PT  - JOURNAL ARTICLE
AU  - Burgos, Joaquín
AU  - Luján, Manel
AU  - Larrosa, Maria Nieves
AU  - Fontanals, Dionísia
AU  - Bermudo, Guadalupe
AU  - Planes, Ana Maria
AU  - Puig, Mireia
AU  - Rello, Jordi
AU  - Falcó, Vicenç
AU  - Pahissa, Albert
TI  - Risk factors for respiratory failure in pneumococcal pneumonia: the importance of pneumococcal serotypes
AID  - 10.1183/09031936.00050413
DP  - 2014 Feb 01
TA  - European Respiratory Journal
PG  - 545--553
VI  - 43
IP  - 2
4099  - http://erj.ersjournals.com/content/43/2/545.short
4100  - http://erj.ersjournals.com/content/43/2/545.full
SO  - Eur Respir J2014 Feb 01; 43
AB  - Pneumococcal serotypes are one of the main determinants of pneumococcal disease severity; however, data about their implication in respiratory failure are scarce. We conducted an observational study of adults hospitalised with invasive pneumococcal pneumonia to describe the host- and pathogen-related factors associated with respiratory failure. Of 1258 adults with invasive pneumococcal disease, 615 (48.9%) had respiratory failure at presentation. Patients with respiratory failure were older (62.1 years versus 55.4 years, p<0.001) and had a greater proportion of comorbid conditions. They also had a greater proportion of septic shock (41.7% versus 6.1%, p<0.001), required admission to the intensive care unit more often (38.4% versus 4.2%, p<0.001) and had a higher mortality (25.5% versus 3.5%, p<0.001). After adjustment, independent risk factors for respiratory failure were: age >50 years (OR 1.63, 95% CI 1.15–2.3), chronic lung disease (OR 1.54, 95% CI 1.1–2.15), chronic heart disease (OR 1.49, 95% CI 1.01–2.22) and infection caused by serotypes 3 (OR 1.97, 95% CI 1.23–3.16), 19A (OR 2.34, 95% CI 1.14–4.42) and 19F (OR 3.55, 95% CI 1.22–10.28). In conclusion, respiratory failure is a frequent complication of pneumococcal pneumonia and causes high morbidity and mortality. Pneumococcal serotypes 3, 19A and 19F are the main risk factors for this complication. Respiratory failure in invasive pneumonia is determined by older age, comorbidities and serotypes 3, 19A and 19F http://ow.ly/qHN6D