Abstract
The aim. The frequency of pneumococcal community-acquired pneumonia (CAP) has been studied among the patients of hospitals in 3 regions of the Russian Federation in 2011 year: the Republic of Sakha-Yakutia (group 1); the Novgorod region (group 2); the city Samara (group 3).
The methods.
The number of patients with CAP confirmed by the chest radiography was 266 people: the group 1 - 91 people (55 men and 36 women), the group 2 - 81 people (52 men and 29 women), the group 3 - 94 people (55 men and 39 women). Pneumococcal etiology of CAP was confirmed by the selection of phlegm pathogen and antigen capsules Pneumococcus (AgP) in urine using test Binax NOW Streptococcus pneumoniae (United States).
The results.
Urinary test for AgP was positive at 19,9% of the patients: 24,2% (1); 25,9% (2); 10,6 (3) respectively. In the sputum Pneumococcus was detected at 20,4% of surveyed: 7,0% (1), 442% (2) and 22,1% (3) respectively. Pneumococcal etiology of CAP, confirmed by 2 laboratory methods, amounted to 13,1%: 5,8 (1); 30,2 (2) and 11,7% (3) respectively. AgP in the urine was found at 25,7% patients with severe disease and 37,9% patients with CAP and death. In patients with CAP and pleuritis AgP in the urine was found at 29,4%, at 18,5 % without pleural effusion and at 15,0 % of mild CAP. The sensitivity of the Binax NOW S. pneumoniae urine test in patients with pneumococcal CAP confirmed by bacteriological methods was 64,3 % and its specificity was 90,9 %.
Conclusions. The high prevalence of pneumococcal CAP in adult patients admitted to a hospital and severe disease with the risk of death in patients at the age 40 years and older with co-morbidity provide an urgent need for pneumococcal vaccination of these cohorts.
- © 2014 ERS