Global Trends in Community-Acquired Pneumonia

In this issue of Seminars in Respiratory and Critical Care Medicine, leading researchers from around the world provide state-of-the-art reviews on trending topics related to translating basic knowledge to clinical practice for patients with community-acquired pneumonia (CAP). Our efforts focused on providing expert reviews with a global perspective.

The first series of manuscripts describe how several countries have developed large epidemiological databases to track the outcomes and microbiological evolution of patients with CAP. In addition, large global epidemiological studies have contributed to a better understanding of the changes and differences of care among continents, regions, countries, cities, and hospitals. Multiple risk factors are associated with the development of CAP, and several of these risk factors are associated with worse outcomes. Microbiology trends of typical and atypical pathogens are important in deciding on empirical antimicrobial therapies. There is also a rising concern for the development of antimicrobial resistance of common pathogens linked to patients with CAP. Significant progress has been made with newer technologies, such as genomics, proteomics, and metabolomics, which may bring important advances to the understanding of disease mechanisms and drug development.

Accurate assessment of disease severity in CAP patients at the time of clinical presentation is critical for clinicians managing patients with pneumonia. Therefore a good understanding of how to apply decision tools is paramount. In addition, rapid diagnostic methods and point of care testing with the use of biomarkers that may predict the severity of the disease, suggest when to remove or change antimicrobial therapies, and predict clinical outcomes are hot topics for care of patients with CAP.

Despite the best care possible and the incorporation of technological advances directed toward improving the implementation of evidence-based practices, some patients do not reach clinical stability and fail therapy. These patients with CAP carry the worst prognosis and account for significant resource utilization. The treatment of patients with CAP depends on the use of antimicrobial therapies and nonantimicrobial adjunctive therapies that have been shown to provide improvement in the care of patients with CAP. However, there is significant interest in new interventions that may immunomodulate and continue to improve patients' clinical outcomes.

Finally, despite appropriate treatments, patients with CAP continue to die after surviving the initial hospitalization or care. A section focusing on the impact of long-term outcomes for patients with CAP may help clinicians follow these patients and develop future strategies to improve long-term survival.

We sincerely thank each of the authors who has contributed to this issue of Seminars in Respiratory and Critical Care Medicine dedicated to important topics of global trends in community-acquired pneumonia. We believe that the current state-of-the art reviews presented here by an internationally recognized group of experts in the field will serve as a useful resource for clinicians in the diagnosis and management of patients with community-acquired pneumonia.