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We also collected the number of admissions to the IMD and Neratinib cost that of patients newly diagnosed with pneumonia. Demographic data and data on underlying conditions included age, sex, Charlson co-momorbity index, Barthel index, and the presence of risk factors for aspiration pneumonia such as altered consciousness, altered gag reflex, dysphagia, severe periodontal disease or putrid sputum [4]. We recorded the Pneumonia Severity Index (PSI) and the CURB-65 (confusion, urea nitrogen, respiratory rate, blood pressure, and age 65?years or older) severity score in CAP and HCAP patients. We recorded collection data and results for the following samples: blood culture, sputum, bronchial aspirate, bronchoalveolar lavage, pulmonary biopsy, pneumococcal and Legionella urinary antigen, serology and nasopharyngeal swab for detection of the influenza virus. We defined pneumonia due to difficult-to-treat (DTT) microorganisms as those episodes caused by Enterobacteriaceae, Pseudomonas aeruginosa or methicillin-resistant Staphylococcus aureus (MRSA). Data on therapeutic management included administration of empirical antibiotic treatment, time from diagnosis to first antibiotic dose, route of administration, adherence to IDSA guidelines for the management of CAP Quinapyramine [21] and ATS guidelines for the management of HAP and HCAP [2]. In patients with positive cultures, we also evaluated the adequacy of empirical therapy according to the sensitivity tests of the causative agent. Outcomes were evaluated using the following: time to clinical stability [22]; need for intubation and days of mechanical ventilation; development of a complication such as empyema, septic shock and multi-organ failure; persistent bacteraemia and/or emergence of antibiotic resistance in the causative organism; in-hospital death; and length of hospitalization from the diagnosis of pneumonia. Categorical variables are presented as absolute numbers and their relative frequencies. Quantitative variables are presented as mean and standard deviation (SD) if normally distributed or as median and interquartile range (IQR) if non-normally distributed. We compared categorical variables between three epidemiological groups (CAP, HCAP and HAP) learn more using the Pearson chi-squared and Fisher exact tests, while the non-parametric Mann�CWhitney and Kruskal�CWallis tests were used to compare quantitative variables. A post hoc Bonferroni correction was performed for pairwise comparisons. Stepwise logistic regression models were used in the multivariate analysis to analyse risk factors for pneumonia due to DTT microorganisms and for in-hospital mortality. Variables with p?