Invasive Disease vs Urinary Antigen-Confirmed Pneumococcal Community-Acquired Pneumonia

Background: The burden of pneumococcal disease is measured only through patients with invasive pneumococcal disease. The urinary antigen test (UAT) for pneumococcus has exhibited high sensitivity and specificity. We aimed to compare the pneumococcal pneumonias diagnosed as invasive disease with pneu...

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Autores: Ceccato, Adrian, Torres Martí, Antoni, Cillóniz, Catia, Amaro, Rosanel, Gabarrús, Albert, Polverino, Eva, Prina, Elena, Garcia Vidal, Carolina, Muñoz Conejero, Eva, Méndez, Cristina, Cifuentes, Isabel, Puig de la Bellacasa, Jordi, Menéndez, Rosario, Niederman, Michael S.
Tipo de recurso: artículo
Estado:Versión aceptada para publicación
Fecha de publicación:2017
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/144559
Acceso en línea:https://hdl.handle.net/2445/144559
Access Level:acceso abierto
Palabra clave:Pneumònia adquirida a la comunitat
Infeccions per pneumococs
Community-acquired pneumonia
Pneumococcal Infections
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spelling Invasive Disease vs Urinary Antigen-Confirmed Pneumococcal Community-Acquired PneumoniaCeccato, AdrianTorres Martí, AntoniCillóniz, CatiaAmaro, RosanelGabarrús, AlbertPolverino, EvaPrina, ElenaGarcia Vidal, CarolinaMuñoz Conejero, EvaMéndez, CristinaCifuentes, IsabelPuig de la Bellacasa, JordiMenéndez, RosarioNiederman, Michael S.Pneumònia adquirida a la comunitatInfeccions per pneumococsCommunity-acquired pneumoniaPneumococcal InfectionsBackground: The burden of pneumococcal disease is measured only through patients with invasive pneumococcal disease. The urinary antigen test (UAT) for pneumococcus has exhibited high sensitivity and specificity. We aimed to compare the pneumococcal pneumonias diagnosed as invasive disease with pneumococcal pneumonias defined by UAT results. Methods: A prospective observational study of consecutive nonimmunosuppressed patients with community-acquired pneumonia was performed from January 2000 to December 2014. Patients were stratified into two groups: invasive pneumococcal pneumonia (IPP) defined as a positive blood culture or pleural fluid culture result and noninvasive pneumococcal pneumonia (NIPP) defined as a positive UAT result with negative blood or pleural fluid culture result. Results: We analyzed 779 patients (15%) of 5,132, where 361 (46%) had IPP and 418 (54%) had NIPP. Compared with the patients with IPP, those with NIPP presented more frequent chronic pulmonary disease and received previous antibiotics more frequently. Patients with IPP presented more severe community-acquired pneumonia, higher levels of inflammatory markers, and worse oxygenation at admission; more pulmonary complications; greater extrapulmonary complications; longer time to clinical stability; and longer length of hospital stay compared with the NIPP group. Age, chronic liver disease, mechanical ventilation, and acute renal failure were independent risk factors for 30-day crude mortality. Neither IPP nor NIPP was an independent risk factor for 30-day mortality. Conclusions: A high percentage of confirmed pneumococcal pneumonia is diagnosed by UAT. Despite differences in clinical characteristics and outcomes, IPP is not an independent risk factor for 30-day mortality compared with NIPP, reinforcing the importance of NIPP for pneumococcal pneumonia.American College of Chest Physicians2017info:eu-repo/semantics/articleinfo:eu-repo/semantics/acceptedVersionapplication/pdfhttps://hdl.handle.net/2445/144559Articles publicats en revistes (Medicina)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésVersió postprint del document publicat a: https://doi.org/10.1016/j.chest.2017.01.005Chest, 2017, vol. 151, num. 6, p. 1311-1319https://doi.org/10.1016/j.chest.2017.01.005(c) American College of Chest Physicians, 2017info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/1445592026-05-27T06:46:51Z
dc.title.none.fl_str_mv Invasive Disease vs Urinary Antigen-Confirmed Pneumococcal Community-Acquired Pneumonia
title Invasive Disease vs Urinary Antigen-Confirmed Pneumococcal Community-Acquired Pneumonia
spellingShingle Invasive Disease vs Urinary Antigen-Confirmed Pneumococcal Community-Acquired Pneumonia
Ceccato, Adrian
Pneumònia adquirida a la comunitat
Infeccions per pneumococs
Community-acquired pneumonia
Pneumococcal Infections
