The risk factors of clinical practice for bacteremia in community- acquired pneumococcal pneumonia

Abstract

Background: Risk factors for predicting bacteremia in community acquired pneumococcal pneumonia are unclear. The aim of this study was to identify risk factors for predicting bacteremia in pneumococcal pneumonia.

Methods: We analyzed retrospectively community-acquired pneumococcal pneumonia patients which were hospitalized between April 2007 and August 2015. Logistic regression models were performed to identify the risk factors for predicting bacteremia and log-rank analysis were performed to compare with the 30 day mortality between the patients with and without bacteremia.

Results: A total of 402 patients were diagnosed pneumococcal pneumonia by sputum culture or urine antigen test and 49 patients were pneumococcal bacteremia. The age (Hazard ratio (HR):0.97, 95% confidence interval (95% CI): 0.95-0.99, p<0.01), albumin (HR:0.34, 95%CI:0.21-0.53, p<0.01), IDSA/ATS severe pneumonia (HR:3.3, 95%CI:1.75-6.1, p<0.01), BUN (HR:1.02, 95%CI:1.01-1.04, p<0.01), creatinine(HR:1.51, 95%CI:1.12-2.02, p<0.01), CRP (HR:1.08, 95%CI:1.05-1.11, p<0.01), P/F ratio (HR:0.99, 95%CI:0.99-1.00, p<0.01) were significant risk factors for predicting pneumococcal bacteremia on univariate analysis. The younger age, lower albumin, higher creatinine, higher CRP levels were significant risk factors on multivariate analysis. The Patients with pneumococcal bacteremia had greater 30-day mortality (14.3%) than without bacteremia (2.9%) (p= 0.002).

Conclusions: Age, albumin, creatinine, CRP were risk factors of bacteremia in pneumococcal pneumonia, which is related to poor outcomes.