Subscribe to RSS
DOI: 10.1055/s-0030-1256275
© Georg Thieme Verlag KG Stuttgart · New York
Symposium: Pneumonie 2010 – State of the Art
4. – 5. 11. 2010, KasselSymposium: Pneumonia 2010 – State of the ArtPublication History
eingereicht 11. 2. 2011
akzeptiert 14. 2. 2011
Publication Date:
11 April 2011 (online)
![](https://www.thieme-connect.de/media/pneumologie/201104/lookinside/thumbnails/10.1055-s-0030-1256275-1.jpg)
Zusammenfassung
Die ambulant erworbene Pneumonie (community-acquired pneumonia [CAP]) ist mit einer hohen Morbidität und Mortalität assoziiert – sie gehört in den westlichen Industrieländern noch immer zu den häufigsten Todesursachen. Während des Symposiums „Pneumonie 2010 – State of the Art” wurden daher neue Erkenntnisse zur Epidemiologie und Pathogenese sowie aktuelle Ansätze zur Diagnose, Risiko-Stratifizierung, Prävention und Therapie der CAP präsentiert und diskutiert. An dem Symposium, das von der CAPNETZ STIFTUNG ausgerichtet wurde und vom 4. – 5. November in Kassel stattfand, nahmen mehr als 70 Experten aus Klinik, Forschung und Industrie teil. Der vorliegende Bericht gibt einen Überblick über die wichtigsten Fakten und Erkenntnisse, die während des Symposiums erörtert wurden.
Abstract
Community-acquired pneumonia (CAP) is associated with significant morbidity and mortality. It ranks as the fourth leading cause of death in the Western industrialized countries. New insights in the epidemiology and pathogenesis, recent developments in diagnosis and risk-stratification, and current recommendations on prevention and therapy were presented at the symposium „Pneumonie 2010 – State of the Art”, held in Kassel, Germany, on the 4. – 5. November 2010. This symposium was organized by the CAPNETZ STIFTUNG. More than 70 experts from medical research, academia, and industry participated. This report provides an overview of issues, insights, and conclusions that were discussed during the meeting.
Literatur
- 1 Schnoor M, Hedicke J, Dalhoff K et al. Approaches to estimate the population-based incidence of community acquired pneumonia. J Infect. 2007; 55 233-239
- 2 Ewig S, Birkner N, Strauss R et al. New perspectives on community-acquired pneumonia in 388 406 patients. Results from a nationwide mandatory performance measurement programme in healthcare quality. Thorax. 2009; 64 1062-1069
- 3 Waterer G W, Kessler L A, Wunderink R G. Medium-term survival after hospitalization with community-acquired pneumonia. Am J Respir Crit Care Med. 2004; 169 910-914
- 4 Jokinen C, Heiskanen L, Juvonen H et al. Incidence of community-acquired pneumonia in the population of four municipalities in eastern Finland. Am J Epidemiol. 1993; 137 977-988
- 5 Kothe H, Bauer T, Marre R et al. Outcome of community-acquired pneumonia: influence of age, residence status and antimicrobial treatment. Eur Respir J. 2008; 32 139-146
- 6 Hoffken G, Lorenz J, Kern W et al. Epidemiology, diagnosis, antimicrobial therapy and management of community-acquired pneumonia and lower respiratory tract infections in adults. Guidelines of the Paul-Ehrlich-Society for Chemotherapy, the German Respiratory Society, the German Society for Infectiology and the Competence Network CAPNETZ Germany. Pneumologie. 2009; 63 e1-e68
- 7 Baum H von, Welte T, Marre R et al. Community-acquired pneumonia through Enterobacteriaceae and Pseudomonas aeruginosa: Diagnosis, incidence and predictors. Eur Respir J. 2010; 35 598-605
