Risk Factors and Pathogenic Significance of Bacteremic Pneumonia in Adult Patients With Community-Acquired Pneumococcal Pneumonia

J Infect. 2013 Jan;66(1):34-40. doi: 10.1016/j.jinf.2012.08.011. Epub 2012 Aug 23.

Abstract

Objective: This study was performed to identify risk factors for the development of bacteremic pneumonia and to evaluate the impact of bacteremia on the outcome of pneumococcal pneumonia.

Methods: Using a database from a surveillance study of community-acquired pneumococcal pneumonia, we compared data of the bacteremic group with that of the non-bacteremic group.

Results: Among 981 adult patients with pneumococcal pneumonia, 114 (11.6%) patients who had documented pneumococcal bacteremia were classified into the bacteremic group. In a multivariable analysis, use of immunosuppressant drugs, younger age (<65 years), and DM were independent risk factors associated with the development of bacteremic pneumonia among patients with pneumococcal pneumonia (all P < 0.05). The mortality rate was significantly higher in the bacteremic group than in the non-bacteremic group (28.6% vs. 8.5%; P < 0.001). The multivariable analysis revealed that concomitant bacteremia was one of the significant risk factors associated with mortality (OR, 2.57; 95% CI, 1.24-5.29), along with cerebrovascular disease and presentation with septic shock (all P < 0.05).

Conclusions: Bacteremia was a common finding in pneumococcal pneumonia and was associated with a higher mortality rate. Several clinical variables may be useful for predicting bacteremic pneumonia among patients with pneumococcal pneumonia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Asia / epidemiology
  • Bacteremia / epidemiology
  • Bacteremia / microbiology*
  • Chi-Square Distribution
  • Community-Acquired Infections / epidemiology
  • Community-Acquired Infections / microbiology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Pneumonia, Pneumococcal / epidemiology
  • Pneumonia, Pneumococcal / microbiology*
  • Prospective Studies
  • Risk Factors
  • Streptococcus pneumoniae / isolation & purification*