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Risk factors for drug-resistant pathogens in immunocompetent patients with pneumonia: Evaluation of PES pathogens

Tadashi Ishida1, Akihiro Ito1, Yasuyoshi Washio1

  • 1Dept. of Respiratory Medicine, Kurashiki Central Hospital, Ohara Memorial Kurashiki Central Healthcare Foundation, Kurashiki, Japan.

Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy
|October 13, 2016
PubMed
Abstract

Insights

The study identified risk factors for PES pathogens (Pseudomonas aeruginosa, ESBL-positive Enterobacteriaceae, MRSA) in community-acquired pneumonia. Female sex, recent admission, poor performance, and enteral feeding were significant risk factors.

Area of Science:

  • Infectious Diseases
  • Pulmonology
  • Antimicrobial Resistance

Background:

  • A novel acronym, PES pathogens (Pseudomonas aeruginosa, Enterobacteriaceae extended-spectrum beta-lactamase-positive, and methicillin-resistant Staphylococcus aureus), has been proposed to identify drug-resistant pathogens in community-acquired pneumonia.
  • Antimicrobial resistance is a growing concern in treating respiratory infections.

Purpose of the Study:

  • To evaluate risk factors for antimicrobial-resistant pathogens in immunocompetent patients with pneumonia.
  • To validate the clinical utility of the PES pathogens classification.

Main Methods:

  • Retrospective analysis of a prospective observational study.
  • Inclusion of immunocompetent patients diagnosed with pneumonia between March 2009 and June 2015.
  • Multivariate analysis to identify independent risk factors for PES pathogen infection.

Main Results:

  • PES pathogens were identified in 7.2% of patients with a confirmed etiological diagnosis.
  • Independent risk factors for PES pathogens included female sex, recent hospital admission, poor performance status, and enteral feeding.
  • Patients with PES pathogens showed trends toward initial treatment failure, 30-day readmission, and prolonged hospitalization.

Conclusions:

  • The PES pathogen classification is appropriate for describing drug-resistant pneumonia pathogens in immunocompetent individuals.
  • While infrequent, PES pathogens can lead to refractory pneumonia requiring distinct antimicrobial strategies.
  • Early recognition of PES pathogens is crucial for effective patient management.
Keywords:
Drug-resistant pathogenImmunocompetent patientsPneumonia

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