PT  - JOURNAL ARTICLE
AU  - Rosanel Amaro Rodriguez
AU  - Adamatia Liapikou
AU  - Catia Cilloniz
AU  - Albert Gabarrús
AU  - Framcesc Marco
AU  - Jacobo Sellarés
AU  - Eva Polverino
AU  - Javier Garau
AU  - Miquel Ferrer
AU  - Daniel M. Musher
AU  - Antoni Torres
TI  - Bacteremic vs. non-bacteremic pneumococcal pneumonia in immunocompetent patients: Predictive and prognostic factors
AID  - 10.1183/13993003.congress-2016.PA604
DP  - 2016 Sep 01
TA  - European Respiratory Journal
PG  - PA604
VI  - 48
IP  - suppl 60
4099  - http://erj.ersjournals.com/content/48/suppl_60/PA604.short
4100  - http://erj.ersjournals.com/content/48/suppl_60/PA604.full
SO  - Eur Respir J2016 Sep 01; 48
AB  - In patients with Streptococcus pneumoniae community-acquired pneumonia (CAP), the risk factors for bacteremia, and its impact on major outcomes are not fully elucidated. We aimed to compare characteristics of patients with bacteremic vs. definitive non-bacteraemic pneumococcal CAP, and to characterize serotypes associated with bacteremic disease.We describe a prospective, observational study on non-immunocompromised patients with pneumococcal CAP, from 1996 to 2013.Of a total of 917 patients with pneumonia caused by S. pneumoniae,362 with bacteremic pneumococcal pneumonia (BPP; 39%) were identified. High level of C-reactive protein (≥20 mg/dL) (OR 2.36, 95% CI 1.45-3.85), pleural effusion (OR 2.03, 95% CI 1.13-3.65), and multilobar involvement (OR 1.69, 95% CI 1.02-2.79) were independently associated with bacteremic CAP in the multivariate analysis, while nursing home resident (OR 0.12, 95% CI 0.01-1.00) was found as protective factor. Despite the clinical differences, BPP showed similar outcomes to NBPP patients in multivariate analyses (ICU admission, 30-day mortality, and length of hospital stay). 14% of the serotypes (years 2006-2013) causing bacteremia are included in PVC7, 74% in PVC13, and 83% in PPV23.Pleural effusion, a high level of C-reactive protein, and multilobar involvement predicted an increased risk of BPP. Although BPP patients were more severely ill at admission, mortality was not significantly greater than in NBPP patients.