Clinical Characteristics and Pathogen Analysis of Bronchoalveolar Lavage Fluid in Elderly Patients with Community-acquired Pneumonia

Overview

Journal Immun Inflamm Dis

Specialties Allergy & Immunology
Infectious Diseases

Date 2023 Apr 27

PMID 37102644

Authors

Rui-Nan Guo

Zhang Dan

Zhu Fan

Jing-Jing Jin

Cai-Hong Li

Bai-Yi Liu

Xue-Juan Li

Yan Huang

Affiliations

Soon will be listed here.

Abstract

Objective: To analyze the clinical characteristics and bronchoalveolar lavage fluid pathogens in elderly patients with community-acquired pneumonia (CAP).

Methods: This was a retrospective observational epidemiological study using that elderly cases diagnosed with community-acquired pneumonia receiving treatment at the Affiliated Hospital of North China University of Technology, Tangshan Hongci Hospital and Tangshan Fengnan District Hospital of Traditional Chinese Medicine. A total of 92 cases were divided into two groups according to age. There were 44 patients over 75-year-old and 48 patients between 65 and 74-year-old.

Results: Compared with the elderly 65 to 74-year-old, the elderly over 75-year-old with diabetes are more likely to suffer from CAP (35.42% vs. 63.64%, p = 0.007) and are more likely to have mixed infections (6.25% vs. 22.73%, p = 0.023) or larger lesions (45.83% vs. 68.18%, p = 0.031). Their hospital stays will also be extended (39.58% vs. 63.64%, p = 0.020), and the albumin level (37.51 ± 8.92 vs. 30.93 ± 6.58, p = 0.000), the neutrophils level (9.09(6.26-10.63) vs. 7.18(5.35-9.17),p = 0.026) is significantly lower and the d-dimer (505.42 ± 197.12 vs. 611.82 ± 195.85, p = 0.011), PCT (0.08 ± 0.04 vs. 0.12 ± 0.07, p = 0.001) levels are significantly higher.

Conclusion: The clinical symptoms and signs of elderly CAP patients are not so typical, and the infection is more serious. Attention should therefore be paid to elderly patients. Hypoalbuminemia and high d-dimer can predict the prognosis of patients.

Citing Articles

Clinical characteristics and pathogen analysis of bronchoalveolar lavage fluid in elderly patients with community-acquired pneumonia.

Guo R, Dan Z, Fan Z, Jin J, Li C, Liu B Immun Inflamm Dis. 2023; 11(4):e813.

PMID: 37102644 PMC: 10134761. DOI: 10.1002/iid3.813.

References

Yahav D, Giske C, Gramatniece A, Abodakpi H, Tam V, Leibovici L . New β-Lactam-β-Lactamase Inhibitor Combinations. Clin Microbiol Rev. 2020; 34(1). PMC: 7667665. DOI: 10.1128/CMR.00115-20. View

Sogaard M, Nielsen R, Schonheyder H, Norgaard M, Thomsen R . Nationwide trends in pneumonia hospitalization rates and mortality, Denmark 1997-2011. Respir Med. 2014; 108(8):1214-22. DOI: 10.1016/j.rmed.2014.05.004. View

Matsuo A, Takamori A, Kawaura F, Iwanaga Y, Ono H, Kobayashi-Watanabe N . Risk for prolonged hospitalization and mortality in aged community acquired pneumonia patients: a retrospective study in Japan. J Clin Biochem Nutr. 2020; 67(3):302-306. PMC: 7705084. DOI: 10.3164/jcbn.20-85. View

Mandell L, Wunderink R, Anzueto A, Bartlett J, Campbell G, Dean N . Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis. 2007; 44 Suppl 2:S27-72. PMC: 7107997. DOI: 10.1086/511159. View

Ayerbe-Algaba R, Gil-Marques M, Miro-Canturri A, Parra-Millan R, Pachon-Ibanez M, Jimenez-Mejias M . The anthelmintic oxyclozanide restores the activity of colistin against colistin-resistant Gram-negative bacilli. Int J Antimicrob Agents. 2019; 54(4):507-512. DOI: 10.1016/j.ijantimicag.2019.07.006. View

Violi F, Cangemi R, Falcone M, Taliani G, Pieralli F, Vannucchi V . Cardiovascular Complications and Short-term Mortality Risk in Community-Acquired Pneumonia. Clin Infect Dis. 2017; 64(11):1486-1493. DOI: 10.1093/cid/cix164. View

Aydin M, Azak E, Bilgin H, Menekse S, Asan A, Elmaslar Mert H . Changes in antimicrobial resistance and outcomes of health care-associated infections. Eur J Clin Microbiol Infect Dis. 2021; 40(8):1737-1742. DOI: 10.1007/s10096-020-04140-y. View

