RT Journal Article
SR Electronic
T1 Predictors of treatment failure in patients with bacteremic pneumococcal community-acquired pneumonia
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P296
VO 42
IS Suppl 57
A1 Ane Uranga
A1 Alberto Capelastegui
A1 Pedro Pablo Espana
A1 Rosa Díez
A1 Rafael Zalacaín
A1 Luis Alberto López
A1 Amaia Bilbao
A1 Maria Jose Lopez
YR 2013
UL http://erj.ersjournals.com/content/42/Suppl_57/P296.abstract
AB Background: Bacteremia has usually been associated with poor outcomes in patients with pneumococcal pneumonia. However, risk factors for a worse in-hospital course are not easily recognized.Objectives: The aim of this study was to identify predictive characteristics for treatment failure in patients with bacteremic pneumococcal pneumonia.Methods: A prospective and observational study was carried out in 2 hospitals. We analysed cases with bacteremic pneumococcal pneumonia from a cohort of hospitalized patients. Patients with meningitis and/or endocarditis were excluded. Treatment failure was defined as clinical deterioration during hospitalization with hemodynamic inestability, confirmation of respiratory failure or the onset thereof, need of mechanical ventilation, demonstrated radiological progression of pneumonia or a new focus of infection, or persistent fever or the reappearance of fever if a change in treatment was needed.The predictive accuracy was measured by means of logistic regression models while the AUC was used to measure the predictive ability.ResultsWe analyzed 399 (44.8%) patients with bacteremic pneumococcal pneumonia. Figure 1 shows predictors of treatment failure with an AUC of 0.78.ConclusionsThe presence of pH < 7.35, respiratory rate ≥ 30 and serotypes 3, 6A, 6B, 8, 19F and 23F were identified as predictors for treatment failure in patients with bacteremic pneumococcal pneumonia.