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Multidrug-resistant pathogens in patients with pneumonia coming from the community

Oriol Sibila1, Ana Rodrigo-Troyano, Yuichiro Shindo

  • 1aServei de Pneumologia, Hospital de la Santa Creu i Sant Pau; Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain bDepartment of Respiratory Medicine, Institute for Advanced Research, Nagoya University, Nagoya University Graduate School of Medicine, Nagoya, Japan cSchool of Medicine and Surgery, University of Milan Bicocca, AO San Gerardo, Monza, Italy dSouth Texas Veterans Healthcare System and University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA.

Current Opinion in Pulmonary Medicine
|March 10, 2016
PubMed
Abstract

Insights

Identifying patients with multidrug-resistant (MDR) pathogens early is crucial for community-onset pneumonia treatment. Current Healthcare-Associated Pneumonia (HCAP) criteria are insufficient; new risk factors and scores are needed for accurate pathogen identification.

Area of Science:

  • Infectious Diseases
  • Pulmonology
  • Clinical Microbiology

Background:

  • Accurate identification of multidrug-resistant (MDR) pathogens in community-onset pneumonia is vital for effective empiric treatment.
  • The existing Healthcare-Associated Pneumonia (HCAP) classification system is debated for its utility in identifying patients at risk for MDR pathogens.

Purpose of the Study:

  • To review and interpret current data on the association between MDR pathogens and community-onset pneumonia.
  • To assess the effectiveness of various risk factors and prediction scores in identifying MDR pathogens.

Main Methods:

  • Systematic review of recent clinical literature.
  • Analysis of risk factors for MDR pathogens, including novel factors and those specific to MRSA and Pseudomonas aeruginosa.
  • Evaluation of clinical scoring systems for MDR risk assessment.

Main Results:

  • Recent studies indicate that the HCAP risk factor alone does not reliably identify resistant pathogens.
  • Several new risk factors and prediction scores for MDR pathogens in community-onset pneumonia have been proposed.
  • The review examines general MDR risk factors, specific pathogen risks (MRSA, Pseudomonas aeruginosa), and clinical scoring systems.

Conclusions:

  • Various MDR risk factors and prediction scores have been recently developed for community-onset pneumonia.
  • Further research is necessary to refine these tools and aid clinicians in differentiating between various MDR pathogens.

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