ArticleJournal of the American Medical Directors Association2013
Role of atypical pathogens in nursing home-acquired pneumonia.
Article in Journal of the American Medical Directors Association, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.
- Predictors of mortality for nursing home-acquired pneumonia: a systematic review.BioMed research international · 2015Pooled it
- Modeling of nursing care-associated airborne transmission of SARS-CoV-2 in a real-world hospital setting.GeroScience · 2022Article
- The effect of oral care intervention on pneumonia hospitalization, Staphylococcus aureus distribution, and salivary bacterial concentration in Taiwan nursing home residents: a pilot study.BMC infectious diseases · 2020Article
- Nursing Home-Associated Pneumonia, Part II: Etiology and Treatment.Journal of the American Medical Directors Association · 2020Review
- Optimizing treatment of respiratory tract infections in nursing homes: Nurse-initiated polymerase chain reaction testing.American journal of infection control · 2019Article
- Role of Atypical Bacteria in Hospitalized Patients With Nursing Home-Acquired Pneumonia.Hospital pharmacy · 2016Article
- Review
- Facility characteristics as independent prognostic factors of nursing home-acquired pneumonia.The Korean journal of internal medicine · 2016Article
- Mycoplasma pneumoniae outbreak in a long-term care facility--Nebraska, 2014.MMWR. Morbidity and mortality weekly report · 2015Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesNo international consensus has been reached on the empirical use of antibiotics with atypical coverage in nursing home-acquired pneumonia (NHAP). Aspiration is an important cause of NHAP, but it may not require antimicrobial treatment. This study aimed to investigate the prevalence and clinical characteristics of AP infections and review the need for empirical antibiotics with atypical coverage in NHAP.
designA prospective cohort study.
settingFour nursing homes with a total number of 772 residents.
participantsPatients were aged ≥ 65 years, hospitalized for NHAP, which was defined as the presence of respiratory symptoms and abnormal chest radiographs, from April 2006 to March 2007. MEASUREMENTS: Demographics, clinical parameters, and investigation results were recorded. Microbial investigations comprised sputum routine and mycobacterial cultures, blood and urine cultures, serology, and nasopharyngeal aspirate viral culture and polymerase chain reaction tests. Suspected aspiration pneumonitis was arbitrarily defined as NHAP without pathogens identified.
resultsAfter excluding lone bacteriuria, 108 episodes of NHAP in 94 patients were included. Twelve APs were detected in 11 patients. There was no clinical feature to distinguish between infections caused by APs and other pathogens. The commonest APs were Mycoplasma pneumoniae (6) and Chlamydophila pneumoniae (3). No Legionella pneumophila was detected by urinary antigen test. None of the patients with AP infection received antibiotics indicated for AP infections. However, AP infections did not result in mortality. No pathogen was isolated in 31.5% of cases. Patients without pathogens isolated were less likely to have purulent sputum and crepitations on chest auscultation, compared with those with pneumonia caused by identified pathogens.
conclusionsAtypical pathogens (APs) were not associated with mortality even in cases where the prescribed antibiotics did not cover APs. NHAP may not necessarily be treated with empirical antibiotics covering APs.
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