Severe Community-acquired Pneumonia
Pulmonary and extrapulmonary complications, including sepsis, septic shock, acute respiratory distress syndrome, and acute cardiac events, frequently complicate CAP resulting in a significant increase in mortality and the need for ICU admission.[18] A large active population-based surveillance study that enrolled US adults with CAP requiring hospitalization concluded that 21% of these patients needed admission to the ICU and 26% of them needed mechanical ventilation, thus making up a subgroup of patients with severe community-acquired pneumonia (sCAP).[5] The hospital mortality of sCAP remains unacceptably high ranging from 25% to more than 50%.[19–22] Although there is no consensus on its definition, the most accepted criteria to define sCAP are from the 2007 Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of CAP in adults.[1] sCAP was defined by the presence of at least one of major criteria: severe acute respiratory failure requiring invasive mechanical ventilation and/or septic shock. Other criteria requiring high-intensity monitoring and treatment have also been proposed for defining sCAP.[23,24] sCAP represents individuals requiring ICU care and being at the highest risk for mortality and administration of ineffective initial antibiotic treatment because of increased risk of infection with antibiotic-resistant pathogens.
Curr Opin Infect Dis. 2019;32(2):169-175. © 2019 Lippincott Williams & Wilkins
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