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Wiener klinische Wochenschrift

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04.10.2021 | case report

New insights and antimicrobial stewardship opportunities in viral pneumonia: five lung ultrasound cases

verfasst von: Lukas Antonitsch, Ronald Gallob, Gerhard Weidinger, Joachim Kettenbach

Erschienen in: Wiener klinische Wochenschrift | Ausgabe 21-22/2021

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Summary

Background

Antimicrobial stewardship is crucial to avoid antimicrobial resistance in microbes and adverse drug effects in patients. In respiratory infections, however, viral pneumonia is difficult to distinguish from bacterial pneumonia, which explains the overuse of antibiotic therapy in this indication.

Cases

Five cases of lung consolidation are presented. Lung ultrasound, in conjunction with procalcitonin levels, were used to exclude or corroborate bacterial pneumonia.

Conclusion

Lung ultrasound is easy to learn and perform and is helpful in guiding diagnosis in unclear cases of pneumonia and may also offer new insights into the spectrum of certain virus diseases. The use of lung ultrasound can raise awareness in clinicians of the need for antimicrobial stewardship and may help to avoid the unnecessary use of antibiotics.

Vorheriger Artikel Role of new digital technologies and telemedicine in pulmonary rehabilitation

Nächster Artikel New insights from GINA 2019/2020—Focus on early anti-inflammatory therapy

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Kunin CM, Tupasi T, Craig WA. Use of antibiotics: a brief exposition of the problem and some tentative solutions. Ann Intern Med. 1973;79(4):555–60.PubMed

Price DJE, Sleigh JD. Control of infection due to Klebsiella aerogenes in a neurosurgical unit by withdrawal of all antibiotics. Lancet. 1970;296(7685):1213–5.

Selden R, et al. Nosocomial Klebsiella infections: intestinal colonization as a reservoir. Ann Intern Med. 1971;74(5):657–64.PubMed

Woerther P‑L, Andremont A, Kantele A. Travel-acquired ESBL-producing Enterobacteriaceae: impact of colonization at individual and community level. J Travel Med. 2017;24(suppl_1):S29–S34.PubMedPubMedCentral

Kantele A, et al. Antimicrobials increase travelers’ risk of colonization by extended-spectrum betalactamase-producing Enterobacteriaceae. Clin Infect Dis. 2015;60(6):837–46.PubMedPubMedCentral

Cassini A, et al. Attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the EU and the European Economic Area in 2015: a population-level modelling analysis. Lancet Infect Dis. 2019;19(1):56–66.PubMedPubMedCentral

Jarlier V, et al. Strong correlation between the rates of intrinsically antibiotic-resistant species and the rates of acquired resistance in Gram-negative species causing bacteraemia, EU/EEA, 2016. Euro Surveill. 2019;24(33):1800538. https://doi.org/10.2807/1560-7917.ES.2019.24.33.1800538CrossRef

European Centre for Disease Prevention and Control. Proposals for EU guidelines on the prudent use of antimicrobials in humans. Stockholm: ECDC; 2017.

Kärki T, et al. Burden of healthcare-associated infections in European acute care hospitals. Wien Medizinische Wochenschrift. 2019;169(1):3–5.

10.

Friedrich AW. Control of hospital acquired infections and antimicrobial resistance in Europe: the way to go. Wien Med Wochenschr. 2019;169(1):25–30.PubMedPubMedCentral

11.

Wang Q, et al. Risk factors and clinical outcomes for carbapenem-resistant Enterobacteriaceae nosocomial infections. Eur J Clin Microbiol Infect Dis. 2016;35(10):1679–89.PubMed

12.

Hui C, et al. Previous antibiotic exposure and evolution of antibiotic resistance in mechanically ventilated patients with nosocomial infections. J Crit Care. 2013;28(5):728–34.PubMed

13.

Wu D, Jiachang C, Liu J. Risk factors for the acquisition of nosocomial infection with carbapenem-resistant Klebsiella pneumoniae. South Med J. 2011;104(2):106–10.PubMed

14.

