title: Age-related risk factors for bacterial aetiology in community-acquired pneumonia.
abstract: The objective of this study was to evaluate the effect of age and comorbidities, smoking and alcohol use on microorganisms in patients with community-acquired pneumonia (CAP).
  
  
  
  A prospective multicentre study was performed with 4304 patients. We compared microbiological results, bacterial aetiology, smoking, alcohol abuse and comorbidities in three age groups: young adults (<45 years), adults (45-64 years) and seniors (>65 years).
  
  
  
  Bacterial aetiology was identified in 1522 (35.4%) patients. In seniors, liver disease was independently associated with Gram-negative bacteria (Haemophilus influenzae and Enterobacteriaceae), COPD with Pseudomonas aeruginosa (OR = 2.69 (1.46-4.97)) and Staphylococcus aureus (OR = 2.8 (1.24-6.3)) and neurological diseases with S. aureus. In adults, diabetes mellitus (DM) was a risk factor for Streptococcus pneumoniae and S. aureus, and COPD for H. influenzae (OR = 3.39 (1.06-10.83)). In young adults, DM was associated with S. aureus. Smoking was a risk factor for Legionella pneumophila regardless of age. Alcohol intake was associated with mixed aetiology and Coxiella burnetii in seniors, and with S. pneumoniae in young adults.
  
  
  
  It should be considered that the bacterial aetiology may differ according to the patient's age, comorbidities, smoking and alcohol abuse. More extensive microbiological testing is warranted in those with risk factors for infrequent microorganisms.
authors.affiliation: Microbiology Service, University and Politechnic Hospital La Fe, Valencia, Spain.
authors.forename: José M
authors.initials: JM
authors.lastname: Sahuquillo-Arce
authors.affiliation: Pneumology Service, IIS/ University and Politechnic Hospital La Fe, Valencia, Spain. rosmenend@gmail.com.|CIBERES, Valencia, Spain. rosmenend@gmail.com.
authors.forename: Rosario
authors.initials: R
authors.lastname: Menéndez
authors.affiliation: Pneumology Service, IIS/ University and Politechnic Hospital La Fe, Valencia, Spain.|CIBERES, Valencia, Spain.
authors.forename: Raúl
authors.initials: R
authors.lastname: Méndez
authors.affiliation: Pneumology Service, IIS/ University and Politechnic Hospital La Fe, Valencia, Spain.|CIBERES, Valencia, Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: Amara-Elori
authors.affiliation: Pneumology Service, University Hospital Cruces, Bilbao, Spain.
authors.forename: Rafael
authors.initials: R
authors.lastname: Zalacain
authors.affiliation: Pulmonology Service, Hospital of Galdakao, Galdakao, Spain.
authors.forename: Alberto
authors.initials: A
authors.lastname: Capelastegui
authors.affiliation: Pneumology Service, University Hospital of Princesa, Madrid, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Aspa
authors.affiliation: Pneumology Service, Hospital San Jorge, Huesca, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Borderías
authors.affiliation: Pneumology Service, University Hospital Carlos Haya, Malaga, Spain.
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Martín-Villasclaras
authors.affiliation: Pneumology Service, University Hospital Miguel Servet, Zaragoza, Spain.
authors.forename: Salvador
authors.initials: S
authors.lastname: Bello
authors.affiliation: Pneumology Service, Universitary Hospital de Valme, Sevilla, Spain.
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Alfageme
authors.affiliation: Pneumology Service, University Hospital Doctor Negrin, Las Palmas de Gran Canaria, Spain.
authors.forename: Felipe Rodriguez
authors.initials: FR
authors.lastname: de Castro
authors.affiliation: Critical Care Unit, University Hospital Joan XXIII, Tarragona, Spain.|Critical Care Unit, University Hospital Vall Hebron, Autonomous University of Barcelona, Barcelona, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Rello
authors.affiliation: Pneumology Service, University Hospital Central, Oviedo, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Molinos
authors.affiliation: Pneumology Service, Hospital Germans Trias i Pujol, Badalona, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Ruiz-Manzano
authors.affiliation: CIBERES, Valencia, Spain.|Pneumology Service, Clinic Hospital, IDIBAPS, University of Barcelona, Barcelona, Spain.
authors.forename: Antoni
authors.initials: A
authors.lastname: Torres
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000437:Alcoholism / Q000453:epidemiology; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000382:microbiology / Q000628:therapy; D015897:Comorbidity; D005260:Female; D006090:Gram-Negative Bacteria / Q000302:isolation & purification*; D006193:Haemophilus influenzae / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000453:epidemiology / Q000382:microbiology / Q000628:therapy; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D013030:Spain / Q000453:epidemiology; D013183:Sputum / Q000382:microbiology; D013211:Staphylococcus aureus / Q000302:isolation & purification*; D013296:Streptococcus pneumoniae / Q000302:isolation & purification*
keywords: age; community-acquired pneumonia; comorbidities; risk factors; smoking and alcohol use