Mahboub Bassam, Al Zaabi Ashraf, Al Ali Ola Mohamed, Ahmed Raees, Niederman Michael S, El-Bishbishi Rania
Rashid Hospital, Oud Metha Road, Umm Hurair Area 2, PO Box 4545, Dubai, UAE.
Zayed Military Hospital, Abu Dhabi, United Arab Emirates.
BMC Pulm Med. 2015 Sep 30;15:112. doi: 10.1186/s12890-015-0108-x.
Very few data exist on the management of community-acquired pneumonia (CAP) in patients admitted to hospitals in the Gulf region. The objectives of this study were to describe treatment patterns for CAP in 38 hospitals in five Gulf countries (United Arab Emirates, Kuwait, Bahrain, Oman, and Qatar) and to compare the findings to the most recent Infectious Diseases Society of America (IDSA)/American Thoracic Society (ATS) guidelines.
This was a prospective, observational study conducted between January 2009 and February 2011. Adult patients hospitalised (excluding intensive care units) for CAP and subsequently discharged were included. Data were collected retrospectively at hospital discharge, and prospectively during two follow-up visits. Data on medical history, mortality-risk scores, diagnostic criteria, antibiotic treatment, isolated pathogens and clinical and radiographic outcomes were collected. Care practices were compared to the IDSA/ATS guidelines.
A total of 684 patients were included. The majority (82.9 %) of patients were classified as low risk for mortality (pneumonia severity index II and III). The majority of patients fulfilled criteria for treatment success at discharge, although only 77.6 % presented a normalised leukocyte count. Overall, the management of CAP in Gulf countries is in line with the IDSA/ATS guidelines. This applied to the diagnosis of CAP, to the identification of high-risk CAP patients, to the identification of etiologic agent responsible for CAP and to the type of treatment despite the fact that combinations of antimicrobial agents were not consistent with the guidelines in 10 % of patients. In all patients, information about Gram's staining was not captured as recommended by the IDSA/ATS and in the majority of patients (>85 %) chest radiography was not systematically performed at the post-discharge follow-up visits.
The management of CAP in the Gulf region is globally in line with current IDSA/ATS guidelines, although rates of pathogen characterisation and post-discharge follow-up need to be improved.
Compliance with established guidelines should be encouraged in order to improve the management of the disease in this region.
关于海湾地区医院收治的社区获得性肺炎（CAP）患者的管理，现有数据极少。本研究的目的是描述五个海湾国家（阿拉伯联合酋长国、科威特、巴林、阿曼和卡塔尔）38家医院中CAP的治疗模式，并将研究结果与美国感染病学会（IDSA）/美国胸科学会（ATS）的最新指南进行比较。
这是一项于2009年1月至2011年2月进行的前瞻性观察性研究。纳入因CAP住院（不包括重症监护病房）并随后出院的成年患者。数据在出院时进行回顾性收集，并在两次随访期间进行前瞻性收集。收集了病史、死亡风险评分、诊断标准、抗生素治疗、分离出的病原体以及临床和影像学结果等数据。将护理实践与IDSA/ATS指南进行比较。
共纳入684例患者。大多数（82.9%）患者被归类为低死亡风险（肺炎严重程度指数II和III）。大多数患者在出院时达到治疗成功标准，尽管只有77.6%的患者白细胞计数恢复正常。总体而言，海湾国家对CAP的管理符合IDSA/ATS指南。这适用于CAP的诊断、高危CAP患者的识别、CAP病原体的识别以及治疗类型，尽管10%的患者抗菌药物联合使用不符合指南。在所有患者中，未按照IDSA/ATS的建议记录革兰氏染色信息，并且在大多数患者（>85%）中，出院后随访时未系统地进行胸部X线检查。
海湾地区对CAP的管理总体上符合当前的IDSA/ATS指南，尽管病原体鉴定率和出院后随访需要改进。
应鼓励遵守既定指南，以改善该地区对该疾病的管理。
