Microbiological testing of adults hospitalised with community-acquired pneumonia: an international study

Carugati, Manuela; Aliberti, Stefano; Reyes, Luis Felipe; Franco Sadud, Ricardo; Irfan, Muhammad; Prat, Cristina; Soni, Nilam J.; Faverio, Paola; Gori, Andrea; Blasi, Francesco; Restrepo, Marcos I.

CAP was defined by evidence of new pulmonary infiltrates on thoracic imaging (chest radiograph, computed tomography or ultrasound) during the first 48 h of hospitalisation and at least one of the following criteria: new or increased cough with or without sputum production or with purulent respiratory secretions; fever or hypothermia (documented rectal or oral temperature ⩾37.8°C or <36°C, respectively); and evidence of systemic inflammation, such as abnormal white blood cell count (leukocytosis (>10 000 cells·mL −1 ), leukopenia (<4000 cells·mL −1 ) or bandaemia (>10%)) and increased C-reactive protein or procalcitonin concentrations above the local upper limit of normal. Hospitalisation was defined as admission at an inpatient service and subsequent stay for ⩾24 h. Methicillin-resistant Staphylococcus aureus was defined according to the Clinical and Laboratory Standards Institute (CLSI) guidelines, in which the minimum inhibitory concentration was ⩾4 µg·mL −1 to oxacillin. Production of extended-spectrum β-lactamase was defined according to the CLSI guidelines via broth microdilution or disk diffusion clavulanate inhibition test.