Superti Vargas S, Augusti G, Prehn Zavascki A. Risk factors for and mortality of extended-spectrum-β-lactamase-producing Klebsiella pneumoniae and Escherichia coli nosocomial bloodstream infections. Rev Inst Med trop S Paulo. 2009;51(4):211–6.

15.

Altunsoy A, et al. The impact of a nationwide antibiotic restriction program on antibiotic usage and resistance against nosocomial pathogens in Turkey. Int J Med Sci. 2011;8(4):339.PubMedPubMedCentral

16.

Chalmers JD. The modern diagnostic approach to community-acquired pneumonia in adults. Semin Respir Crit Care Med. 2016;37(6):876–885. https://doi.org/10.1055/s-0036-1592125CrossRefPubMed

17.

Quirós-González V, et al. Real-time surveillance systems: applicability for the control of influenza in acute care. Influenza Other Respi Viruses. 2020;14(3):331–339. https://doi.org/10.1111/irv.12720CrossRef

18.

Sansone M, et al. Extensive hospital in-ward clustering revealed by molecular characterization of influenza A virus infection. Clin Infect Dis. 2020;71(9):e377–e383. https://doi.org/10.1093/cid/ciaa108CrossRefPubMed

19.

Godoy P, et al. Hospital-acquired influenza infections detected by a surveillance system over six seasons, from 2010/2011 to 2015/2016. BMC Infect Dis. 2020;20(1):80.PubMedPubMedCentral

20.

Naudion P, Lepiller Q, Bouiller K. Risk factors and clinical characteristics of patients with nosocomial influenza A infection. J Med Virol. 2019;92(8):1047–1052. https://doi.org/10.1002/jmv.25652CrossRefPubMed

21.

Zhao X, et al. Airborne Transmission of Influenza Virus in a Hospital of Qinhuangdao During 2017–2018 Flu Season. Food Environ Virol. 2019;11(4):427–39.PubMed

22.

Blackburn RM, et al. Nosocomial transmission of influenza: a retrospective cross-sectional study using next generation sequencing at a hospital in england (2012–2014). Influenza Other Respi Viruses. 2019;13(6):556–63.

23.

Houlihan CF, et al. Use of whole-genome sequencing in the investigation of a nosocomial influenza virus outbreak. J INFECT DIS. 2018;218(9):1485–9.PubMedPubMedCentral

24.

Zhou F, et al. Risk factors for nosocomial infection among hospitalised severe influenza A (H1N1) pdm09 patients. Respir Med. 2018;134:86–91. https://doi.org/10.1016/j.rmed.2017.11.017CrossRefPubMed

25.

Heyd R, et al. Retrospective analysis of clinical and virological parameters of influenza cases at four university hospitals in Germany, 2015. Infection. 2017;45(3):349–54.PubMed

26.

Álvarez-Lerma F, et al. Characteristics of patients with hospital-acquired influenza A (H1N1) pdm09 virus admitted to the intensive care unit. J Hosp Infect. 2017;95(2):200–6.PubMed

27.

Manchal N, et al. Hospital acquired viral respiratory tract infections: an underrecognized nosocomial infection. Infect Dis Health. 2020;25(3):175–180. https://doi.org/10.1016/j.idh.2020.02.002CrossRefPubMed

28.

Kakiuchi S, et al. Human parainfluenza virus type 3 infections in patients with hematopoietic stem cell transplants: the mode of nosocomial infections and prognosis. Jpn J Infect Dis. 2018;71(2):109–115. https://doi.org/10.7883/yoken.JJID.2017.424CrossRefPubMed

29.

Loubet P, et al. Impact of respiratory viruses in hospital-acquired pneumonia in the intensive care unit: a single-center retrospective study. J Clin Virol. 2017;91:52–7.PubMedPubMedCentral

30.

Cui X, et al. Human adenovirus type 7 infection associated with severe and fatal acute lower respiratory illness and nosocomial transmission. J Clin Microbiol. 2015;53(2):746–9.PubMedPubMedCentral

31.

