RT Journal Article
SR Electronic
T1 Risk factors for respiratory failure in pneumococcal pneumonia: the importance of pneumococcal serotypes
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 545
OP 553
DO 10.1183/09031936.00050413
VO 43
IS 2
A1 Burgos, Joaquín
A1 Luján, Manel
A1 Larrosa, Maria Nieves
A1 Fontanals, Dionísia
A1 Bermudo, Guadalupe
A1 Planes, Ana Maria
A1 Puig, Mireia
A1 Rello, Jordi
A1 Falcó, Vicenç
A1 Pahissa, Albert
YR 2014
UL http://erj.ersjournals.com/content/43/2/545.abstract
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