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International Journal of Infectious... Mar 2024Pseudomonas fluorescens (P. fluorescens) is not generally considered a bacterial pathogen in humans; however, multiple culture-based and culture-independent studies have...
Pseudomonas fluorescens (P. fluorescens) is not generally considered a bacterial pathogen in humans; however, multiple culture-based and culture-independent studies have identified it in the indigenous microbiota of multiple body sites. We herein report a rare case of pneumonia caused by P. fluorescens. A man in his 80 s with chronic obstructive pulmonary disease and diabetes mellitus was diagnosed with stage II rectal cancer. He underwent laparoscopic surgery, and on the 6th postoperative day, he developed a high fever. Chest computed tomography revealed infiltration in the left lower lung. Gram staining of the sputum showed Gram-negative rods phagocytosed by neutrophils, suggesting postoperative nosocomial pneumonia. The patient was started on tazobactam/piperacillin, and his pneumonia quickly improved. Later, only P. fluorescens was detected in a sputum culture. It was susceptible to common antipseudomonal agents. Gram staining of P. fluorescens appears to show a slightly thicker and larger morphology in comparison to Pseudomonas aeruginosa. Although there have been reports of opportunistic infections caused by P. fluorescens in immunosuppressed patients, including those with advanced cancer, most have been bloodstream infections, with very few reports of pneumonia alone. Clinicians should be aware that patients, who are not necessarily immunosuppressed, may develop pneumonia caused by P. fluorescens.
Topics: Male; Humans; Pseudomonas fluorescens; Pseudomonas Infections; Pneumonia; Pneumonia, Bacterial; Piperacillin, Tazobactam Drug Combination; Pseudomonas aeruginosa; Anti-Bacterial Agents
PubMed: 38218379
DOI: 10.1016/j.ijid.2024.01.007 -
The Lancet. Infectious Diseases Mar 2006Bacterial pneumonia is a substantial cause of childhood morbidity and mortality worldwide, but determination of pathogen-specific burden remains a challenge. In less... (Review)
Review
Bacterial pneumonia is a substantial cause of childhood morbidity and mortality worldwide, but determination of pathogen-specific burden remains a challenge. In less developed settings, the WHO recommended guidelines are useful for initiating care, but are non-specific. Blood culture has low sensitivity, while radiological findings are non-specific and do not discriminate between viral and bacterial causes of pneumonia. In vaccine probe studies, efficacy is dependent on the specificity of the study outcome to detect pneumonia and the impact of the vaccine on the selected outcome, and may underestimate the true burden of bacterial pneumonia. The rising incidence of antibiotic resistance, emerging respiratory pathogens, potential replacement pneumococcal disease following widespread introduction of pneumococcal polysaccharide-protein conjugate vaccine, the limited specificity of chest radiography, and the poor sensitivity of blood culture are substantial obstacles to accurate surveillance. We provide an overview of the diagnostic challenges of bacterial pneumonia and highlight the need for refining the current diagnostic approach to ensure adequate epidemiological surveillance of childhood pneumonia and the success, or otherwise, of any immunisation strategies.
Topics: Bacterial Vaccines; Blood; Child, Preschool; Drug Resistance, Bacterial; Humans; Immunization Programs; Infant; Infant, Newborn; Pneumococcal Vaccines; Pneumonia, Bacterial; Population Surveillance
PubMed: 16500596
DOI: 10.1016/S1473-3099(06)70411-X -
Clinical Infectious Diseases : An... Nov 2021
Topics: Community-Acquired Infections; Humans; Pneumonia, Bacterial
PubMed: 32584958
DOI: 10.1093/cid/ciaa853 -
Postgraduate Medical Journal Mar 2006Hospital acquired or nosocomial infections continue to be an important cause of morbidity and mortality. The critically ill patient is at particular risk of developing... (Review)
Review
Hospital acquired or nosocomial infections continue to be an important cause of morbidity and mortality. The critically ill patient is at particular risk of developing intensive care unit acquired infection, with the lungs being especially vulnerable. Nosocomial bacterial pneumonia occurring after two days of mechanical ventilation is referred to as ventilator associated pneumonia, and is the most common nosocomial infection seen in the intensive care unit. Intubation of the trachea and mechanical ventilation is associated with a 7-fold to 21-fold increase in the incidence of pneumonia and up to 28% of patients receiving mechanical ventilation will develop this complication. Its development is associated with an attributable increase in morbidity and mortality. The establishment of an accurate diagnosis of ventilator associated pneumonia remains problematic and as yet there is still no accepted "gold standard" for diagnosis. The responsible pathogens vary according to case mix, local resistance patterns, and methodology of sampling. However, there is general agreement that rapid initiation of appropriate antimicrobial therapy improves outcome.
