Investigation of etiology of community-acquired pneumonia in hospitalized patients in a tertiary hospital of Sao Paulo City, Brazil

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorJOELSONS, Daniel
dc.contributor.authorALENCAR, Cecilia Salete
dc.contributor.authorPINHO, Joao Renato Rebello
dc.contributor.authorHO, Yeh-Li
dc.date.accessioned2024-02-15T14:55:27Z
dc.date.available2024-02-15T14:55:27Z
dc.date.issued2023
dc.description.abstractBackground: Community-Acquired Pneumonia (CAP) is the primary cause of hospitalization in the United States and the third leading cause of death in Brazil. The gold standard for diagnosing the etiology of CAP includes blood culture, Gram-stained sputum, and sputum culture. However, these methods have low sensitivity. No studies investigating the etiology of CAP have been conducted in Brazil in the last 20-years, and the empirical choice of antimicrobials is mainly based on the IDSA guidelines. This is the first national study with this aim, and as a result, there's potential for the Brazilian consensus to be impacted and possibly modify its guidelines rather than adhering strictly to the IDSA's recommendations. Methods: The aim of this study is to identify the main microorganisms implicated in CAP by employing a multiplex Polymerase Chain Reaction (mPCR) at the foremost public hospital in Brazil. All patients who were admitted to the emergency department and diagnosed with severe CAP underwent an mPCR panel using nasopharyngeal and oropharyngeal swabs, with the aim of detecting 13 bacterial and 21 viral pathogens. Results: A total of 169 patients were enrolled in the study. The mPCR panel identified an etiological agent in 61.5% of patients, with viruses being the most common (42.01%), led by Rhinovirus, followed by Influenza and Coronavirus (non-SARS-CoV-2). Bacterial agents were identified in 34.91% of patients, with S. pneumoniae being the most common, followed by H. influenzae, M. catarrhalis, and S. aureus. Additionally, we found that the prescription for 92.3% of patients could be modified, with most changes involving de-escalation of antibiotics and antiviral therapy. Conclusion: Our study revealed different etiological causes of CAP than those suggested by the Brazilian guidelines. Using molecular diagnostic tests, we were able to optimize treatment by using fewer antibiotics. (c) 2023 Sociedade Brasileira de Infectologia.eng
dc.description.indexMEDLINE
dc.description.indexPubMed
dc.description.indexWoS
dc.description.indexScopus
dc.identifier.citationBRAZILIAN JOURNAL OF INFECTIOUS DISEASES, v.27, n.6, article ID 103690, 6p, 2023
dc.identifier.doi10.1016/j.bjid.2023.103690
dc.identifier.eissn1678-4391
dc.identifier.issn1413-8670
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/58164
dc.language.isoeng
dc.publisherELSEVIER BRAZILeng
dc.relation.ispartofBrazilian Journal of Infectious Diseases
dc.rightsopenAccesseng
dc.rights.holderCopyright ELSEVIER BRAZILeng
dc.subjectCommunity-acquired pneumoniaeng
dc.subjectSevere pneumoniaeng
dc.subjectBrazileng
dc.subjectEtiologyeng
dc.subjectMultiplex polymerase chain reactioneng
dc.subject.otherinfectious-diseases-societyeng
dc.subject.otherthoracic-societyeng
dc.subject.otherblood cultureseng
dc.subject.otheradult patientseng
dc.subject.othermanagementeng
dc.subject.otherguidelineseng
dc.subject.otherdiagnosiseng
dc.subject.othercovid-19eng
dc.subject.othersputumeng
dc.subject.wosInfectious Diseaseseng
dc.titleInvestigation of etiology of community-acquired pneumonia in hospitalized patients in a tertiary hospital of Sao Paulo City, Brazileng
dc.typearticleeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.citation.scopus0
hcfmusp.contributor.author-fmusphcDANIEL JOELSONS
hcfmusp.contributor.author-fmusphcCECILIA SALETE ALENCAR DA SILVA
hcfmusp.contributor.author-fmusphcJOAO RENATO REBELLO PINHO
hcfmusp.contributor.author-fmusphcHO YEH LI
hcfmusp.description.articlenumber103690
hcfmusp.description.issue6
hcfmusp.description.volume27
hcfmusp.origemWOS
hcfmusp.origem.pubmed37972649
hcfmusp.origem.scopus2-s2.0-85178055227
hcfmusp.origem.wosWOS:001125350100001
hcfmusp.publisher.cityRIO DE JANEIROeng
hcfmusp.publisher.countryBRAZILeng
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hcfmusp.scopus.lastupdate2024-05-17
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