TY - JOUR
T1 - Multidrug-resistant pathogens in hospitalised patients coming from the community with pneumonia
T2 - a European perspective
AU - Aliberti, Stefano
AU - Cilloniz, Catia
AU - Chalmers, James D.
AU - Zanaboni, Anna Maria
AU - Cosentini, Roberto
AU - Tarsia, Paolo
AU - Pesci, Alberto
AU - Blasi, Francesco
AU - Torres, Antoni
PY - 2013/11
Y1 - 2013/11
N2 - Background: Probabilistic scores have been recently suggested to identify pneumonia caused by multidrug-resistant (MDR) bacteria. The aim of the study was to validate both Aliberti and Shorr scores in predicting MDR pneumonia, comparing them with healthcare associated pneumonia (HCAP) classification. Methods: Two independent European cohorts of consecutive patients hospitalised with pneumonia were prospectively evaluated in Barcelona, Spain (BC) and Edinburgh, UK (EC). Data on admission and during hospitalisation were collected. The predictive value of the three scores was explored for correctly indicating the presence of MDR pneumonia via a receiver-operating characteristic (ROC) curve. Results: A total of 1591 patients in the BC and 1883 patients in the EC were enrolled. The prevalence of patients with MDR pathogen among those with isolated bacteria was 7.6% in the BC and 3.3% in the EC. The most common MDR pathogen found in both cohorts was MRSA, followed by MDR P aeruginosa. A significantly higher prevalence of MDR bacteria was found among patients in the intensive care unit (ICU). The two probabilistic scores, and particularly the Aliberti one, showed an area under the ROC curve higher than the HCAP classification in predicting MDR pneumonia, especially in the ICU. Conclusions: Risk scores able to identify MDR pneumonia could help in developing strategies for antimicrobial stewardship.
AB - Background: Probabilistic scores have been recently suggested to identify pneumonia caused by multidrug-resistant (MDR) bacteria. The aim of the study was to validate both Aliberti and Shorr scores in predicting MDR pneumonia, comparing them with healthcare associated pneumonia (HCAP) classification. Methods: Two independent European cohorts of consecutive patients hospitalised with pneumonia were prospectively evaluated in Barcelona, Spain (BC) and Edinburgh, UK (EC). Data on admission and during hospitalisation were collected. The predictive value of the three scores was explored for correctly indicating the presence of MDR pneumonia via a receiver-operating characteristic (ROC) curve. Results: A total of 1591 patients in the BC and 1883 patients in the EC were enrolled. The prevalence of patients with MDR pathogen among those with isolated bacteria was 7.6% in the BC and 3.3% in the EC. The most common MDR pathogen found in both cohorts was MRSA, followed by MDR P aeruginosa. A significantly higher prevalence of MDR bacteria was found among patients in the intensive care unit (ICU). The two probabilistic scores, and particularly the Aliberti one, showed an area under the ROC curve higher than the HCAP classification in predicting MDR pneumonia, especially in the ICU. Conclusions: Risk scores able to identify MDR pneumonia could help in developing strategies for antimicrobial stewardship.
UR - http://www.scopus.com/inward/record.url?scp=84879379288&partnerID=8YFLogxK
U2 - 10.1136/thoraxjnl-2013-203384
DO - 10.1136/thoraxjnl-2013-203384
M3 - Article
C2 - 23774884
SN - 0040-6376
VL - 68
SP - 997
EP - 999
JO - Thorax
JF - Thorax
IS - 11
ER -