RT Journal Article
SR Electronic
T1 Impact of bacterial coinfection on clinical outcomes in pneumococcal pneumonia
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP PA1842
DO 10.1183/13993003.congress-2015.PA1842
VO 46
IS suppl 59
A1 Shogo Kumagai
A1 Tadashi Ishida
A1 Hiromasa Tachibana
A1 Yuhei Ito
A1 Akihiro Ito
A1 Toru Hashimoto
YR 2015
UL http://erj.ersjournals.com/content/46/suppl_59/PA1842.abstract
AB Purpose: The aim of this study was to investigate the influence of bacterial coinfection on patients with pneumococcal pneumonia.Methods: We retrospectively analyzed the incidence, clinical features, microbial distributions, and outcomes of patients with bacterial coinfection in a cohort of 433 hospitalized patients with pneumococcal pneumonia.Results: Eighty-five patients (19.6%) were diagnosed with bacterial coinfection; the most frequent pathogens were Haemophilus influenzae (25 patients, 33.3%), methicillin-sensitive Staphylococcus aureus (15 patients, 20.0%), and Moraxella catarrhalis (13 patients, 17.3%). The CURB-65 score and pneumonia severity index (PSI) were significantly higher in patients with bacterial coinfection (both P < 0.001). In addition, the proportion of patients with bacterial coinfection who met the IDSA/ATS severe pneumonia criteria was significantly higher (P < 0.001). Multivariate logistic regression analysis identified three risk factors for bacterial coinfection in patients with pneumococcal pneumonia: alcoholism (odds ratio [OR], 5.12; 95% confidence interval (95% CI), 1.60-16.4; P = 0.006), hospitalization for two days or more within 90 days preceding admission (OR, 2.02; 95% CI, 1.03-3.98; P = 0.041), and residence in a nursing home or extended care facility (OR, 3.22; 95% CI, 1.48-6.97; P = 0.003). Multivariate analysis for 30-day mortality showed that bacterial coinfection was a significant adverse prognostic factor (OR, 2.50; 95% CI, 1.13-5.53; P = 0.023), independent of IDSA/ATS severe pneumonia, PSI, or healthcare-associated pneumonia.Conclusion: Bacterial coinfection may have an adverse impact on severity and outcomes of pneumococcal pneumonia.