Community-acquired Haemophilus influenzae pneumonia - New insights from the CAPNETZ study

被引：23

作者：

Forstner, Christina ^{[1
,2
]}

Rohde, Gernot ^{[3
,10
,11
]}

Rupp, Jan ^{[4
,11
]}

Schuette, Hartwig ^{[5
,11
]}

Ott, Sebastian R. ^{[6
,7
]}

Hagel, Stefan ^{[1
]}

Harrison, Nicole ^{[2
]}

Thalhammer, Florian ^{[2
]}

von Baum, Heike ^{[8
]}

Suttorp, Norbert ^{[5
,11
]}

Welte, Tobias ^{[9
,10
,11
]}

Pletz, Mathias W. ^{[1
,11
]}

机构：

[1] Jena Univ Hosp, Ctr Infect Dis & Infect Control, Erlanger Allee 101, D-07747 Jena, Germany

[2] Med Univ Vienna, Div Infect Dis & Trop Med, Dept Med 1, Wahringer Gurtel 18-20, A-1090 Vienna, Austria

[3] Maastricht Univ, Med Ctr, Dept Resp Med, P Debyelaan 25, NL-6202 AZ Maastricht, Netherlands

[4] Univ Lubeck, Dept Infect Dis & Microbiol, Ratzeburger Allee 160, D-23538 Lubeck, Germany

[5] Charite, Dept Internal Med Infect Dis & Pulm Med, Augustenburger Pl 1, D-13353 Berlin, Germany

[6] Inselspital Bern, Univ Hosp, Dept Pulm Med, Freiburgstr 4, CH-3010 Bern, Switzerland

[7] Univ Bern, Freiburgstr 4, CH-3010 Bern, Switzerland

[8] Ulm Univ Hosp, Inst Med Microbiol & Hyg, Albert Einstein Allee 23, D-89081 Ulm, Germany

[9] Hannover Med Sch, Dept Pulm Med, Carl Neuberg Str 1, D-30625 Hannover, Germany

[10] Biomed Res Endstage & Obstruct Lung Dis Hannover, Carl Neuberg Str 1, D-30625 Hannover, Germany

[11] CAPNETZ STIFTUNG, Carl Neuberg Str 1, D-30625 Hannover, Germany

来源：

JOURNAL OF INFECTION | 2016年 / 72卷 / 05期

关键词：

Respiratory tract infection; Fluoroquinolones; Macrolides; Beta-lactams; Haemophilus influenzae; CURB-65; score; RESPIRATORY-TRACT INFECTIONS; GERMAN COMPETENCE NETWORK; MACROLIDE SUSCEPTIBILITY; MANAGEMENT; RESISTANCE; ADULTS; GUIDELINES; ETIOLOGY; PATHOGEN; CHILDREN;

D O I：

10.1016/j.jinf.2016.02.010

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Objectives: We aimed to identify clinical characteristics and to assess effectiveness of different initial antibiotic regimens in adult patients with community-acquired pneumonia (CAP) caused by Haemophilus influenzae. Methods: Characteristics were compared between patients with H. influenzae monoinfection versus CAP of other and unknown aetiology enrolled by the German prospective cohort study CAPNETZ. Impact of initial antibiotic treatment on "early clinical response" according to FDA criteria and overall clinical cure were analysed. Results: H. influenzae was found in 176 out of 2790 patients with pathogen detection (6.3%). Characteristics significantly associated with a H. influenzae CAP (p < 0.017) included purulent sputum, prior pneumococcal vaccination and respiratory co-morbidities. Early clinical response rates on day 4 did not differ between patients receiving any mono-versus combination therapy (85.9% versus 88%), but were numerically higher for regimens including any fluoroquinolone (96.7%) and lower under macrolide monotherapy (70%). Initial CURB-65 score and chronic liver disease were identified as negative predictors for "early clinical response". At day 14, overall clinical cure was 91.9%. Conclusions: H. influenzae was a common CAP pathogen, particularly in patients with previous pneumococcal vaccination and respiratory co-morbidities. Severity of illness and chronic liver disease were associated with a lower rate of "early clinical response". (C) 2016 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

引用

页码：554 / 563

页数：10

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