Etiology of severe community - acquired pneumonia in adults: results of the first Russian multicenter study


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Abstract

Aim: to study the etiology of severe community - acquired pneumonia (SCAP) in adults in Russian Federation. SCAP is distinguished by high mortality and socio - economic burden. Both etiology and antimicrobial resistance are essential for appropriate antibiotic choice. Materials and methods. A prospective cohort study recruited adults with confirmed diagnosis of SCAP admitted to multi - word hospitals of six Russian cities in 2014-2018. Etiology was confirmed by routine culture of blood, respiratory (sputum, endotracheal aspirate or bronchoalveolar lavage) and when appropriate, autopsy samples, urinary antigen tests (L. pneumophila serogroup 1, S. pneumoniae); real - time PCR for identification of “atypical” bacterial pathogens (M. pneumoniae, C. pneumoniae, L. pneumophila) and respiratory viruses (influenza viruses A and B, parainfluenza, human metapneumovirus, etc.) was applied. Results. Altogether 109 patients (60.6% male; mean age 50.8±18.0 years old) with SCAP were enrolled. Etiological agent was identified in 65.1% of patients, S. pneumoniae, rhinovirus, S. aureus and K. pneumoniae were the most commonly isolated pathogens (found in 43.7, 15.5, 14.1 and 11.3% of patients with positive results of microbiological investigations, respectively). Bacteriemia was seen in 14.6% of patients and most commonly associated with S. pneumoniae. Co - infection with 2 or more causative agents was revealed in 36.6% of cases. Combination of bacterial pathogens (mainly S. pneumoniae with S. aureus or/and Enterobacterales) prevailed - 57.7% of cases; associations of bacteria and viruses were identified in 38.5% of patients, different viruses - in one case. Conclusion. S. pneumoniae was the most common pathogen in adults with SCAP. A high rate of respiratory viruses (mainly rhinovirus and influenza viruses) identification both as mixt infection with bacteria and mono - infection should be taken into account.

About the authors

I A Zakharenkov

Bryansk city hospital №1; The Interregional Association for Clinical Microbiology and Antimicrobial Chemotherapy

Email: Ivan.Zaharenkov@antibiotic.ru
врач-анестезиолог-реаниматолог ГАУЗ «БГБ №1», координатор исследований Межрегиональной ассоциации по клинической микробиологии и антимикробной химиотерапии; ORCID: 0000-0001-6577-4849 Bryansk, Russia

S A Rachina

RUDN University

д.м.н., проф. каф. внутренних болезней с курсом кардиологии и функциональной диагностики им. акад. В.С. Моисеева ФГАОУ ВО «РУДН», ORCID: 0000-0002-3329-7846 Moscow, Russia

N N Dekhnich

Smolensk State Medical University

к.м.н., доцент каф. факультетской терапии ФГБОУ ВО «Смоленский государственный медицинский университет» Минздрава России, ORCID: 0000-0002-6144-3919 Smolensk, Russia

R S Kozlov

The Interregional Association for Clinical Microbiology and Antimicrobial Chemotherapy; Smolensk State Medical University

член-корр. РАН, д.м.н., проф., ректор ФГБОУ ВО «Смоленский государственный медицинский университет» Минздрава России, ORCID: 0000-0001-8728-1113 Smolensk, Russia

A I Sinopalnikov

Russian Medical Academy of Postgraduate Education

д.м.н., проф., зав. каф. пульмонологии Российской медицинской академии непрерывного профессионального образования, ORCID: 0000-0002-1990-2042 Moscow, Russia

N V Ivanchik

Smolensk State Medical University

к.м.н., н. с. НИИ антимикробной химиотерапии ФГБОУ ВО «Смоленский государственный медицинский университет» Минздрава России, ORCID: 0000-0002-9392-0732 Smolensk, Russia

S B Yatsyshina

Central Research Institute of Epidemiology

к.б.н, с.н.с., руководитель референс-центра по мониторингу за возбудителями инфекций верхних и нижних дыхательных путей ФБУН «Центральный НИИ эпидемиологии» Роспотребнадзора, ORCID: 0000-0003-4737-941X Moscow, Russia

M A Elkina

Central Research Institute of Epidemiology

м.н.с. ФБУН «Центральный НИИ эпидемиологии» Роспотребнадзора Moscow, Russia

M V Archipenko

Regional Clinical Hospital №1

врач клинико-диагностической лаб. ГБУЗ «НИИ - Краевая клиническая больница №1 им. проф. С.В. Очаповского» Минздрава Краснодарского края Krasnodar, Russia

S A Gordeeva

P.A. Bayandin Murmansk State Regional Clinical Hospital

зав. централизованной многофункциональной лаб. ГОБУЗ «Мурманская областная клиническая больница им. П.А. Баяндина» Murmansk, Russia

M S Lebedeva

State Budgetary Healthcare Institution «Saint-Petersburg clinical scientific and practical center for specialised types of medical care (oncological)»

врач-клинический фармаколог Санкт-Петербургского клинического научно-практического центра специализированных видов медицинской помощи (онкологический) Saint-Petersburg, Russia

U S Portnyagina

M.K. Ammosov Federal North-Eastern University

к.м.н., доцент каф. внутренних болезней и общеврачебной практики (семейной медицины) ФГАОУ ВО «Северо-Восточный федеральный университет им. М.К. Аммосова» Yakutsk, Russia

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