Hogea S, Tudorache E, Pescaru C, Marc M, Oancea C . Bronchoalveolar lavage: role in the evaluation of pulmonary interstitial disease. Expert Rev Respir Med. 2020; 14(11):1117-1130. DOI: 10.1080/17476348.2020.1806063. View

Mohamed A, Daef E, Nafie A, Shaban L, Ibrahim M . Characteristics of Carbapenem-Resistant Gram-Negative Bacilli in Patients with Ventilator-Associated Pneumonia. Antibiotics (Basel). 2021; 10(11). PMC: 8615042. DOI: 10.3390/antibiotics10111325. View

10.

Wan G, Zheng L, Li H, Yuan H, Xue H, Zhang X . Effects of enteral nutritional rich in n-3 polyunsaturated fatty acids on the nutritional status of gastrointestinal cancer patients: a systematic review and meta-analysis. Eur J Clin Nutr. 2019; 74(2):220-230. DOI: 10.1038/s41430-019-0527-5. View

11.

Giurazza R, Mazza M, Andini R, Sansone P, Pace M, Durante-Mangoni E . Emerging Treatment Options for Multi-Drug-Resistant Bacterial Infections. Life (Basel). 2021; 11(6). PMC: 8229628. DOI: 10.3390/life11060519. View

12.

de Mangou A, Combe A, Coolen-Allou N, Miltgen G, Traversier N, Belmonte O . Severe community-acquired pneumonia in Reunion Island: Epidemiological, clinical, and microbiological characteristics, 2016-2018. PLoS One. 2022; 17(4):e0267184. PMC: 9012352. DOI: 10.1371/journal.pone.0267184. View

13.

Guo R, Dan Z, Fan Z, Jin J, Li C, Liu B . Clinical characteristics and pathogen analysis of bronchoalveolar lavage fluid in elderly patients with community-acquired pneumonia. Immun Inflamm Dis. 2023; 11(4):e813. PMC: 10134761. DOI: 10.1002/iid3.813. View

14.

Yang C, Zeng H, Huang J, Zhang Q, Lin K . Predictive roles of D-dimer for mortality of patients with community-acquired pneumonia: a systematic review and meta-analysis. J Bras Pneumol. 2021; 47(6):e20210072. PMC: 8836614. DOI: 10.36416/1806-3756/e20210072. View

15.

Alemayehu T, Asnake S, Tadesse B, Azerefegn E, Mitiku E, Agegnehu A . Phenotypic Detection of Carbapenem-Resistant Gram-Negative Bacilli from a Clinical Specimen in Sidama, Ethiopia: A Cross-Sectional Study. Infect Drug Resist. 2021; 14:369-380. PMC: 7866937. DOI: 10.2147/IDR.S289763. View

16.

Cheng S, Hou G, Liu Z, Lu Y, Liang S, Cang L . Risk prediction of in-hospital mortality among patients with type 2 diabetes mellitus and concomitant community-acquired pneumonia. Ann Palliat Med. 2020; 9(5):3313-3325. DOI: 10.21037/apm-20-1489. View

17.

Kartal O, Kartal A . Value of neutrophil to lymphocyte and platelet to lymphocyte ratios in pneumonia. Bratisl Lek Listy. 2017; 118(9):513-516. DOI: 10.4149/BLL_2017_099. View

18.

Fesus A, Benko R, Matuz M, Engi Z, Ruzsa R, Hambalek H . Impact of Guideline Adherence on Outcomes in Patients Hospitalized with Community-Acquired Pneumonia (CAP) in Hungary: A Retrospective Observational Study. Antibiotics (Basel). 2022; 11(4). PMC: 9026550. DOI: 10.3390/antibiotics11040468. View

19.

Liu H, Zhang Y, Chen G, Sun S, Wang J, Chen F . Diagnostic Significance of Metagenomic Next-Generation Sequencing for Community-Acquired Pneumonia in Southern China. Front Med (Lausanne). 2022; 9:807174. PMC: 8885724. DOI: 10.3389/fmed.2022.807174. View

20.

Nonaka S, Fujii S, Hara M, Morita S, Sueoka E, Node K . Incidence of aspiration pneumonia during hospitalization in Japanese hospitalized cases did not increase whereas concern factors were exacerbated in a time-dependent manner: analysis of Diagnosis Procedure Combination (DPC) data. J Clin Biochem Nutr. 2018; 63(1):66-69. PMC: 6064811. DOI: 10.3164/jcbn.17-119. View