Pseudomonas aeruginosa is a common cause of community-acquired and nosocomial-acquired pneumonia. The development of resistance of P. aeruginosa to antibiotics is increasing globally due to the ...overuse of antibiotics. This article examines, retrospectively, the antibiotic resistance in patients with community-acquired versus nosocomial-acquired pneumonia caused by P. aeruginosa or multidrug-resistant (MDR) P. aeruginosa.
Data from patients with community-acquired and nosocomial-acquired pneumonia caused by P. aeruginosa and MDR P. aeruginosa were collected from the hospital charts at the HELIOS Clinic, Witten/Herdecke University, Wuppertal, Germany, between January 2004 and August 2014. An antibiogram was created from all study patients with community-acquired and nosocomial-acquired pneumonia caused by P. aeruginosa or MDR P. aeruginosa.
A total of 168 patients with mean age 68.1 ± 12.8 (113 67.3% males and 55 32.7% females) were identified; 91 (54.2%) had community-acquired and 77 (45.8%) had nosocomial-acquired pneumonia caused by P. aeruginosa. Patients with community-acquired versus nosocomial-acquired pneumonia had a mean age of 66.4 ± 13.8 vs. 70.1 ± 11.4 years 59 vs. 54 (64.8% vs. 70.1%) males and 32 vs. 23 (35.2% vs. 29.9%) females. They included 41 (24.4%) patients with pneumonia due to MDR P. aeruginosa: 27 (65.9%) community-acquired and 14 (34.1%) nosocomial-acquired cases. P. aeruginosa and MDR P. aeruginosa showed a very high resistance to fosfomycin (community-acquired vs. nosocomial-acquired) (81.0% vs. 84.2%; 0 vs. 85.7%). A similar resistance pattern was seen with ciprofloxacin (35.2% vs. 24.0%; 70.4% vs. 61.5%), levofloxacin (34.6% vs. 24.5%; 66.7% vs. 64.3%), ceftazidime (15.9% vs. 30.9; 33.3% vs. 61.5%), piperacillin (24.2% vs. 29.9%; 44.4% vs. 57.1%), imipenem (28.6% vs. 27.3%; 55.6% vs. 50.0%), piperacillin and tazobactam (23.1% vs. 28.6%; 44.4% vs. 50.0%), tobramycin (28.0% vs. 17.2%; 52.0% vs. 27.3%), gentamicin (26.4% vs. 18.2%; 44.4% vs. 21.4%), and meropenem (20.2% vs. 20.3%; 42.3% vs. 50.0%). An elevated resistance of P. aeruginosa and MDR P. aeruginosa was found for cefepime (11.1% vs. 23.3%; 25.9% vs. 50.0%), and amikacin (10.2% vs. 9.1%; 27.3% vs. 9.1%). Neither pathogen was resistant to colistin (P = 0.574).
While P. aeruginosa and MDR P. aeruginosa were resistant to a variety of commonly used antibiotics, they were not resistant to colistin in the few isolates recovered from patients with pneumonia.
Background
A deficiency in alpha-1 antitrypsin (A1AD) leads to increased activity of proteolytic enzymes. The consequence is a damage of airways and alveoli and, ultimately, the development of ...emphysema and chronic obstructive pulmonary disease (COPD).
Purpose
Gender-specific differences in terms of comorbidities are still unclear due to the rarity of this genetic autosomal recessive disease.
Patients and methods
This retrospective observational study was conducted from January 1, 2005, to November 30, 2022, in the Department of Pneumology, HELIOS University-Clinic Wuppertal, University of Witten/Herdecke, Germany.
Results
Eleven patients with COPD due to A1AD could be included into the study (6 males, 54.5%; 95%
CI
23.4–83.3%) with a mean age of 53.9 ± 11.6 years. The male study participants were of normal weight body mass index 24.17 ± 4.67, while the females were obese 31.2 ± 4.87 (
p
= 0.054). More women were smokers (60%,
p
= 0.567). Furthermore, all of the women had panlobular emphysema (100%,
p
= 0.455). All subjects suffered from COPD, with most male subjects in severe advanced stages (50%,
p
= 0.545). No case of liver involvement was observed in this study.
Conclusion
The findings of this study showed no statistically relevant gender-specific differences in comorbidities of patients with COPD due to A1AD.
