5 years in Kasese District to inform prevention and control strategies.
Methods: We conducted a 1:1 hospital-based case-control study among children aged 2-59 months presenting with pneumonia at five high-volume facilities in Kasese District from January to April 2023. A case was defined as pneumonia with ≥1 of the following danger signs: low oxygen saturation, central cyanosis, severe respiratory distress, feeding difficulties, altered consciousness, and convulsions. Controls were outpatient children aged 2-59 months with a diagnosis of non-severe pneumonia. We reviewed medical records at facilities and used an interviewer-administered questionnaire with caregivers to obtain information on socio-demographic and clinical characteristics. Logistic regression was used to identify factors associated with severe pneumonia.
Results: We enrolled 199 cases and 174 controls. The odds of severe pneumonia were higher among children with diarrhoea only (adjusted odds ratio [aOR] = 2.9, 95%CI: 1.7-4.9), or malaria and diarrhoea (aOR = 3.4, 95%CI: 2.0-5.9), than those without a co-existing illness at the time of pneumonia diagnosis. Not being exclusively breastfed for ≥ 6 months (aOR = 2.0, 95%CI: 1.1-3.3) and exposure to indoor air pollution from cooking combustion sources (aOR = 2.9, 95%CI: 1.8-4.7) increased odds of severe pneumonia.
Conclusion: The findings highlight the significance of comorbidities, lack of exclusive breastfeeding, and exposure to indoor air pollution in the development of severe pneumonia. Promoting exclusive breastfeeding for ≥ 6 months and advocating for the use of clean energy sources, could mitigate morbidity attributable to severe pneumonia in the region.
{"title":"Factors associated with severe pneumonia among children <5 years, Kasese District, Uganda: a case-control study, January-April 2023.","authors":"Mercy Wendy Wanyana, Richard Migisha, Patrick King, Abraham Kibaba Muhesi, Benon Kwesiga, Daniel Kadobera, Lilian Bulage, Alex Riolexus Ario","doi":"10.1186/s41479-024-00134-y","DOIUrl":"10.1186/s41479-024-00134-y","url":null,"abstract":"<p><strong>Background: </strong>Pneumonia is one of the leading causes of infant mortality globally, particularly in sub-Saharan Africa. In Uganda, pneumonia was the fourth leading cause of death in children <5 years in 2018. Analysis of 2013-2022 data for children <5 years from the District Health Information System indicated a high incidence of severe pneumonia in Kasese District, Uganda. We investigated to identify factors associated with severe pneumonia among children <5 years in Kasese District to inform prevention and control strategies.</p><p><strong>Methods: </strong>We conducted a 1:1 hospital-based case-control study among children aged 2-59 months presenting with pneumonia at five high-volume facilities in Kasese District from January to April 2023. A case was defined as pneumonia with ≥1 of the following danger signs: low oxygen saturation, central cyanosis, severe respiratory distress, feeding difficulties, altered consciousness, and convulsions. Controls were outpatient children aged 2-59 months with a diagnosis of non-severe pneumonia. We reviewed medical records at facilities and used an interviewer-administered questionnaire with caregivers to obtain information on socio-demographic and clinical characteristics. Logistic regression was used to identify factors associated with severe pneumonia.</p><p><strong>Results: </strong>We enrolled 199 cases and 174 controls. The odds of severe pneumonia were higher among children with diarrhoea only (adjusted odds ratio [aOR] = 2.9, 95%CI: 1.7-4.9), or malaria and diarrhoea (aOR = 3.4, 95%CI: 2.0-5.9), than those without a co-existing illness at the time of pneumonia diagnosis. Not being exclusively breastfed for ≥ 6 months (aOR = 2.0, 95%CI: 1.1-3.3) and exposure to indoor air pollution from cooking combustion sources (aOR = 2.9, 95%CI: 1.8-4.7) increased odds of severe pneumonia.</p><p><strong>Conclusion: </strong>The findings highlight the significance of comorbidities, lack of exclusive breastfeeding, and exposure to indoor air pollution in the development of severe pneumonia. Promoting exclusive breastfeeding for ≥ 6 months and advocating for the use of clean energy sources, could mitigate morbidity attributable to severe pneumonia in the region.</p>","PeriodicalId":45120,"journal":{"name":"Pneumonia","volume":"16 1","pages":"13"},"PeriodicalIF":8.5,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11270805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-05DOI: 10.1186/s41479-024-00133-z
Josef Yayan, Karl-Josef Franke, Melanie Berger, Wolfram Windisch, Kurt Rasche
Tuberculosis remains a significant global health challenge. Tuberculosis affects millions of individuals worldwide. Early detection of tuberculosis plays a relevant role in the management of treatment of tuberculosis. This systematic review will analyze the findings of several published studies on the topic of the early detection of tuberculosis. This systematic review highlights their methodologies and limitations as well as their contributions to our understanding of this pressing issue. Early detection of tuberculosis can be achieved through tuberculosis screening for contacts. Comprehensive health education for household contacts can be used as early detection. The in-house deep learning models can be used in the X-ray used for automatic detection of tuberculosis. Interferon gamma release assay, routine passive and active case detection, portable X-ray and nucleic acid amplification testing, and highly sensitive enzyme-linked immunosorbent assay tests play critical roles in improving tuberculosis detection.
