Table 2.
Common, pandemic, and endemic pathogens responsible for ARDS and their features and risk factors
| Features and risk factors | |
|---|---|
| Common pathogens | |
| Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae, Moraxella catarrhalis, Legionella pneumophila, Chlamydia pneumonia, Mycoplasma pneumonia |
Community-acquired pneumonia Co-morbid conditions* Influenza active in community (Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae) Cruise ships or resorts (Legionella pneumophila) |
| Pseudomonas aeruginosa, Klebsiella pneumoniae, Escherichia coli, Acinetobacter species, Enterobacter species |
Hospital-acquired pneumonia Co-morbid conditions* Mechanical ventilation |
| Anaerobes | Aspiration |
| Influenza A or B virus |
Influenza A can cause pandemics Co-morbid conditions* Influenza active in community |
| Picornaviruses (rhinovirus, enterovirus), Human coronaviruses (229E, NL63, OC43, HKU1), Respiratory syncytial virus, Human metapneumovirus, Parainfluenza (1–4), Adenoviruses |
Frequently detected in critically ill patients with ARDS May cause disease in the elderly and in patients with co-morbid conditions* |
| Pneumocystis jirovecii | HIV infection or other causes of immunosuppression |
| Pandemic pathogens | |
| SARS-CoV-2 |
Pandemic situation Exposure to patient with known COVID-19 Residence or travel in an area with active COVID-19 |
| Endemic pathogens | |
| Bacillus anthracis (anthrax) | In context of bioterrorism |
| Yersinia pestis (pneumonic plague) |
Residence in rural areas in Madagascar Camping, hunting or contact with rodents |
| Francisella tularensis (tularemia) | Exposure to rabbits |
| Chlamydophila psittaci (psittacosis) | Exposure to birds and poultry/poultry market |
| Coxiella burnetti (Q fever) | Exposure to farm animals or parturient cats |
| Mycobacterium tuberculosis |
Residence in tuberculosis endemic areas Co-morbid conditions: Alcoholism, injection drug use, HIV infection, immunosuppression |
| Avian influenza A/H5N1, A/H5N6, A/H7N9 and other subtypes |
Residence or travel to Southeast and East Asia Exposure to birds and poultry/poultry market |
| MERS-CoV |
Residence or travel to the Arabian Peninsula Exposure to dromedary camel |
| Hantaviruses (e.g., Sin Nombre, Andes) |
Residence or travel to Western and Southwestern United States Exposure to rodent excretions |
| Measles virus | Incomplete vaccination |
| Human adenovirus type 55 (HAdV-55) | Residence or travel to Southeast and East Asia |
| Varicella-zoster virus |
Pregnancy Immunosuppression |
| Cytomegalovirus | Immunosuppression |
| Blastomyces dermatitidis, Histoplasma capsulatum, Coccidioides immitis |
Residence or travel to Ohio and Mississippi River valleys and Great Lakes (Blastomyces dermatitidis, Histoplasma capsulatum) or Western and southwestern United States (Coccidioides immitis) Outdoor activities in wooded areas (Blastomyces dermatitidis) |
| Plasmodium falciparum | Residence or travel to malaria endemic areas |
*Co-morbid conditions include alcoholism, COPD, aspiration, pregnancy, bronchiectasis, injection drug use, HIV infection, and immunosuppression