Community-Acquired Pneumonia Outside the Intensive Care Unit: Clinical Characteristics and Impact of Rapid Molecular Diagnostics in the Italian SIS-NET Study.

Authors

Luca Pipitò, Ilenia Giacchino, Chiara Vincenza Mazzola, Emanuele Nicastri, Teresa M A Fasciana, Massimo Puoti, Vincenzo Malagnino, Marco Iannetta, Delia Goletti, Maria Grazia Bocci, Antonella Minutolo, Clementina Cocuzza, Marco Merli, Prezioso Carla, Matteo Velardo, Marina Campione, Michael Damiano, Michele Spinicci, Bruno Tassone, Sandro Grelli, Marco Falcone, Laura Rindi, Alessandro Russo, Angela Quirino, Lorenzo Zammarchi, Dolores Limongi, Gian Maria Rossolini, Loredana Sarmati, Giovanni M Giammanco, Antonino Giarratano, Antonio Cascio, SIS-NET Working Group

Published in

International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases. Pages 108988. Jul 17, 2026. Epub Jul 17, 2026.

Abstract

To describe the clinical, radiological, and microbiological characteristics of community-acquired pneumonia (CAP) managed outside the ICU and evaluate the impact of rapid microbiological diagnostics on hospital outcomes in a multicenter Italian cohort.
In this prospective observational study conducted across seven Italian centers (October 2024-October 2025), 176 adults hospitalized with CAP outside the ICU and a PaO₂/FiO₂ ratio <300 were enrolled. Demographic, clinical, laboratory, radiological, microbiological, therapeutic, and outcome data were collected. Syndromic respiratory panels were performed in a subset of patients. Secondary outcomes included factors associated with in-hospital mortality and time to live discharge within 28 days.
Patients were predominantly elderly (mean age 69.7±14.4 years) with high comorbidity burden (Charlson Comorbidity Index 4.9±2.1). Dyspnea, fever, and cough were the most frequent symptoms. Microbiological testing was performed in 48% of cases; viral pathogens were detected more often than bacteria (42.3% vs 27.0%), with viral-bacterial co-detection in 14.1%. In-hospital mortality was 2%, and 3% required ICU transfer. Rapid microbiological testing was independently associated with earlier discharge (HR 1.67, 95%CI 1.17-2.38; p=0.005), while chronic corticosteroid therapy predicted longer hospitalization.
CAP outside the ICU mainly affects elderly multimorbid patients. Rapid molecular diagnostics may facilitate earlier discharge by supporting clinical decision-making.

PMID:
42468735
Bibliographic data and abstract were imported from PubMed on 18 Jul 2026.

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