结核病仍然是全球健康面临的重大挑战。结核病影响着全球数百万人。结核病的早期发现在结核病的治疗管理中发挥着重要作用。本系统综述将分析已发表的几项关于结核病早期检测主题的研究结果。本系统综述将重点介绍这些研究的方法和局限性，以及它们对我们了解这一紧迫问题所做的贡献。结核病的早期发现可以通过对接触者进行结核病筛查来实现。针对家庭接触者的全面健康教育可作为早期检测手段。内部深度学习模型可用于自动检测结核病的 X 射线。伽马干扰素释放检测、常规被动和主动病例检测、便携式 X 射线和核酸扩增检测以及高灵敏度酶联免疫吸附检测在改进结核病检测方面发挥着至关重要的作用。
{"title":"Early detection of tuberculosis: a systematic review.","authors":"Josef Yayan, Karl-Josef Franke, Melanie Berger, Wolfram Windisch, Kurt Rasche","doi":"10.1186/s41479-024-00133-z","DOIUrl":"10.1186/s41479-024-00133-z","url":null,"abstract":"<p><p>Tuberculosis remains a significant global health challenge. Tuberculosis affects millions of individuals worldwide. Early detection of tuberculosis plays a relevant role in the management of treatment of tuberculosis. This systematic review will analyze the findings of several published studies on the topic of the early detection of tuberculosis. This systematic review highlights their methodologies and limitations as well as their contributions to our understanding of this pressing issue. Early detection of tuberculosis can be achieved through tuberculosis screening for contacts. Comprehensive health education for household contacts can be used as early detection. The in-house deep learning models can be used in the X-ray used for automatic detection of tuberculosis. Interferon gamma release assay, routine passive and active case detection, portable X-ray and nucleic acid amplification testing, and highly sensitive enzyme-linked immunosorbent assay tests play critical roles in improving tuberculosis detection.</p>","PeriodicalId":45120,"journal":{"name":"Pneumonia","volume":"16 1","pages":"11"},"PeriodicalIF":8.5,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11225244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141535647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-25DOI: 10.1186/s41479-024-00132-0
Fernando García-García, Dae-Jin Lee, Mónica Nieves-Ermecheo, Olaia Bronte, Pedro Pablo España, José María Quintana, Rosario Menéndez, Antoni Torres, Luis Alberto Ruiz Iturriaga, Isabel Urrutia
<p><strong>Background: </strong>There exists consistent empirical evidence in the literature pointing out ample heterogeneity in terms of the clinical evolution of patients with COVID-19. The identification of specific phenotypes underlying in the population might contribute towards a better understanding and characterization of the different courses of the disease. The aim of this study was to identify distinct clinical phenotypes among hospitalized patients with SARS-CoV-2 pneumonia using machine learning clustering, and to study their association with subsequent clinical outcomes as severity and mortality.</p><p><strong>Methods: </strong>Multicentric observational, prospective, longitudinal, cohort study conducted in four hospitals in Spain. We included adult patients admitted for in-hospital stay due to SARS-CoV-2 pneumonia. We collected a broad spectrum of variables to describe exhaustively each case: patient demographics, comorbidities, symptoms, physiological status, baseline examinations (blood analytics, arterial gas test), etc. For the development and internal validation of the clustering/phenotype models, the dataset was split into training and test sets (50% each). We proposed a sequence of machine learning stages: feature scaling, missing data imputation, reduction of data dimensionality via Kernel Principal Component Analysis (KPCA), and clustering with the k-means algorithm. The optimal cluster model parameters -including k, the number of phenotypes- were chosen automatically, by maximizing the average Silhouette score across the training set.</p><p><strong>Results: </strong>We enrolled 1548 patients, each of them characterized by 92 clinical attributes (d=109 features after variable encoding). Our clustering algorithm identified k=3 distinct phenotypes and 18 strongly informative variables: Phenotype A (788 cases [50.9% prevalence] - age <math><mo>∼</mo></math> 57, Charlson comorbidity <math><mo>∼</mo></math> 1, pneumonia CURB-65 score <math><mo>∼</mo></math> 0 to 1, respiratory rate at admission <math><mo>∼</mo></math> 18 min<sup>-1</sup>, FiO<sub>2</sub> <math><mo>∼</mo></math> 21%, C-reactive protein CRP <math><mo>∼</mo></math> 49.5 mg/dL [median within cluster]); phenotype B (620 cases [40.0%] - age <math><mo>∼</mo></math> 75, Charlson <math><mo>∼</mo></math> 5, CURB-65 <math><mo>∼</mo></math> 1 to 2, respiration <math><mo>∼</mo></math> 20 min<sup>-1</sup>, FiO<sub>2</sub> <math><mo>∼</mo></math> 21%, CRP <math><mo>∼</mo></math> 101.5 mg/dL); and phenotype C (140 cases [9.0%] - age <math><mo>∼</mo></math> 71, Charlson <math><mo>∼</mo></math> 4, CURB-65 <math><mo>∼</mo></math> 0 to 2, respiration <math><mo>∼</mo></math> 30 min<sup>-1</sup>, FiO<sub>2</sub> <math><mo>∼</mo></math> 38%, CRP <math><mo>∼</mo></math> 152.3 mg/dL). Hypothesis testing provided solid statistical evidence supporting an interaction between phenotype and each clinical outcome: severity and mortality. By computing their corresponding odds ratios, a clear t
