HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Guest Access | Sign In via User Name/Password

This Article Full Text (PDF) All Versions of this Article: chest.07-1322v1 133/3/618    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Bordón, J. Articles by Ramirez, J. Search for Related Content PubMed PubMed Citation Articles by Bordón, J. Articles by Ramirez, J.

The Presence of Pneumococcal Bacteremia does not Influence Clinical Outcomes in Patients with Community-Acquired Pneumonia: Results from the Community-Acquired Pneumonia Organization (CAPO) International Cohort Study.

¹Providence Hospital, Department of Medicine, Section of Infectious Diseases ²University of Louisville Medical School, Division of Infectious Diseases ³University of Louisville, School of Public Health and Information Sciences, Department of Bioinformatics and Biostatistics ⁴Università degli Studi di Milano, Ospedale Maggiore Milano, Istituto Malattie Respiratorie ⁵Joan XXIII University Hospital, Critical Care Department and ⁶Summa Health System, Department of Medicine

Abstract

BackgroundIt remains unknown whether pneumococcal bacteremia increases the risk of poor outcomes in hospitalized patients with CAP. The objective of this study is to investigate if the presence of pneumococcal bacteremia influences the clinical outcomes of hospitalized patients with CAP.

MethodsWe performed secondary analyses of the community-acquired pneumonia organization (CAPO) database of hospitalized patients with CAP and pneumococcal bacteremia and patients with CAP and negative blood cultures. To identify the effect of pneumococcal bacteremia on patients outcomes, we modeled all-cause mortality and CAP-related mortality using logistic regression analysis, and time to clinical stability and length of hospital stay using Cox proportional hazards models.

ResultsWe studied 125 subjects with pneumococcal bacteremic CAP and 1,847 subjects with non-bacteremic CAP. The multivariable regression analysis revealed lack of association of pneumococcal bacteremic CAP and time to clinical stability (HR 0.87, 95% CI 0.7-1.1, p=0.25), length of hospital stay (HR 1.14, 95% CI 0.91-1.43, p=0.25), all-cause mortality (OR 0.68, 95% CI 0.36-1.3, p=0.25) and CAP-related mortality (OR 0.86, 95% CI 0.35-2.06 p=0.73).

ConclusionsPneumococcal bacteremia does not increase the risk of poor outcomes in patients with CAP. Factors related to severity of disease are confounders of the association between pneumococcal bacteremia and poor outcomes. This study indicates that the presence of pneumococcal bacteremia by itself should not be a contraindication for de-escalation of therapy in clinically stable hospitalized patients with CAP.