ROSON B, CARRATALA J, LERIDA A, FERNANDEZ S, DORCA J, MANRESA F, GUDIOL F; Interscience Conference on Antimicrobial Agents and Chemotherapy.
Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 1999 Sep 26-29; 39: 659 (abstract no. 521).
Hosp. de Bellvitge. Univ. of Barcelona, Barcelona, SPAIN.
Aspiration pneumonia (AP) may be underestimated as a cause of community-acquired pneumonia (CAP) because its recognition requires a careful clinical evaluation. The aim of our study was to assess its relevance in a cohort of 847 consecutive pts with CAP prospectively studied from Feb. 1995 to Dec. 1998. Diagnosis of AP (excluding lung abscess) was considered definitive when there was isolation of mixed aerobic/anaerobic flora from an uncontaminated sample, and presumptive in pts with predisposing causes for aspiration and radiographic evidence of involvement of a dependent pulmonary segment. Most common causative agents of CAP were Streptococcus pneumoniae (203) and Legionella pneumophila (72). Fifty-two pts were diagnosed of AP, 11 definitive and 41 presumptive. Thirty-one percent of them were unrecognized as AP at admission. Main predisposing conditions for aspiration were neurological disorders (21), head and neck cancer (6), and history of drug overdose or alcohol abuse (6). In comparison with other pneumonia cases, pts with AP had less frequently (p<.05), chills (20% vs 55%), pleuritic chest pain (22% vs 50%), myalgias (6% vs 23%), and headache (6% vs 22%). Impaired consciousness was more common in AP pts (41% vs 10%). Putrid sputum was present in 10% of AP pts,. cavitation in 18%, and concomitant empyema in 10%. Patients with AP had a longer hospitalization (15.4 vs 10.7 days) and also received parenteral antibiotics for longer time (8.6 vs 4.8 days). Overall mortality was significantly higher in AP pts than in pts with other pneumonias (21% vs 11%) (p=.03). In summary, AP was the third cause of CAP in our series and was frequently misdiagnosed at admission. Regarding the high mortality associated with AP, its early recognition should be promoted in order to provide an adequate antianaerobic coverage.
Publication Types:
Keywords:
- Anti-Bacterial Agents
- Hospitalization
- Humans
- Lung Abscess
- Pneumonia
- Pneumonia, Aspiration
- Sputum
- Streptococcus pneumoniae
- etiology
Other ID:
UI: 102246378
From Meeting Abstracts