Hanada S, et al. Respiratory viral infection-induced Microbiome alterations and secondary bacterial pneumonia. Front Immunol. 2018;9:2640. https://doi.org/10.3389/fimmu.2018.02640CrossRefPubMedPubMedCentral

32.

Schuetz P, et al. Procalcitonin to initiate or discontinue antibiotics in acute respiratory tract infections. Evid Based Child Health. 2013;8(4):1297–371.PubMed

33.

Schuetz P, et al. Effect of procalcitonin-guided antibiotic treatment on mortality in acute respiratory infections: a patient level meta-analysis. Lancet Infect Dis. 2018;18(1):95–107.PubMed

34.

Lippi G, Plebani M. Procalcitonin in patients with severe coronavirus disease 2019 (COVID-19): a meta-analysis. Clin Chim Acta. 2020;505:190–191. https://doi.org/10.1016/j.cca.2020.03.004CrossRef

35.

Schuetz P, et al. Procalcitonin (PCT)-guided antibiotic stewardship: an international experts consensus on optimized clinical use. Clin Chem Lab Med (cclm). 2019;57(9):1308–18.

36.

Lee C‑C, et al. Combining procalcitonin and rapid multiplex respiratory virus testing for antibiotic stewardship in older adult patients with severe acute respiratory infection. J Am Med Dir Assoc. 2020;21(1):62–7.PubMed

37.

Moradi T, et al. Use of procalcitonin and a respiratory polymerase chain reaction panel to reduce antibiotic use via an electronic medical record alert. Clin Infect Dis. 2019;71(7):1684–1689. https://doi.org/10.1093/cid/ciz1042CrossRef

38.

Creamer AW, Alice EK, Albur M. Procalcitonin in respiratory disease: use as a biomarker for diagnosis and guiding antibiotic therapy. Breathe. 2019;15(4):296–304.PubMedPubMedCentral

39.

Lichtenstein DA, Meziere GA. Relevance of lung ultrasound in the diagnosis of acute respiratory failure*: the BLUE protocol. Chest. 2008;134(1):117–25.PubMedPubMedCentral

40.

Tsung JW, Kessler DO, Shah VP. Prospective application of clinician-performed lung ultrasonography during the 2009 H1N1 influenza A pandemic: distinguishing viral from bacterial pneumonia. Crit Ultrasound J. 2012;4(1):1–10.

41.

Berce V, et al. The usefulness of lung ultrasound for the aetiological diagnosis of community-acquired pneumonia in children. Sci Rep. 2019;9(1):1–10.

42.

Arbelot C, et al. Lung ultrasound in emergency and critically ill patientsnumber of supervised exams to reach basic competence. Anesthesiology. 2020;132(4):899–907.PubMed

43.

Buonsenso D, et al. Point-of-care lung ultrasound findings in novel coronavirus disease-19 pnemoniae: a case report and potential applications during COVID-19 outbreak. Eur Rev Med Pharmacol Sci. 2020;24:2776–80.PubMed

44.

Moro F, et al. How to perform lung ultrasound in pregnant women with suspected COVID-19 infection. Ultrasound Obstet Gynecol. 2020;55(5):593–598. https://doi.org/10.1002/uog.22028CrossRefPubMed

45.

Zhang H‑W, et al. Corona virus international public health emergencies: implications for radiology management. Acad Radiol. 2020;27(4):463–467. https://doi.org/10.1016/j.acra.2020.02.003CrossRefPubMedPubMedCentral

46.

Bosch ARMP, Guix S. Human astroviruses. Clin Microbiol Rev. 2014;27(4):1048–74.PubMedPubMedCentral

47.

Jeger V, et al. Is there a role for procalcitonin in differentiating uncomplicated and complicated diverticulitis in order to reduce antibiotic therapy? A prospective diagnostic cohort study. Swiss Med Wkly. 2017;147:w14555.PubMed

48.

