RT Journal Article
SR Electronic
T1 Bacteremic vs. non-bacteremic pneumococcal pneumonia in immunocompetent patients: Predictive and prognostic factors
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP PA604
DO 10.1183/13993003.congress-2016.PA604
VO 48
IS suppl 60
A1 Rosanel Amaro Rodriguez
A1 Adamatia Liapikou
A1 Catia Cilloniz
A1 Albert Gabarrús
A1 Framcesc Marco
A1 Jacobo Sellarés
A1 Eva Polverino
A1 Javier Garau
A1 Miquel Ferrer
A1 Daniel M. Musher
A1 Antoni Torres
YR 2016
UL http://erj.ersjournals.com/content/48/suppl_60/PA604.abstract
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.