ArticleBMC infectious diseases2018
Impact of microbial Aetiology on mortality in severe community-acquired pneumonia.
Article in BMC infectious diseases, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 2 of them syntheses that pooled it.
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Who cites it
36 citing papers in PubMed, 2 syntheses or guidelines pooled it, 73 citations in OpenAlex.
- Efficacy of traditional Chinese medicine in treating severe pneumonia: A meta-analysis and systematic review.Medicine · 2026Pooled it
- Association between Glucocorticoids and Mortality in Patients with Severe Pneumonia: A Systematic Review and Meta-Analysis Based on Randomized Controlled Trials.Computational and mathematical methods in medicine · 2022Pooled it
- Severe community-acquired pneumonia: current concepts and controversies.Intensive care medicine · 2026Review
- Assessment of T-cell subsets and procalcitonin for diagnosing and stratifying severity in community acquired pneumonia.Scientific reports · 2025Article
- Severe Community-Acquired Pneumonia: Impact of HIV on Clinical Presentation, Microbiological and Laboratory Findings, and Outcome.Journal of intensive care medicine · 2025Observational
- Analysis of co-infection in severe and critical patients with influenza A (H1N1) pneumonia using metagenomic next-generation sequencing on bronchoalveolar lavage samples.Frontiers in cellular and infection microbiology · 2025Article
- Aetiological agents of pneumonia among HIV and non-HIV infected children in Ghana: A case-control study.PloS one · 2024Article
- Mathematical Modeling of the Lethal Synergism of Coinfecting Pathogens in Respiratory Viral Infections: A Review.Microorganisms · 2023Review
- The impact of the secondary infections in ICU patients affected by COVID-19 during three different phases of the SARS-CoV-2 pandemic.Clinical and experimental medicine · 2023Article
- Metagenomic next‑generation sequencing of BALF for the clinical diagnosis of severe community‑acquired pneumonia in immunocompromised patients: A single‑center study.Experimental and therapeutic medicine · 2023Article
- Prepandemic viral community-acquired pneumonia: Diagnostic sensitivity and specificity of nasopharyngeal swabs and performance of clinical severity scores.Journal of medical virology · 2023Observational
- Specialized pro-resolving lipid mediators regulate inflammatory macrophages: A paradigm shift from antibiotics to immunotherapy for mitigating COVID-19 pandemic.Frontiers in molecular biosciences · 2023Review
- Article
- Aetiology of severe community acquired pneumonia in adults identified by combined detection methods: a multi-centre prospective study in China.Emerging microbes & infections · 2022Article
- Bacterial Co-Infection in Patients with COVID-19 Hospitalized (ICU and Not ICU): Review and Meta-Analysis.Antibiotics (Basel, Switzerland) · 2022Review
- Bacterial Resistance to Antibiotics and Clonal Spread in COVID-19-Positive Patients on a Tertiary Hospital Intensive Care Unit, Czech Republic.Antibiotics (Basel, Switzerland) · 2022Article
- Neutrophil-lymphocyte ratio as a predictor of adverse outcome in patients with community-acquired pneumonia: A systematic review.Health science reports · 2022Review
- Viral Load as a Factor Affecting the Fatality of Patients Suffering from Severe Fever with Thrombocytopenia Syndrome.Viruses · 2022Article
- Diagnostic stewardship aiming at expectorated or induced sputum promotes microbial diagnosis in community-acquired pneumonia.BMC infectious diseases · 2022Article
- Evaluation of bacterial agents isolated from endotracheal aspirate cultures of Covid-19 general intensive care patients and their antibiotic resistance profiles compared to pre-pandemic conditions.Microbial pathogenesis · 2022Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
backgroundThe impact of different classes of microbial pathogens on mortality in severe community-acquired pneumonia is not well elucidated. Previous studies have shown significant variation in the incidence of viral, bacterial and mixed infections, with conflicting risk associations for mortality. We aimed to determine the risk association of microbial aetiologies with hospital mortality in severe CAP, utilising a diagnostic strategy incorporating molecular testing. Our primary hypothesis was that respiratory viruses were important causative pathogens in severe CAP and was associated with increased mortality when present with bacterial pathogens in mixed viral-bacterial co-infections.
methodsA retrospective cohort study from January 2014 to July 2015 was conducted in a tertiary hospital medical intensive care unit in eastern Singapore, which has a tropical climate. All patients diagnosed with severe community-acquired pneumonia were included.
resultsA total of 117 patients were in the study. Microbial pathogens were identified in 84 (71.8%) patients. Mixed viral-bacterial co-infections occurred in 18 (15.4%) of patients. Isolated viral infections were present in 32 patients (27.4%); isolated bacterial infections were detected in 34 patients (29.1%). Hospital mortality occurred in 16 (13.7%) patients. The most common bacteria isolated was Streptococcus pneumoniae and the most common virus isolated was Influenza A. Univariate and multivariate logistic regression showed that serum procalcitonin, APACHE II severity score and mixed viral-bacterial infection were associated with increased risk of hospital mortality. Mixed viral-bacterial co-infections were associated with an adjusted odds ratio of 13.99 (95% CI 1.30-151.05, p = 0.03) for hospital mortality.
conclusionsRespiratory viruses are common organisms isolated in severe community-acquired pneumonia. Mixed viral-bacterial infections may be associated with an increased risk of mortality.
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