Topics: Cross Infection; Humans; Pneumonia, Bacterial; Respiration, Artificial; Risk Factors
PubMed: 16517798
DOI: 10.1136/pgmj.2005.036905 -
The Pediatric Infectious Disease Journal May 2022Bacterial pneumonia imparts a major morbidity and mortality burden on children living with HIV, yet effective prevention and treatment options are underutilized. We...
BACKGROUND
Bacterial pneumonia imparts a major morbidity and mortality burden on children living with HIV, yet effective prevention and treatment options are underutilized. We explored clinical factors associated with severe recurrent bacterial pneumonia among children living with HIV.
METHODS
Children enrolled in the TREAT Asia Pediatric HIV Observational Database were included if they started antiretroviral therapy (ART) on or after January 1st, 2008. Factors associated with severe recurrent bacterial pneumonia were assessed using competing-risk regression.
RESULTS
A total of 3,944 children were included in the analysis; 136 cases of severe recurrent bacterial pneumonia were reported at a rate of 6.5 [95% confidence interval (CI): 5.5-7.7] events per 1,000 patient-years. Clinical factors associated with severe recurrent bacterial pneumonia were younger age [adjusted subdistribution hazard ratio (aHR): 4.4 for <5 years versus ≥10 years, 95% CI: 2.2-8.4, P < 0.001], lower weight-for-age z-score (aHR: 1.5 for <-3.0 versus >-2.0, 95% CI: 1.1-2.3, P = 0.024), pre-ART diagnosis of severe recurrent bacterial pneumonia (aHR: 4.0 versus no pre-ART diagnosis, 95% CI: 2.7-5.8, P < 0.001), past diagnosis of symptomatic lymphoid interstitial pneumonitis or chronic HIV-associated lung disease, including bronchiectasis (aHR: 4.8 versus no past diagnosis, 95% CI: 2.8-8.4, P < 0.001), low CD4% (aHR: 3.5 for <10% versus ≥25%, 95% CI: 1.9-6.4, P < 0.001) and detectable HIV viral load (aHR: 2.6 versus undetectable, 95% CI: 1.2-5.9, P = 0.018).
CONCLUSIONS
Children <10-years-old and those with low weight-for-age, a history of respiratory illness, low CD4% or poorly controlled HIV are likely to gain the greatest benefit from targeted prevention and treatment programs to reduce the burden of bacterial pneumonia in children living with HIV.
Topics: Anti-HIV Agents; CD4 Lymphocyte Count; Child; HIV Infections; Humans; Pneumonia, Bacterial
PubMed: 35185140
DOI: 10.1097/INF.0000000000003494 -
Clinical Microbiology and Infection :... Jan 2009Chlamydophila pneumoniae infection is ubiquitous. It accounts for 10% of community-acquired pneumonias and 5% of cases of pharyngitis, bronchitis and sinusitis in both... (Review)
Review
Chlamydophila pneumoniae infection is ubiquitous. It accounts for 10% of community-acquired pneumonias and 5% of cases of pharyngitis, bronchitis and sinusitis in both immunocompetent and immunocompromised hosts. It is also involved in exacerbations of chronic bronchitis and asthma. Moreover, C. pneumoniae has been reported as a possible cause of atherosclerosis and central nervous system disorders. The current reference standard for serological diagnosis of acute infection is microimmunofluorescence testing, although molecular detection techniques may well become reference diagnostic tests in the near future. Tetracyclines and erythromycin show good in vitro activity, and so far have been the most commonly employed drugs in the treatment of C. pneumoniae infection. New macrolides, ketolides and fluoroquinolones are other potentially effective drugs. This review analyses the most recent data concerning the involvement of C. pneumoniae in human diseases.
Topics: Chlamydophila Infections; Chlamydophila pneumoniae; Humans; Pneumonia, Bacterial
PubMed: 19220337
DOI: 10.1111/j.1469-0691.2008.02130.x -
International Journal of Infectious... May 2012Post-influenza bacterial pneumonia is a major cause of morbidity and mortality associated with both seasonal and pandemic influenza virus illness. However, despite much... (Review)
Review
Post-influenza bacterial pneumonia is a major cause of morbidity and mortality associated with both seasonal and pandemic influenza virus illness. However, despite much interest in influenza and its complications in recent years, good clinical trial data to inform clinicians in their assessment of treatment options are scant. This paucity of evidence needs to be addressed urgently in order to improve guidance on the management of post-influenza bacterial pneumonia. The objectives of the current article are to evaluate the emergence of the 2009 H1N1 influenza pandemic and use this information as background for an in-depth review of the epidemiology of bacterial pneumonia complicating influenza, to review the bacterial pathogens most likely to be associated with post-influenza bacterial pneumonia, and to discuss treatment considerations in these patients. When determining optimal management approaches, both antiviral and antibacterial agents should be considered, and their selection should be based upon a clear understanding of how their mechanisms of action intervene in the pathogenesis of post-influenza acute bacterial pneumonia.