Staphylococci can cause wound infections and community- and nosocomial-acquired pneumonia, among a range of illnesses. Staphylococcus aureus and methicillin-resistant S. aureus (MRSA) have been ...rapidly increasing as a cause of infections worldwide in recent decades. Numerous reports indicate that S. aureus and MRSA are becoming resistant to many antibiotics, which makes them very dangerous. Therefore, this study retrospectively investigated the resistance to antimicrobial agents in all hospitalized patients suffering from community- or nosocomial-acquired pneumonia due to S. aureus and MRSA.
Information from the study groups suffering from either community- or nosocomial-acquired pneumonia caused by S. aureus or MRSA was gathered by searching records from 2004 to 2014 at the HELIOS Clinic Wuppertal, Witten/Herdecke University, Germany. The findings of antibiotic resistance were analyzed after the evaluation of susceptibility testing for S. aureus and MRSA.
Total of 147 patients (63.9%, 95% CI 57.5%-69.8%), mean age 67.9 ± 18.5 years, with pneumonia triggered by S. aureus, and 83 patients (36.1%, 95% CI 30.2%-42.5%), mean age 72.3 ± 13.8 years, with pneumonia due to MRSA. S. aureus and MRSA developed no resistance to vancomycin (P = 0.019 vs. < 0.0001, respectively) or linezolid (P = 0.342 vs. < 0.0001, respectively). MRSA (95.3%) and S. aureus (56.3%) showed a high resistance to penicillin. MRSA (87.7%) was also found to have a high antibiotic resistance against ß-lactam antibiotics, compared to S. aureus (9.6%). Furthermore, MRSA compared to S. aureus, respectively, had increased antibiotic resistance to ciprofloxacin (90.1% vs. 17.0%), cefazolin (89.7% vs. 10.2%), cefuroxime (89.0% vs. 9.1%), levofloxacin (88.2% vs. 18.4%), clindamycin (78.0% vs. 14.7%), and erythromycin (76.5% vs. 20.8%).
No development of resistance was found to vancomycin and linezolid in patients with pneumonia caused by S. aureus and MRSA.
Depression, anxiety, and panic disorders are common in chronic obstructive pulmonary disease (COPD) and important for the further course of the disease, as they are associated with increased hospital ...admissions, longer hospital stays, more frequent doctor visits, and a worsened quality of life. There are also indications of premature death in affected patients. Therefore, knowledge of the risk factors for depression in COPD patients is all the more important for early detection and treatment. Hence, Embase, the Cochrane Library, and the MEDLINE/PubMed databases were analyzed for studies on these risk factors. The main factors are as follows: female gender; older/younger age; living alone; higher education; unemployment; retirement; a low quality of life; social isolation; high/low income; high cigarette and alcohol consumption; poor physical fitness; severe respiratory symptoms; high/low body mass index, airway obstruction, dyspnea, exercise capacity index scores; and comorbidities (mainly heart disease, cancer, diabetes, and stroke). This article presents the analyzed medical literature.
•Risk factors.•Causes.•Depression.•Anxiety.•COPD.•Comorbidities.
Sleep apnea, a prevalent global health issue, is characterized by repeated interruptions in breathing during sleep. This systematic review aggregates global data to outline a comprehensive analysis ...of its associated risk factors.
The systematic review underscores the global prevalence of sleep apnea and the universal importance of its early detection and management by delineating key risk factors contributing to its development.
We conducted a thorough systematic review of international medical databases up to July 31, 2023, including PubMed, Medline, and Cochrane Library, to ensure a wide-ranging collection of data reflective of various populations.
The systematic review identifies several risk factors such as obesity, age, gender, neck circumference, family history, smoking, alcohol use, underlying medical conditions, and nasal congestion, highlighting their prevalence across diverse demographics globally.
Emphasizing lifestyle modifications and proactive interventions, our findings advocate for global health strategies to mitigate the risk of sleep apnea and enhance sleep health worldwide.
Der 54-jährige Heinz D. stellt sich mit wiederholt von seiner Ehefrau gemessenen erhöhten Blutdruckwerten vor. Bei näherem Nachfragen berichtet er, dass er in letzter Zeit auch zunehmend müde sei und ...manchmal auch ungewollt spontan einschlafe.
PDF
