Incidence and Cinical Characteristics of Severe Community-Acquired Pneumococcal Pneumonia: Comparisons with Non-Pneumoccocal Pathogens.
- Author:
Seok Won LEE
1
;
Ji Young PARK
;
Young Hwan AN
;
Gil Su JANG
;
So Yeon KIM
;
Jung Sun AN
;
Eun Yeong HONG
;
Dong Hoon KANG
;
Soo Young LIM
;
Ho Joong KIM
;
Sung Yeon LEE
;
Su Hee SONG
;
Rul Bin KIM
;
Yong Kyun KIM
;
Sunghoon PARK
;
Dong Kyu KIM
;
Ki Sung JUNG
Author Information
1. Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea. pulmoks@hallym.or.kr
- Publication Type:Original Article
- Keywords:
Pneumonia;
Intensive care unit;
Streptococcus pneumoniae
- MeSH:
Communicable Diseases;
Humans;
Incidence;
Intensive Care Units;
Male;
Multivariate Analysis;
Pneumonia;
Pseudomonas aeruginosa;
Retrospective Studies;
Shock;
Staphylococcus aureus;
Streptococcus pneumoniae;
Tertiary Care Centers;
Treatment Failure
- From:Korean Journal of Medicine
2012;82(1):52-59
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: Only limited data are available on severe community-acquired pneumonia (severe CAP or SCAP) caused by Streptococcus pneumoniae in Korea. METHODS: All patients who were admitted to a tertiary hospital for CAP from January 2007 to December 2008 were reviewed retrospectively, and SCAP was defined by 2007 Infectious Disease Society of America/American Thoracic Society criteria. RESULTS: In total, 94 patients were diagnosed with SCAP (mean age, 73.5 +/- 14.3 years; male, 70). Among them, pneumococcal SCAP (P-SCAP) accounted for 24.5%, and non-P-SCAP accounted for 18.1% (four with Pseudomonas aeruginosa, [4.3%]; four with Staphylococcus aureus, [4.3%]), and no organisms were identified in 57.4% of the patients. A history of neoplasm was less frequent, and the incidence of shock and pneumonia severity index (PSI) scores were lower in patients with P-SCAP than in those with non-P-SCAP or with SCAP with no organism identified (p = 0.012, 0.023 and 0.007, respectively). Patients with P-SCAP had a lower rate of treatment failure (p = 0.048) and tended to have lower in-hospital and 30-day mortalities compared with those with non-P-SCAP. In a multivariate analysis, the history of neoplasm was the strongest independent factor for predicting 30-day mortality (odds ratio, 9.068; 95% confidence interval, 1.856-44.309). CONCLUSIONS: P-SCAP accounted for 24.5% of SCAP cases. P-SCAP was associated with lower disease severity and a tendency toward better hospital outcomes compared with non-P-SCAP.
