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Severe community-acquired pneumonia of different etiology: clinical, differential diagnostic and prognostic criteria


AuthorBielosludtseva KO., PhD (medical science)


This scientific workis presented by State Establishment "Dnipropetrovsk Medical Academy of Health Ministry of Ukraine".

This paper solves the important taskof pulmonology – increased efficiency of treatment of patients with severe community-acquired pneumonia (CAP) by optimizing the differential diagnosis with the diagnostic and prognostic value of markers of systemic inflammation (procalcitonin (PCT), C-reactive protein) and cellular immunity (CD4, CD8) and reduce the cost of treatment.

The scientific bases:additional differential diagnostic criteria of severe CAP of bacterial etiology using marker PCT. There were updated scientific data on the clinical course of severe CAP of various etiologies, given the state of cellular immunity.

There were developed and implementedalgorithms for assessing the severity of patients by taking into account the levels of PCT and CD4.There were supplemented scientific data on severe Pneumocystis pneumonia.At first there were established the prognostic role of markers of systemic inflammation and cellular immunity to assess the impact of severe CAP.

Antibacterial treatment (ABT) was optimized at patients with severe CAP through the development of objective criteria for evaluating the effectiveness and adequacy of etiotropic treatment by dynamically determining of the PCT level, which contributes to shorten the stay in the intensive care unit (ICU), fast replacing parenteral to oral antibiotics, reduction in terms of ABT and hospital stay, which reduces the risk of side effects by ABT and entail significant economic benefits to the state and the patient.

The interest of international organizations shows the global level (results were accepted for presentations at the 23rd and the 24th Annual Congress of the European Respiratory Society "23rd, 24rd Annual Congress of the European Respiratory Society" (Barcelona, 2013, Munich, 2014), XV and XVI International Congress on Antimicrobial Therapy "Clinical microbiology and Antimicrobial Chemotherapy" (Moscow, 2013, Moscow, 2014)).

The economic effect of the introduction:the principle of the proposed PCT-oriented therapy reduces the duration of ABT in 1.7 times, which significantly reduces the cost of treatment for the patient and the state (at least (1948,2 ± 206,1) hryvnia per day while in the ICU and (274,5 ± 26,6) hryvnia per day with further treatment in the general ward.

Research results are reflected in 26 printed works, including 7 articles (from which 4 – in the system logs Index CopernicusTM and 1 – in foreign editions), 18 abstracts, 1 practical guide. h-index - 1.

The total number of publications of the author – 35.