- 8 Baum H von, Welte T, Marre R et al. Mycoplasma pneumoniae pneumonia revisited within the German Competence Network for Community-acquired pneumonia (CAPNETZ). BMC Infect Dis. 2009; 9 62
- 9 Baum H von, Schweiger B, Welte T et al. How deadly is seasonal influenza associated pneumonia? The German Competence Network for Community-acquired pneumonia (CAPNETZ). Eur Respir J. 2010; Sep 3 [Epub ahead of print]
- 10 Barbuddhe S B, Maier T, Schwarz G et al. Rapid identification and typing of listeria species by matrix-assisted laser desorption ionization-time of flight mass spectrometry. Appl Environ Microbiol. 2008; 74 5402-5407
- 11 Medini D, Donati C, Tettelin H et al. The microbial pan-genome. Curr Opin Genet Dev. 2005; 15 589-594
- 12 Fine M J, Auble T E, Yealy D M et al. A prediction rule to identify low-risk patients with community-acquired pneumonia. N Engl J Med. 1997; 336 243-250
- 13 Lim W S, van der Eerden M M, Laing R et al. Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study. Thorax. 2003; 58 377-382
- 14 Ewig S, de Roux A, Bauer T et al. Validation of predictive rules and indices of severity for community acquired pneumonia. Thorax. 2004; 59 421-427
- 15 Bauer T T, Ewig S, Marre R et al. CRB-65 predicts death from community-acquired pneumonia. J Intern Med. 2006; 260 93-101
- 16 Krüger S, Ewig S, Marre R et al. Procalcitonin predicts patients at low risk of death from community-acquired pneumonia across all CRB-65 classes. Eur Respir J. 2008; 31 349-355
- 17 Christ-Crain M, Stolz D, Bingisser R et al. Procalcitonin guidance of antibiotic therapy in community-acquired pneumonia: a randomized trial. Am J Respir Crit Care Med. 2006; 174 84-93
- 18 Krüger S, Ewig S, Giersdorf S et al. Cardiovascular and Inflammatory Biomarkers to Predict Short- and Long-term Survival in Community-acquired Pneumonia. Am J Respir Crit Care Med. 2010; 182 1426-1434
- 19 Sorensen T I, Nielsen G G, Andersen P K et al. Genetic and environmental influences on premature death in adult adoptees. N Engl J Med. 1988; 318 727-732
- 20 Hammerschmidt S. Adherence molecules of pathogenic pneumococci. Curr Opin Microbiol. 2006; Feb; 9(1) 12-20
- 21 Agarwal V, Hammerschmidt S. Cdc42 and PI3-kinase-Akt pathway are essential for PspC mediated internalization of pneumococci by respiratory epithelial cells. J Biol Chem. 2009; Jul; 17 284(29) 19 427-19 436
- 22 Dave S, Carmicle S, Hammerschmidt S et al. Dual roles of PspC, a surface protein of Streptococcus pneumoniae, in binding human secretory IgA and factor H. J Immunol. 2004; 173 471-477
- 23 Hammerschmidt S, Agarwal V, Kunert A et al. The host immune regulator factor H interacts via two contact sites with the PspC protein of Streptococcus pneumoniae and mediates adhesion to host epithelial cells. J Immunol. 2007; 178 5848-5858
- 24 Kadioglu A, Brewin H, Hartel T et al. Pneumococcal protein PavA is important for nasopharyngeal carriage and development of sepsis. Mol Oral Microbiol. 2010; 25 50-60
- 25 Noske N, Kammerer U, Rohde M et al. Pneumococcal interaction with human dendritic cells: phagocytosis, survival, and induced adaptive immune response are manipulated by PavA. J Immunol. 2009; 183 1952-1963
- 26 Hess C, Herr C, Beisswenger C et al. Myeloid RelA regulates pulmonary host defense networks. Eur Respir J. 2010; 35 343-352
- 27 Beisswenger C, Kandler K, Hess C et al. Allergic airway inflammation inhibits pulmonary antibacterial host defense. J Immunol. 2006; 177 1833-1837
- 28 Herr C, Beisswenger C, Hess C et al. Suppression of pulmonary innate host defence in smokers. Thorax. 2009; 64 144-149
