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Age‐related risk factors for bacterial aetiology in community‐acquired pneumonia
Author(s) -
SahuquilloArce José M.,
Menéndez Rosario,
Méndez Raúl,
AmaraElori Isabel,
Zalacain Rafael,
Capelastegui Alberto,
Aspa Javier,
Borderías Luis,
MartínVillasclaras Juan J.,
Bello Salvador,
Alfageme Inmaculada,
de Castro Felipe Rodriguez,
Rello Jordi,
Molinos Luis,
RuizManzano Juan,
Torres Antoni
Publication year - 2016
Publication title -
respirology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.857
H-Index - 85
eISSN - 1440-1843
pISSN - 1323-7799
DOI - 10.1111/resp.12851
Subject(s) - medicine , etiology , pneumonia , community acquired pneumonia , intensive care medicine , environmental health
ABSTRACT Background and objective The objective of this study was to evaluate the effect of age and comorbidities, smoking and alcohol use on microorganisms in patients with community‐acquired pneumonia ( CAP ). Methods A prospective multicentre study was performed with 4304 patients. We compared microbiological results, bacterial aetiology, smoking, alcohol abuse and comorbidities in three age groups: young adults (<45 years), adults (45–64 years) and seniors (>65 years). Results Bacterial aetiology was identified in 1522 (35.4%) patients. In seniors, liver disease was independently associated with Gram‐negative bacteria ( Haemophilus influenzae and Enterobacteriaceae ), COPD with Pseudomonas aeruginosa ( OR = 2.69 (1.46–4.97)) and Staphylococcus aureus ( OR = 2.8 (1.24–6.3)) and neurological diseases with S. aureus . In adults, diabetes mellitus ( DM ) was a risk factor for Streptococcus pneumoniae and S. aureus , and COPD for H. influenzae ( OR = 3.39 (1.06–10.83)). In young adults, DM was associated with S. aureus . Smoking was a risk factor for Legionella pneumophila regardless of age. Alcohol intake was associated with mixed aetiology and Coxiella burnetii in seniors, and with S. pneumoniae in young adults. Conclusion It should be considered that the bacterial aetiology may differ according to the patient's age, comorbidities, smoking and alcohol abuse. More extensive microbiological testing is warranted in those with risk factors for infrequent microorganisms.