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Influence of comorbidities in the clinical presentation of invasive pneumococcal disease (IPD) in adults in Spain, 2010-2013. The ODIN study

Catia Cilloniz, Emilio Bouza, Inmaculada Grau, Luis Molinos, Miguel Salavert, Pedro Llinares, José Luis De la Cruz, Inmaculada Alfageme, Olga Rajas, Asunción Fenoll, Josefina Liñares, Isabel Cifuentes
European Respiratory Journal 2014 44: P1051; DOI:
Catia Cilloniz
1Pneumology, Hospital Clinic, Barcelona, Spain
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Emilio Bouza
1Pneumology, Hospital Clinic, Barcelona, Spain
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Inmaculada Grau
1Pneumology, Hospital Clinic, Barcelona, Spain
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Luis Molinos
1Pneumology, Hospital Clinic, Barcelona, Spain
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Miguel Salavert
1Pneumology, Hospital Clinic, Barcelona, Spain
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Pedro Llinares
1Pneumology, Hospital Clinic, Barcelona, Spain
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José Luis De la Cruz
1Pneumology, Hospital Clinic, Barcelona, Spain
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Inmaculada Alfageme
1Pneumology, Hospital Clinic, Barcelona, Spain
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Olga Rajas
1Pneumology, Hospital Clinic, Barcelona, Spain
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Asunción Fenoll
1Pneumology, Hospital Clinic, Barcelona, Spain
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Josefina Liñares
1Pneumology, Hospital Clinic, Barcelona, Spain
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Isabel Cifuentes
1Pneumology, Hospital Clinic, Barcelona, Spain
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Abstract

Objectives: To explore comorbidities associated with the different clinical presentations of IPD in adults in Spain.

Methods: A prospective, active, hospital-based surveillance of culture-confirmed IPD episodes in adults (≥18years) was performed in 9 Spanish hospitals (August 2010-June 2013). IPD was considered as isolation of S. pneumoniae from normally sterile fluids. Comorbidities, risk habits, clinical presentation [complicated pneumonia -CP-(presence of pleural effusion/empyema and/or multilobar infiltration), non-complicated pneumonia -N-CP-, meningitis -M-, primary bacteremia -PB-, peritonitis -P- and others -O-], and outcome were recorded. Comorbidities known to increase the risk of IPD were compared between the different clinical presentations.

Results: Among the 637 IPD cases identified, up to 90.3% of the patients had ≥1 comorbidity and/or risk habits. Table shows comorbidities with significant association with any of the IPD clinical presentations.

Severe sepsis/septic shock occurred in 22% of the patients. Overall mortality was 14.8%, being the highest in PB (21.2%) and CP (20%). Mortality in patients developing severe sepsis/septic shock was 35%.

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Conclusions: This is the first study that clearly demonstrates that some underlying conditions influence the clinical presentation of IPD and thus the mortality rate.

  • Pneumonia
  • Comorbidities
  • Sepsis
  • © 2014 ERS
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Influence of comorbidities in the clinical presentation of invasive pneumococcal disease (IPD) in adults in Spain, 2010-2013. The ODIN study
Catia Cilloniz, Emilio Bouza, Inmaculada Grau, Luis Molinos, Miguel Salavert, Pedro Llinares, José Luis De la Cruz, Inmaculada Alfageme, Olga Rajas, Asunción Fenoll, Josefina Liñares, Isabel Cifuentes
European Respiratory Journal Sep 2014, 44 (Suppl 58) P1051;

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Influence of comorbidities in the clinical presentation of invasive pneumococcal disease (IPD) in adults in Spain, 2010-2013. The ODIN study
Catia Cilloniz, Emilio Bouza, Inmaculada Grau, Luis Molinos, Miguel Salavert, Pedro Llinares, José Luis De la Cruz, Inmaculada Alfageme, Olga Rajas, Asunción Fenoll, Josefina Liñares, Isabel Cifuentes
European Respiratory Journal Sep 2014, 44 (Suppl 58) P1051;
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