Musher DM, Abers MS, Bartlett JG. Evolving understanding of the causes of pneumonia in adults, with special attention to the role of pneumococcus. Clin Infect Dis. 2017;65(10):1736–44.PubMed

49.

Viasus D, et al. Impact of antibiotic de-escalation on clinical outcomes in community-acquired pneumococcal pneumonia. J Antimicrob Chemother. 2017;72(2):547–53.PubMed

50.

Nascimento-Carvalho CM, et al. Respiratory viral infections among children with community-acquired pneumonia and pleural effusion. Scand J Infect Dis. 2013;45(6):478–83.PubMed

51.

Hyams CO, Williams M, Williams P. Urinary antigen testing for pneumococcal pneumonia: is there evidence to make its use uncommon in clinical practice? ERJ Open Res. 2020;6(1):00223-2019. https://doi.org/10.1183/23120541.00223-2019CrossRef

52.

Karst SM, Zhu S, Goodfellow IG. The molecular pathology of noroviruses. J Pathol. 2015;235(2):206–16.PubMed

53.

Kweon OJ, et al. Fecal respiratory viruses in acute viral respiratory infection and nasopharyngeal diarrheal viruses in acute viral gastroenteritis: clinical impact of ectopic viruses is questionable. J Microbiol Biotechnol. 2018;28(3):465–72.PubMed

54.

Zhang L, et al. Characterization of antibiotic resistance and host-microbiome interactions in the human upper respiratory tract during influenza infection. Microbiome. 2020;8(1):1–12.

55.

de Steenhuijsen Piters WAA, Sanders EAM, Bogaert D. The role of the local microbial ecosystem in respiratory health and disease. Philos Trans R Soc Lond B Biol Sci. 2015;370(1675):20140294.PubMedPubMedCentral

56.

Bearden DM, et al. COVID-19: a primer for healthcare providers. Wien Klin Wochenschr. 2020;132(13-14):390–395. https://doi.org/10.1007/s00508-020-01678-xCrossRefPubMed

57.

Dickson RP, Erb-Downward JR, Huffnagle GB. Homeostasis and its disruption in the lung microbiome. Am J Physiol Cell Mol Physiol. 2015;309(10):L1047–L55.

58.

Quinton LJ, Walkey AJ, Mizgerd JP. Integrative physiology of pneumonia. Physiol Rev. 2018;98(3):1417–64.PubMedPubMedCentral

59.

Marcos MA, et al. The role of viruses in the aetiology of community-acquired pneumonia in adults. Antivir Ther. 2006;11(3):351.

60.

Torres A, Loeches IM, Sligl W, Lee N. Severe flu management: a point of view. Intensive Care Med. 2020;46(2):153–162. https://doi.org/10.1007/s00134-019-05868-8CrossRefPubMedPubMedCentral

61.

Guan W‑j, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708–1720. https://doi.org/10.1056/NEJMoa2002032CrossRefPubMed

62.

Galli C, Plebani M. Clinical laboratory and SARS-CoV‑2 infection: where do we stand? Clin Chem Lab Med. 2020;58(7):1139–1141. https://doi.org/10.1515/cclm-2020-0372CrossRefPubMed

63.

To KKW, Yip CCY, Yuen K‑Y. Rhinovirus–from bench to bedside. J Formos Med Assoc. 2017;116(7):496–504.PubMed

64.

To KKW, et al. Respiratory virus infection among hospitalized adult patients with or without clinically apparent respiratory infection: a prospective cohort study. Clin Microbiol Infect. 2019;25(12):1539–45.PubMedPubMedCentral

Titel: New insights and antimicrobial stewardship opportunities in viral pneumonia: five lung ultrasound cases
verfasst von: Lukas Antonitsch
Ronald Gallob
Gerhard Weidinger
Joachim Kettenbach
Publikationsdatum: 04.10.2021
Verlag: Springer Vienna
Erschienen in: Wiener klinische Wochenschrift / Ausgabe 21-22/2021
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI: https://doi.org/10.1007/s00508-021-01946-4

Springer Medizin Österreich

Summary

Background

Cases

Conclusion

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