Severe community-acquired pneumonia in Reunion Island: Epidemiological, clinical, and microbiological characteristics, 2016-2018.
Axel de Mangou, Agathe Combe, Nathalie Coolen-Allou, Guillaume Miltgen, Nicolas Traversier, Olivier Belmonte, David Vandroux, Michel Bohrer, Julien Cousty, Margot Caron, Charles Vidal, J��r��me Allyn, Nicolas Allou
Author Information
Axel de Mangou: Intensive Care Unit, Centre Hospitalier Universitaire Felix Guyon, Saint-Denis, France. ORCID
Agathe Combe: Intensive Care Unit, Centre Hospitalier Universitaire Felix Guyon, Saint-Denis, France.
Nathalie Coolen-Allou: Respiratory Disease, Centre Hospitalier Universitaire Felix Guyon, Saint-Denis, France.
Guillaume Miltgen: Microbiology, Centre Hospitalier Universitaire Felix Guyon, Saint-Denis, France.
Nicolas Traversier: Microbiology, Centre Hospitalier Universitaire Felix Guyon, Saint-Denis, France.
Olivier Belmonte: Microbiology, Centre Hospitalier Universitaire Felix Guyon, Saint-Denis, France.
David Vandroux: Intensive Care Unit, Centre Hospitalier Universitaire Felix Guyon, Saint-Denis, France.
Michel Bohrer: Department of Medical Information, Saint-Denis University Hospital, Saint-Denis, Reunion Island, France. ORCID
Julien Cousty: Intensive Care Unit, Centre Hospitalier Universitaire Sud R��union, Saint-Pierre, France.
Margot Caron: Intensive Care Unit, Centre Hospitalier Universitaire Felix Guyon, Saint-Denis, France.
Charles Vidal: Intensive Care Unit, Centre Hospitalier Universitaire Felix Guyon, Saint-Denis, France. ORCID
J��r��me Allyn: Intensive Care Unit, Centre Hospitalier Universitaire Felix Guyon, Saint-Denis, France.
Nicolas Allou: Intensive Care Unit, Centre Hospitalier Universitaire Felix Guyon, Saint-Denis, France. ORCID
PURPOSE: No data are available on severe community-acquired pneumonia (CAP) in the French overseas department of Reunion Island. This is unfortunate as the microorganisms responsible for the disease are likely to differ from those in temperate regions due to a tropical climate and proximity to other islands of the Indian Ocean region. The aim of this study was to assess the epidemiological, clinical, prognosis, and microbiological characteristics of patients with severe CAP in Reunion Island. MATERIALS AND METHODS: This retrospective study evaluated all patients with CAP aged >18 years and hospitalized in one of the two intensive care units of Reunion Island between 2016 and 2018. Microorganisms were identified by culture from blood and respiratory samples, multiplex polymerase chain reaction from respiratory samples, urinary antigen tests, and serology. RESULTS: Over the study period, 573 cases of severe CAP were recorded, with a mean incidence of 22 per 100,000 person-years. The most frequently isolated microorganism was influenza (21.9%) followed by Streptococcus pneumoniae (12%). The influenza virus was detected in affected patients all year round. Twenty-four patients with severe CAP came from another island of the Indian Ocean region (4.2%), mainly Madagascar (>50%). Two of these patients presented with melioidosis and 4 were infected with Acinetobacter spp. CONCLUSIONS: Our findings have major implications for the management of severe CAP in tropical regions. The most frequently isolated microorganism in patients with severe CAP in Reunion Island is influenza followed by S. pneumoniae. Physicians should be aware that influenza is the main cause of severe CAP in patients living in or returning from Reunion Island, where this virus circulates all year round.
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