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J Infect. 2016 May;72(5):554-63. doi: 10.1016/j.jinf.2016.02.010. Epub 2016 Mar 3.

Community-acquired Haemophilus influenzae pneumonia--New insights from the CAPNETZ study.

Author information

1
Center for Infectious Diseases and Infection Control, Jena University Hospital, Erlanger Allee 101, 07747 Jena, Germany; Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria. Electronic address: christina.forstner@med.uni-jena.de.
2
Department of Respiratory Medicine, Maastricht University Medical Center (MUMC+), P. Debyelaan 25, 6202 AZ Maastricht, The Netherlands; Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Carl-Neuberg-Strasse 1, 30625 Hannover, Germany; CAPNETZ STIFTUNG, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany.
3
Department of Infectious Diseases and Microbiology, University of Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany; CAPNETZ STIFTUNG, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany.
4
Department of Internal Medicine/Infectious Diseases and Pulmonary Medicine, Charité Berlin, Augustenburger Platz 1, 13353 Berlin, Germany; CAPNETZ STIFTUNG, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany.
5
Department of Pulmonary Medicine, University Hospital (Inselspital) and University of Bern, Freiburgstrasse 4, 3010 Bern, Switzerland.
6
Center for Infectious Diseases and Infection Control, Jena University Hospital, Erlanger Allee 101, 07747 Jena, Germany.
7
Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
8
Institute for Medical Microbiology and Hygiene, Ulm University Hospital, Albert-Einstein-Allee 23, 89081 Ulm, Germany.
9
Department of Pulmonary Medicine, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany; Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Carl-Neuberg-Strasse 1, 30625 Hannover, Germany; CAPNETZ STIFTUNG, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany.
10
Center for Infectious Diseases and Infection Control, Jena University Hospital, Erlanger Allee 101, 07747 Jena, Germany; CAPNETZ STIFTUNG, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany.

Abstract

OBJECTIVES:

We aimed to identify clinical characteristics and to assess effectiveness of different initial antibiotic regimens in adult patients with community-acquired pneumonia (CAP) caused by Haemophilus influenzae.

METHODS:

Characteristics were compared between patients with H. influenzae monoinfection versus CAP of other and unknown aetiology enrolled by the German prospective cohort study CAPNETZ. Impact of initial antibiotic treatment on "early clinical response" according to FDA criteria and overall clinical cure were analysed.

RESULTS:

H. influenzae was found in 176 out of 2790 patients with pathogen detection (6.3%). Characteristics significantly associated with a H. influenzae CAP (p < 0.017) included purulent sputum, prior pneumococcal vaccination and respiratory co-morbidities. Early clinical response rates on day 4 did not differ between patients receiving any mono- versus combination therapy (85.9% versus 88%), but were numerically higher for regimens including any fluoroquinolone (96.7%) and lower under macrolide monotherapy (70%). Initial CURB-65 score and chronic liver disease were identified as negative predictors for "early clinical response". At day 14, overall clinical cure was 91.9%.

CONCLUSIONS:

H. influenzae was a common CAP pathogen, particularly in patients with previous pneumococcal vaccination and respiratory co-morbidities. Severity of illness and chronic liver disease were associated with a lower rate of "early clinical response".

KEYWORDS:

Beta-lactams; CURB-65 score; Fluoroquinolones; Haemophilus influenzae; Macrolides; Respiratory tract infection

PMID:
26940505
DOI:
10.1016/j.jinf.2016.02.010
[Indexed for MEDLINE]

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