- 29 Schmeck B, Huber S, Moog K et al. Pneumococci induced TLR- and Rac1-dependent NF-kappaB-recruitment to the IL-8 promoter in lung epithelial cells. Am J Physiol Lung Cell Mol Physiol. 2006; 290 L730-L737
- 30 Zahlten J, Steinicke R, Opitz B et al. TLR2- and nucleotide-binding oligomerization domain 2-dependent Krüppel-like factor 2 expression downregulates NF-kappa B-related gene expression. J Immunol. 2010; 185 597-604
- 31 Fiedler U, Reiss Y, Scharpfenecker M et al. Angiopoietin-2 sensitizes endothelial cells to TNF-alpha and has a crucial role in the induction of inflammation. Nat Med. 2006; 12 235-239
- 32 Witzenrath M, Schütte H et al. Phosphodiesterase 2 inhibition diminished acute lung injury in murine pneumococcal pneumonia. Crit Care Med. 2009; Feb; 37(2) 584-590
- 33 Pletz M W, Maus U, Krug N et al. Pneumococcal vaccines: mechanism of action, impact on epidemiology and adaption of the species. Int J Antimicrob Agents. 2008; 32 199-206
- 34 Ruckinger S, van der Linden M, Reinert R R et al. Reduction in the incidence of invasive pneumococcal disease after general vaccination with 7-valent pneumococcal conjugate vaccine in Germany. Vaccine. 2009; 27 4136-4141
- 35 Leroux-Roels I, Borkowski A, Vanwolleghem T et al. Antigen sparing and cross-reactive immunity with an adjuvanted rH5N1 prototype pandemic influenza vaccine: a randomised controlled trial. Lancet. 2007; 370 580-589
- 36 Kumar A, Roberts D, Wood K E et al. Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Crit Care Med. 2006; 34 1589-1596
- 37 Kumar A, Ellis P, Arabi Y et al. Initiation of inappropriate antimicrobial therapy results in a fivefold reduction of survival in human septic shock. Chest. 2009; 136 1237-1248
- 38 Pletz M W, McGee L, Jorgensen J et al. Levofloxacin-resistant invasive Streptococcus pneumoniae in the United States: evidence for clonal spread and the impact of conjugate pneumococcal vaccine. Antimicrob Agents Chemother. 2004; 48 3491-3497
- 39 Pletz M W, McGee L, Beall B et al. Interspecies recombination in type II topoisomerase genes is not a major cause of fluoroquinolone resistance in invasive Streptococcus pneumoniae isolates in the United States. Antimicrob Agents Chemother. 2005; 49 779-780
- 40 Pletz M W, van der Linden M, Baum H von et al. Low prevalence of fluoroquinolone resistant strains and resistance precursor strains in Streptococcus pneumoniae from patients with community-acquired pneumonia despite high fluoroquinolone usage. Int J Med Microbiol. 2011; 301 53-57
- 41 American Thoracic Society, Infectious Diseases Society of America . Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med. 2005; 171 388-416
- 42 Kollef M H, Shorr A, Tabak Y P et al. Epidemiology and outcomes of health-care-associated pneumonia: results from a large US database of culture-positive pneumonia. Chest. 2005; 128 3854-3862
- 43 Micek S T, Kollef K E, Reichley R M et al. Health care-associated pneumonia and community-acquired pneumonia: a single-center experience. Antimicrob Agents Chemother. 2007; 51 3568-3573
- 44 Ewig S, Welte T, Chastre J et al. Rethinking the concepts of community-acquired and health-care-associated pneumonia. Lancet Infect Dis. 2010; 10 279-287
- 45 CAPNETZ STIFTUNG .Projektanträge. http://www.capnetz.de/html/research/projects/proposal Stand: 1. 10. 2010
Grit BartenCAPNETZ STIFTUNG
Medizinische Hochschule Hannover
Carl-Neuberg-Str. 1
30625 Hannover
Email: office@capnetz.de