|
KMID : 0882420120820010052
|
|
Korean Journal of Medicine
2012 Volume.82 No. 1 p.52 ~ p.59
|
|
|
Incidence and Cinical Characteristics of Severe Community-Acquired Pneumococcal Pneumonia: Comparisons with Non-Pneumoccocal Pathogens
|
|
Lee Seok-Won
Park Ji-Young
Ah Young-Hwan
Jang Gil-Su
Kim So-Yeon
Ahn Jeung-Sun
Hong Eun-Young
Kang Dong-Hoon
Lim Soo-Young
Kim Ho-Joong
Lee Sung-Yeon
Song Su-Hee
Kim Rul-Bin
Kim Yong-Kyun
Park Sung-Hoon
Kim Dong-Kyu
Jung Ki-Suck
|
|
|
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.
|
|
|
KEYWORD
|
|
|
Pneumonia, Intensive care unit, Streptococcus pneumoniae
|
|
|
FullTexts / Linksout information
|
|
|
|
|
Listed journal information
|
|
  
|
|