Topics: Age Factors; Animals; Anti-Bacterial Agents; Antiviral Agents; Humans; Influenza, Human; Pandemics; Pneumonia, Bacterial; Practice Guidelines as Topic; Risk Factors
PubMed: 22387143
DOI: 10.1016/j.ijid.2012.01.003 -
Deutsches Arzteblatt International Mar 2015
Topics: Cross Infection; Female; Hospital Mortality; Hospitalization; Humans; Male; Pneumonia, Bacterial
PubMed: 25837744
DOI: 10.3238/arztebl.2015.0174 -
Islets Dec 2024Previous observational studies have established the high prevalence of bacterial pneumonia in diabetic patients, which in turn leads to increased mortality. However, the...
BACKGROUND
Previous observational studies have established the high prevalence of bacterial pneumonia in diabetic patients, which in turn leads to increased mortality. However, the presence of a causal connection between bacterial pneumonia and diabetes remains unobserved.
METHODS
We chose genome-wide significant (Ρ < 1 × 10 and Ρ < 1 × 10) and independent (r < 0.001) single-nucleotide polymorphisms (SNPs) as instrumental variables (IVs) to proceed a bidirectional two-sample MR study. The extracted SNPs explored the relationship between bacterial pneumonia and diabetes by Inverse variance weighted (IVW), MR-Egger, and weighted median methods. In addition, we conducted the Heterogeneity test, the Pleiotropy test, MR-presso and the Leave-one-out (LOO) sensitivity test to validate the reliability of results.
RESULTS
In an MR study with bacterial pneumonia as an exposure factor, four different types of diabetes as outcome. It was observed that bacterial pneumonia increases the incidence of GDM (OR = 1.150 (1.027-1.274, = 0.011) and T1DM (OR = 1.277 (1.024-1.531), = 0.016). In the reverse MR analysis, it was observed that GDM (OR = 1.112 (1.023-1.201, = 0.009) is associated with an elevated risk of bacterial pneumonia. However, no significant association was observed bacterial pneumonia with T1DM and other types of diabetes ( > 0.05).
CONCLUSION
This study utilizing MR methodology yields robust evidence supporting a bidirectional causal association between bacterial pneumonia and GDM. Furthermore, our findings suggest a plausible causal link between bacterial pneumonia and T1DM.
Topics: Humans; Diabetes Mellitus, Type 1; Mendelian Randomization Analysis; Reproducibility of Results; Pneumonia, Bacterial; Causality
PubMed: 38095344
DOI: 10.1080/19382014.2023.2291885 -
The Lancet. Respiratory Medicine Sep 2013Pneumonia is a widespread and common infectious lung disease that causes inflammation, which can lead to reduced oxygenation, shortness of breath, and death. An... (Review)
Review
Pneumonia is a widespread and common infectious lung disease that causes inflammation, which can lead to reduced oxygenation, shortness of breath, and death. An estimated nearly 1.2 million children younger than 5 years died in 2011 from pneumonia. Most of these deaths occured in developing countries where access to care is limited and interventions that have improved care in developed countries are scarce. Despite substantial increases in our understanding of the clinical syndrome of pneumonia and its aetiologies, its accurate diagnosis is challenging when clinical indicators are relied on, and improves only modestly with addition of laboratory, microbiological, or radiographical tests. Prevention programmes and treatment guidelines have led to impressive reductions in disease, but children remain at risk of misdiagnosis and inadequate treatment. Research to address challenges in the aetiological diagnosis of pneumonia and widespread implementation of treatment interventions beyond vaccines and antibiotics are necessary to mitigate the burden of pneumonia and improve child survival.
Topics: Anti-Bacterial Agents; Child, Preschool; Developing Countries; Drug Therapy, Combination; Humans; Infant; Infant, Newborn; Pneumonia, Bacterial; Pneumonia, Viral; Practice Guidelines as Topic; Respiratory System Agents
PubMed: 24461618
DOI: 10.1016/S2213-2600(13)70075-4