{"title":"Obtaining patient phenotypes in SARS-CoV-2 pneumonia, and their association with clinical severity and mortality.","authors":"Fernando García-García, Dae-Jin Lee, Mónica Nieves-Ermecheo, Olaia Bronte, Pedro Pablo España, José María Quintana, Rosario Menéndez, Antoni Torres, Luis Alberto Ruiz Iturriaga, Isabel Urrutia","doi":"10.1186/s41479-024-00132-0","DOIUrl":"10.1186/s41479-024-00132-0","url":null,"abstract":"<p><strong>Background: </strong>There exists consistent empirical evidence in the literature pointing out ample heterogeneity in terms of the clinical evolution of patients with COVID-19. The identification of specific phenotypes underlying in the population might contribute towards a better understanding and characterization of the different courses of the disease. The aim of this study was to identify distinct clinical phenotypes among hospitalized patients with SARS-CoV-2 pneumonia using machine learning clustering, and to study their association with subsequent clinical outcomes as severity and mortality.</p><p><strong>Methods: </strong>Multicentric observational, prospective, longitudinal, cohort study conducted in four hospitals in Spain. We included adult patients admitted for in-hospital stay due to SARS-CoV-2 pneumonia. We collected a broad spectrum of variables to describe exhaustively each case: patient demographics, comorbidities, symptoms, physiological status, baseline examinations (blood analytics, arterial gas test), etc. For the development and internal validation of the clustering/phenotype models, the dataset was split into training and test sets (50% each). We proposed a sequence of machine learning stages: feature scaling, missing data imputation, reduction of data dimensionality via Kernel Principal Component Analysis (KPCA), and clustering with the k-means algorithm. The optimal cluster model parameters -including k, the number of phenotypes- were chosen automatically, by maximizing the average Silhouette score across the training set.</p><p><strong>Results: </strong>We enrolled 1548 patients, each of them characterized by 92 clinical attributes (d=109 features after variable encoding). Our clustering algorithm identified k=3 distinct phenotypes and 18 strongly informative variables: Phenotype A (788 cases [50.9% prevalence] - age <math><mo>∼</mo></math> 57, Charlson comorbidity <math><mo>∼</mo></math> 1, pneumonia CURB-65 score <math><mo>∼</mo></math> 0 to 1, respiratory rate at admission <math><mo>∼</mo></math> 18 min<sup>-1</sup>, FiO<sub>2</sub> <math><mo>∼</mo></math> 21%, C-reactive protein CRP <math><mo>∼</mo></math> 49.5 mg/dL [median within cluster]); phenotype B (620 cases [40.0%] - age <math><mo>∼</mo></math> 75, Charlson <math><mo>∼</mo></math> 5, CURB-65 <math><mo>∼</mo></math> 1 to 2, respiration <math><mo>∼</mo></math> 20 min<sup>-1</sup>, FiO<sub>2</sub> <math><mo>∼</mo></math> 21%, CRP <math><mo>∼</mo></math> 101.5 mg/dL); and phenotype C (140 cases [9.0%] - age <math><mo>∼</mo></math> 71, Charlson <math><mo>∼</mo></math> 4, CURB-65 <math><mo>∼</mo></math> 0 to 2, respiration <math><mo>∼</mo></math> 30 min<sup>-1</sup>, FiO<sub>2</sub> <math><mo>∼</mo></math> 38%, CRP <math><mo>∼</mo></math> 152.3 mg/dL). Hypothesis testing provided solid statistical evidence supporting an interaction between phenotype and each clinical outcome: severity and mortality. By computing their corresponding odds ratios, a clear t","PeriodicalId":45120,"journal":{"name":"Pneumonia","volume":"16 1","pages":"12"},"PeriodicalIF":8.5,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11637184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141447271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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