{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T10:33:07Z","timestamp":1792492387642,"version":"4.5.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2015,2,1]],"date-time":"2015-02-01T00:00:00Z","timestamp":1422748800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>To identify pathogens that require different treatments in community-acquired pneumonia (CAP), we propose an acronym, \u201cPES\u201d (P \u00a0seudomonas aeruginosa, E \u00a0nterobacteriaceae extended-spectrum \u03b2-lactamase\u2013positive, and methicillin-resistant S \u00a0taphylococcus aureus).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To compare the clinical characteristics and outcomes between patients with CAP caused by PES versus other pathogens, and to identify the risk factors associated with infection caused by PES.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted an observational prospective study evaluating only immunocompetent patients with CAP and an established etiological diagnosis. We included patients from nursing homes. We computed a score to identify patients at risk of PES pathogens.<\/jats:p>\n                    <jats:p>Measurement and Main Results: Of the 4,549 patients evaluated, we analyzed 1,597 who presented an etiological diagnosis. Pneumonia caused by PES was identified in 94 (6%) patients, with 108 PES pathogens isolated (n\u2009=\u200972 P. aeruginosa, n\u2009=\u200915 E \u00a0nterobacteriaceae extended-spectrum \u03b2-lactamase positive, and n\u2009=\u200921 methicillin-resistant S \u00a0taphylococcus aureus). These patients were older (P\u2009=\u20090.001), had received prior antibiotic treatment more frequently (P\u2009&amp;lt;\u20090.001), and frequently presented with acute renal failure (P\u2009=\u20090.004). PES pathogens were independently associated with increased risk of 30-day mortality (adjusted odds ratio\u2009=\u20092.51; 95% confidence interval\u2009=\u20091.20\u20135.25; P\u2009=\u20090.015). The area under the curve for the score we computed was 0.759 (95% confidence interval, 0.713\u20130.806; P\u2009&amp;lt;\u20090.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PES pathogens are responsible for a small proportion of CAP, resulting in high mortality. These pathogens require a different antibiotic treatment, and identification of specific risk factors could help to identify these microbial etiologies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1513\/annalsats.201407-305oc","type":"journal-article","created":{"date-parts":[[2014,12,19]],"date-time":"2014-12-19T03:15:13Z","timestamp":1418958913000},"page":"153-160","source":"Crossref","is-referenced-by-count":169,"title":["Risk Factors Associated with Potentially Antibiotic-Resistant Pathogens in Community-Acquired Pneumonia"],"prefix":"10.1093","volume":"12","author":[{"given":"Elena","family":"Prina","sequence":"first","affiliation":[{"name":"Servei de Pneumologia, Institut del Torax, Hospital Clinic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain"},{"name":"Pulmonary Division, Heart Institute, Hospital das Cl\u00ednicas, Faculdade de Medicina da Universidade de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Otavio T.","family":"Ranzani","sequence":"additional","affiliation":[{"name":"Servei de Pneumologia, Institut del Torax, Hospital Clinic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain"},{"name":"Pulmonary Division, Heart Institute, Hospital das Cl\u00ednicas, Faculdade de Medicina da Universidade de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Polverino","sequence":"additional","affiliation":[{"name":"Servei de Pneumologia, Institut del Torax, Hospital Clinic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain"},{"name":"Centro de Investigaci\u00f3n Biomedica En Red-Enfermedades Respiratorias, Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catia","family":"Cill\u00f3niz","sequence":"additional","affiliation":[{"name":"Servei de Pneumologia, Institut del Torax, Hospital Clinic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain"},{"name":"Centro de Investigaci\u00f3n Biomedica En Red-Enfermedades Respiratorias, Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miquel","family":"Ferrer","sequence":"additional","affiliation":[{"name":"Servei de Pneumologia, Institut del Torax, Hospital Clinic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain"},{"name":"Centro de Investigaci\u00f3n Biomedica En Red-Enfermedades Respiratorias, Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laia","family":"Fernandez","sequence":"additional","affiliation":[{"name":"Servei de Pneumologia, Institut del Torax, Hospital Clinic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain"},{"name":"Centro de Investigaci\u00f3n Biomedica En Red-Enfermedades Respiratorias, Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Puig de la Bellacasa","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Hospital Clinic, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosario","family":"Men\u00e9ndez","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biomedica En Red-Enfermedades Respiratorias, Barcelona, Barcelona, Spain"},{"name":"Servicio de Neumologia, Hospital Universitario La Fe, Valencia, Spain; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josep","family":"Mensa","sequence":"additional","affiliation":[{"name":"Servicio de Enfermedades Infecciosas, Hospital Cl\u00ednic, IDIBAPS, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoni","family":"Torres","sequence":"additional","affiliation":[{"name":"Servei de Pneumologia, Institut del Torax, Hospital Clinic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain"},{"name":"Centro de Investigaci\u00f3n Biomedica En Red-Enfermedades Respiratorias, Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2015,2,1]]},"reference":[{"key":"2026012303404887300_bib1","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1097\/MCP.0b013e32835f1c0b","article-title":"Advances in antibiotic therapy for community-acquired pneumonia","volume":"19","author":"Viasus","year":"2013","journal-title":"Curr Opin Pulm Med"},{"key":"2026012303404887300_bib2","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1086\/524891","article-title":"Infectious Diseases Society of America. 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