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Article: Fulminant community-acquired Acinetobacter baumannii pneumonia as a distinct clinical syndrome

TitleFulminant community-acquired Acinetobacter baumannii pneumonia as a distinct clinical syndrome
Authors
Issue Date2006
PublisherAmerican College of Chest Physicians. The Journal's web site is located at http://www.chestjournal.org
Citation
Chest, 2006, v. 129 n. 1, p. 102-109 How to Cite?
AbstractStudy objectives: Acinetobacter baumannii (AB) is an important cause of hospital-acquired pneumonia (HAP), and an uncommon but important cause of community-acquired pneumonia (CAP) with high mortality. To better characterize CAP-AB, we compared its clinical features and outcomes with a control group of HAP-AB patients. Methods: This is a retrospective case-control study comparing CAP-AB and HAP-AB patients, which was performed at United Christian Hospital between July 2000 and December 2003. Results: There were 19 cases of CAP-AB and 74 cases of HAP-AB. When compared with the HAP-AB group, the CAP-AB group had more ever-smokers (84.3% vs 55.4%, respectively; p = 0.031), more COPD patients (63.2% vs 29.7%, respectively; p = 0.014), and fewer median days of hospitalization (HAP-AB group, median, 0 days; CAP-AB group, 0 days [range, 0 to 30 days]; p = 0.049) in the previous year. The CAP-AB group had more patients with positive blood culture findings (31.6% vs 0%, respectively; p < 0.001), a higher frequency of ARDS (84.2% vs 17.6%, respectively; p < 0.001), and disseminated intravascular coagulation (DIC) (57.9% vs 8.1%, respectively; p < 0.001). The median survival time was only 8 days in the CAP-AB group, vs 103 days in the HAP-AB group (p = 0.003). Factors associated with the higher mortality in the CAP-AB group included the presence of AB bacteremia (p = 0.040), platelet count of < 120 × 109 cells/L (p = 0.026), pH < 7.35 on presentation (p = 0.047), and the presence of DIC (p = 0.004). Conclusions: CAP-AB appears to be a unique clinical entity with a high incidence of bacteremia, ARDS, DIC, and death, when compared to HAP-AB. Further studies are needed to investigate the mechanism of the fulminant nature of CAP-AB.
Persistent Identifierhttp://hdl.handle.net/10722/78812
ISSN
2015 Impact Factor: 5.94
2015 SCImago Journal Rankings: 3.176
References

 

DC FieldValueLanguage
dc.contributor.authorLeung, WSen_HK
dc.contributor.authorChu, CMen_HK
dc.contributor.authorTsang, KYen_HK
dc.contributor.authorLo, FHen_HK
dc.contributor.authorLo, KFen_HK
dc.contributor.authorHo, PLen_HK
dc.date.accessioned2010-09-06T07:47:06Z-
dc.date.available2010-09-06T07:47:06Z-
dc.date.issued2006en_HK
dc.identifier.citationChest, 2006, v. 129 n. 1, p. 102-109en_HK
dc.identifier.issn0012-3692en_HK
dc.identifier.urihttp://hdl.handle.net/10722/78812-
dc.description.abstractStudy objectives: Acinetobacter baumannii (AB) is an important cause of hospital-acquired pneumonia (HAP), and an uncommon but important cause of community-acquired pneumonia (CAP) with high mortality. To better characterize CAP-AB, we compared its clinical features and outcomes with a control group of HAP-AB patients. Methods: This is a retrospective case-control study comparing CAP-AB and HAP-AB patients, which was performed at United Christian Hospital between July 2000 and December 2003. Results: There were 19 cases of CAP-AB and 74 cases of HAP-AB. When compared with the HAP-AB group, the CAP-AB group had more ever-smokers (84.3% vs 55.4%, respectively; p = 0.031), more COPD patients (63.2% vs 29.7%, respectively; p = 0.014), and fewer median days of hospitalization (HAP-AB group, median, 0 days; CAP-AB group, 0 days [range, 0 to 30 days]; p = 0.049) in the previous year. The CAP-AB group had more patients with positive blood culture findings (31.6% vs 0%, respectively; p < 0.001), a higher frequency of ARDS (84.2% vs 17.6%, respectively; p < 0.001), and disseminated intravascular coagulation (DIC) (57.9% vs 8.1%, respectively; p < 0.001). The median survival time was only 8 days in the CAP-AB group, vs 103 days in the HAP-AB group (p = 0.003). Factors associated with the higher mortality in the CAP-AB group included the presence of AB bacteremia (p = 0.040), platelet count of < 120 × 109 cells/L (p = 0.026), pH < 7.35 on presentation (p = 0.047), and the presence of DIC (p = 0.004). Conclusions: CAP-AB appears to be a unique clinical entity with a high incidence of bacteremia, ARDS, DIC, and death, when compared to HAP-AB. Further studies are needed to investigate the mechanism of the fulminant nature of CAP-AB.en_HK
dc.languageengen_HK
dc.publisherAmerican College of Chest Physicians. The Journal's web site is located at http://www.chestjournal.orgen_HK
dc.relation.ispartofChesten_HK
dc.subject.meshAcinetobacter Infections - drug therapy - epidemiology - microbiologyen_HK
dc.subject.meshAcinetobacter baumannii - isolation & purificationen_HK
dc.subject.meshAcute Diseaseen_HK
dc.subject.meshAgeden_HK
dc.subject.meshAnti-Bacterial Agents - therapeutic useen_HK
dc.subject.meshCommunity-Acquired Infections - drug therapy - epidemiology - microbiologyen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHospitalization - statistics & numerical dataen_HK
dc.subject.meshHumansen_HK
dc.subject.meshIncidenceen_HK
dc.subject.meshMaleen_HK
dc.subject.meshPneumonia, Bacterial - epidemiology - microbiologyen_HK
dc.subject.meshPrognosisen_HK
dc.subject.meshRetrospective Studiesen_HK
dc.subject.meshSeverity of Illness Indexen_HK
dc.subject.meshSurvival Rateen_HK
dc.titleFulminant community-acquired Acinetobacter baumannii pneumonia as a distinct clinical syndromeen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0012-3692&volume=129&spage=102&epage=9&date=2007&atitle=Fulminant+Community-Acquired+Acinetobacter+baumannii+Pneumonia+as+a+Distinct+Clinical+Syndromeen_HK
dc.identifier.emailHo, PL:plho@hkucc.hku.hken_HK
dc.identifier.authorityHo, PL=rp00406en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1378/chest.129.1.102en_HK
dc.identifier.pmid16424419-
dc.identifier.scopuseid_2-s2.0-33144485637en_HK
dc.identifier.hkuros125900en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-33144485637&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume129en_HK
dc.identifier.issue1en_HK
dc.identifier.spage102en_HK
dc.identifier.epage109en_HK
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridLeung, WS=7201504471en_HK
dc.identifier.scopusauthoridChu, CM=7404345558en_HK
dc.identifier.scopusauthoridTsang, KY=12544657100en_HK
dc.identifier.scopusauthoridLo, FH=12545880000en_HK
dc.identifier.scopusauthoridLo, KF=12546082000en_HK
dc.identifier.scopusauthoridHo, PL=7402211363en_HK

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