Evidence map›Paper›PMID 29447989›Full record

ArticleClinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases2018

Aetiology of lower respiratory tract infection in adults in primary care: a prospective study in 11 European countries.

M Ieven, S Coenen, K Loens, C Lammens, F Coenjaerts, A Vanderstraeten, B Henriques-Normark, D Crook, K Huygen, C C Butler and 7 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 85 papers.

0numbers the graph read from it
0cells of the map it votes in
85citing papers in PubMed
13.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

85 citing papers in PubMed, 167 citations in OpenAlex.

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  3. Clinical presentation, microbiological aetiology and disease course in patients with flu-like illness: a post hoc analysis of randomised controlled trial data.The British journal of general practice : the journal of the Royal College of General Practitioners · 2022
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  6. Clinical relevance of bacterial resistance in lower respiratory tract infection in primary care: secondary analysis of a multicentre European trial.The British journal of general practice : the journal of the Royal College of General Practitioners · 2018
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25 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors at 9 institutions in 4 countries.

M IevenDepartment of Medical Microbiology, Antwerp University Hospital, Antwerp, Belgium; Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium. Electronic address: greet.ieven@uza.be.
S CoenenVaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium; Department of Primary and Interdisciplinary Care (ELIZA), University of Antwerp, Antwerp, Belgium; Department of Epidemiology and Social Medicine (ESOC), University of Antwerp, Antwerp, Belgium.
K LoensDepartment of Medical Microbiology, Antwerp University Hospital, Antwerp, Belgium; Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium.
C LammensDepartment of Medical Microbiology, Antwerp University Hospital, Antwerp, Belgium; Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium.
F CoenjaertsDepartment of Medical Microbiology, University Medical Centre Utrecht, Utrecht, The Netherlands.
A VanderstraetenDepartment of Medical Microbiology, Antwerp University Hospital, Antwerp, Belgium; Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium.
B Henriques-NormarkDepartment of Microbiology, Tumour and Cell Biology, Karolinska Institute, Stockholm, Sweden; Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden.
D CrookNuffield Department of Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
K HuygenDepartment of Communicable and Infectious Diseases, Scientific Institute of Public Health, Brussels, Belgium.
C C ButlerNuffield Department of Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
T J M VerheijJulius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands.
P LittleUniversity of Southampton, Southampton, UK.
K ZlatevaLeiden University Medical Centre, Leiden, The Netherlands.
A van LoonDepartment of Medical Microbiology, University Medical Centre Utrecht, Utrecht, The Netherlands.
E C J ClaasLeiden University Medical Centre, Leiden, The Netherlands.
H GoossensDepartment of Medical Microbiology, Antwerp University Hospital, Antwerp, Belgium; Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium.
GRACE consortium
University of Antwerp · BEUniversity Medical Center Utrecht · NLLeiden University Medical Center · NLAntwerp University Hospital · BEInstitut Scientifique de Santé Publique · BEKarolinska University Hospital · SENuffield Health · GBUniversity of Oxford · GBUniversity of Southampton · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo describe the role of bacteria (including bacterial resistance), viruses (including those recently described) and mixed bacterial-viral infections in adults presenting to primary care with lower respiratory tract infection (LRTI).

methodsIn all, 3104 adults with LRTI were enrolled, of whom 141 (4.5%) had community-acquired pneumonia (CAP), and 2985 matched controls in a prospective study in 16 primary care networks in Europe, and followed patients up at 28-35 days. We detected Streptococcus pneumoniae and Haemophilus influenzae and assessed susceptibility, atypical bacteria and viruses.

resultsA potential pathogen was detected in 1844 (59%) (in 350 (11%) bacterial pathogens only, in 1190 (38%) viral pathogens only, and in 304 (10%) both bacterial and viral pathogens). The most common bacterial pathogens isolated were S. pneumoniae (5.5% overall, 9.2% in CAP patients) and H. influenzae (5.4% overall, 14.2% in CAP patients). Less than 1% of S. pneumoniae were highly resistant to penicillin and 12.6% of H. influenzae were β-lactamase positive. The most common viral pathogens detected were human rhinovirus (20.1%), influenza viruses (9.9%), and human coronavirus (7.4%). Influenza virus, human parainfluenza viruses and human respiratory syncytial virus as well as human rhinovirus, human coronavirus and human metapneumovirus were detected significantly more frequently in LRTI patients than in controls.

conclusionsA bacterial pathogen is identified in approximately one in five adult patients with LRTI in primary care, and a viral pathogen in just under half, with mixed infections in one in ten. Penicillin-resistant pneumococci and β-lactamase-producing H. influenzae are uncommon. These new findings support a restrictive approach to antibiotic prescribing for LRTI and the use of first-line, narrow-spectrum agents in primary care.

Indexed as

AdolescentAdultAgedAged, 80 and overBacteriaCommunity-Acquired InfectionsEuropeFemaleHumansMaleMiddle AgedPneumoniaProspective StudiesVirusesYoung AdultAetiologyLower respiratory tract infectionRespiratory

Identifiers

PMID29447989
PMCPMC7129248
OpenAlexW2787636909

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.