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Semin Respir Crit Care Med 2019; 40(04): 498-507
DOI: 10.1055/s-0039-1696961
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Bacterial Pneumonias in Immunocompromised Patients

Andry Van de Louw‡   *
1   Division of Pulmonary and Critical Care Medicine, Penn State University College of Medicine, Hershey, Pennsylvania
,
Adrien Mirouse‡   *
2   Medical ICU, Hôpital Saint Louis APHP, Paris, France
,
Olivier Peyrony
2   Medical ICU, Hôpital Saint Louis APHP, Paris, France
,
Virginie Lemiale
2   Medical ICU, Hôpital Saint Louis APHP, Paris, France
,
Elie Azoulay
2   Medical ICU, Hôpital Saint Louis APHP, Paris, France
› Author Affiliations
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Publication History

Publication Date:
04 October 2019 (online)

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Abstract

With the overall improvement in survival of cancer patients and the widespread use of novel immunotherapy drugs for malignant as well as nonmalignant diseases, the prevalence of immunosuppression is rising in the population. Immunocompromised patients are particularly exposed to pulmonary infections which remain a leading cause for acute hypoxic respiratory failure and intensive care unit admission. Although fungal or opportunistic infections are always a concern, bacterial pneumonia remains the most common cause of pulmonary infection, is associated with a significant mortality, and has some specificity in this population. Adequate and timely prevention, diagnosis, and management of bacterial pneumonias require knowledge about the complex interplay between host factors (type and severity of immunosuppression) and bacterial pathogenesis, to improve the outcome. We provide an overview of bacterial pneumonias in immunocompromised patients including their epidemiology, risk factors with respect to the pattern of immunosuppression, microbiological characteristics, diagnostic approach, management, and prevention.

Keywords

pneumonia - immunosuppression - cancer - bacteria - acute respiratory failure

* Both authors contributed equally to this work.