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

Yasuyoshi Washio, Akihiro Ito, Shogo Kumagai, Tadashi Ishida
European Respiratory Journal 2016 48: PA605; DOI: 10.1183/13993003.congress-2016.PA605
Yasuyoshi Washio
1Respiratory Medicine, Kurashiki Central Hospital, Kurashiki, OkayamaJapan
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Akihiro Ito
1Respiratory Medicine, Kurashiki Central Hospital, Kurashiki, OkayamaJapan
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Shogo Kumagai
1Respiratory Medicine, Kurashiki Central Hospital, Kurashiki, OkayamaJapan
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Tadashi Ishida
1Respiratory Medicine, Kurashiki Central Hospital, Kurashiki, OkayamaJapan
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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.

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The risk factors of clinical practice for bacteremia in community- acquired pneumococcal pneumonia
Yasuyoshi Washio, Akihiro Ito, Shogo Kumagai, Tadashi Ishida
European Respiratory Journal Sep 2016, 48 (suppl 60) PA605; DOI: 10.1183/13993003.congress-2016.PA605

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The risk factors of clinical practice for bacteremia in community- acquired pneumococcal pneumonia
Yasuyoshi Washio, Akihiro Ito, Shogo Kumagai, Tadashi Ishida
European Respiratory Journal Sep 2016, 48 (suppl 60) PA605; DOI: 10.1183/13993003.congress-2016.PA605
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