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Severe community-acquired Enterobacter pneumonia: a plea for greater awareness of the concept of health-care-associated pneumonia.

Abstract : ABSTRACT: BACKGROUND: Patients with Enterobacter community-acquired pneumonia (EnCAP) were admitted to our intensive care unit (ICU). Our primary aim was to describe them as few data are available on EnCAP. A comparison with CAP due to common and typical bacteria was performed. METHODS: Baseline clinical, biological and radiographic characteristics, criteria for health-care-associated pneumonia (HCAP) were compared between each case of EnCAP and thirty age-matched typical CAP cases. A univariate and multivariate logistic regression analysis was performed to determine factors independently associated with ENCAP. Their outcome was also compared. RESULTS: In comparison with CAP due to common bacteria, a lower leukocytosis and constant HCAP criteria were associated with EnCAP. Empiric antibiotic therapy was less effective in EnCAP (20%) than in typical CAP (97%) (p<0.01). A delay in the initiation of appropriate antibiotic therapy (3.3+/-1.6 vs. 1.2+/-0.6 days; p<0.01) and an increase in duration of mechanical ventilation (8.4+/-5.2 vs. 4.0+/-4.3 days; p=0.01) and ICU stay were observed in EnCAP patients. CONCLUSIONS: EnCAP is a severe infection which is more consistent with HCAP than with typical CAP. This retrospectively suggests that the application of HCAP guidelines should have improved EnCAP management.
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Submitted on : Saturday, June 18, 2011 - 4:03:06 PM
Last modification on : Friday, October 23, 2020 - 4:35:02 PM
Long-term archiving on: : Sunday, December 4, 2016 - 6:23:30 PM

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Alexandre Boyer, Brice Amadeo, Frédéric Vargas, Ma Yu, Sylvie Maurice-Tison, et al.. Severe community-acquired Enterobacter pneumonia: a plea for greater awareness of the concept of health-care-associated pneumonia.. BMC Infectious Diseases, BioMed Central, 2011, 11 (1), pp.120. ⟨10.1186/1471-2334-11-120⟩. ⟨inserm-00601548⟩

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