title_short Invasive Disease vs Urinary Antigen-Confirmed Pneumococcal Community-Acquired Pneumonia
title_full Invasive Disease vs Urinary Antigen-Confirmed Pneumococcal Community-Acquired Pneumonia
title_fullStr Invasive Disease vs Urinary Antigen-Confirmed Pneumococcal Community-Acquired Pneumonia
title_full_unstemmed Invasive Disease vs Urinary Antigen-Confirmed Pneumococcal Community-Acquired Pneumonia
title_sort Invasive Disease vs Urinary Antigen-Confirmed Pneumococcal Community-Acquired Pneumonia
dc.creator.none.fl_str_mv Ceccato, Adrian
Torres Martí, Antoni
Cillóniz, Catia
Amaro, Rosanel
Gabarrús, Albert
Polverino, Eva
Prina, Elena
Garcia Vidal, Carolina
Muñoz Conejero, Eva
Méndez, Cristina
Cifuentes, Isabel
Puig de la Bellacasa, Jordi
Menéndez, Rosario
Niederman, Michael S.
author Ceccato, Adrian
author_facet Ceccato, Adrian
Torres Martí, Antoni
Cillóniz, Catia
Amaro, Rosanel
Gabarrús, Albert
Polverino, Eva
Prina, Elena
Garcia Vidal, Carolina
Muñoz Conejero, Eva
Méndez, Cristina
Cifuentes, Isabel
Puig de la Bellacasa, Jordi
Menéndez, Rosario
Niederman, Michael S.
author_role author
author2 Torres Martí, Antoni
Cillóniz, Catia
Amaro, Rosanel
Gabarrús, Albert
Polverino, Eva
Prina, Elena
Garcia Vidal, Carolina
Muñoz Conejero, Eva
Méndez, Cristina
Cifuentes, Isabel
Puig de la Bellacasa, Jordi
Menéndez, Rosario
Niederman, Michael S.
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Pneumònia adquirida a la comunitat
Infeccions per pneumococs
Community-acquired pneumonia
Pneumococcal Infections
topic Pneumònia adquirida a la comunitat
Infeccions per pneumococs
Community-acquired pneumonia
Pneumococcal Infections
description Background: The burden of pneumococcal disease is measured only through patients with invasive pneumococcal disease. The urinary antigen test (UAT) for pneumococcus has exhibited high sensitivity and specificity. We aimed to compare the pneumococcal pneumonias diagnosed as invasive disease with pneumococcal pneumonias defined by UAT results. Methods: A prospective observational study of consecutive nonimmunosuppressed patients with community-acquired pneumonia was performed from January 2000 to December 2014. Patients were stratified into two groups: invasive pneumococcal pneumonia (IPP) defined as a positive blood culture or pleural fluid culture result and noninvasive pneumococcal pneumonia (NIPP) defined as a positive UAT result with negative blood or pleural fluid culture result. Results: We analyzed 779 patients (15%) of 5,132, where 361 (46%) had IPP and 418 (54%) had NIPP. Compared with the patients with IPP, those with NIPP presented more frequent chronic pulmonary disease and received previous antibiotics more frequently. Patients with IPP presented more severe community-acquired pneumonia, higher levels of inflammatory markers, and worse oxygenation at admission; more pulmonary complications; greater extrapulmonary complications; longer time to clinical stability; and longer length of hospital stay compared with the NIPP group. Age, chronic liver disease, mechanical ventilation, and acute renal failure were independent risk factors for 30-day crude mortality. Neither IPP nor NIPP was an independent risk factor for 30-day mortality. Conclusions: A high percentage of confirmed pneumococcal pneumonia is diagnosed by UAT. Despite differences in clinical characteristics and outcomes, IPP is not an independent risk factor for 30-day mortality compared with NIPP, reinforcing the importance of NIPP for pneumococcal pneumonia.
publishDate 2017
dc.date.none.fl_str_mv 2017
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/acceptedVersion
format article
status_str acceptedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/144559
url https://hdl.handle.net/2445/144559
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Versió postprint del document publicat a: https://doi.org/10.1016/j.chest.2017.01.005
Chest, 2017, vol. 151, num. 6, p. 1311-1319
https://doi.org/10.1016/j.chest.2017.01.005
dc.rights.none.fl_str_mv (c) American College of Chest Physicians, 2017
info:eu-repo/semantics/openAccess
rights_invalid_str_mv (c) American College of Chest Physicians, 2017
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv American College of Chest Physicians
publisher.none.fl_str_mv American College of Chest Physicians
dc.source.none.fl_str_mv Articles publicats en revistes (Medicina)
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,301603

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