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. 2014 Aug 5:14:128.
doi: 10.1186/1471-2466-14-128.

Pneumococcal pneumonia: differences according to blood culture results

Alberto Capelastegui  1 , Rafael Zalacain, Amaia Bilbao, Mikel Egurrola, Luis Alberto Ruiz Iturriaga, Jose M Quintana, Ainhoa Gomez, Cristobal Esteban, Pedro P España
Affiliations

Pneumococcal pneumonia: differences according to blood culture results

Alberto Capelastegui et al. BMC Pulm Med. .

Abstract

Background: Bacteremia by Streptococcus pneumoniae has been traditionally associated with poor outcomes in patients with pneumonia; however, data on its impact on outcomes are limited and are sometimes contradictory.

Methods: We performed a prospective study in two hospitals in northern Spain in which cases diagnosed with pneumococcal pneumonia were selected from a cohort of hospitalized patients with pneumonia between January 2001 and July 2009. We compared patients with pneumococcal bacteremic pneumonia with those with pneumococcal non-bacteremic pneumonia.

Results: We compared 492 patients with negative blood culture and 399 with positive culture results. Host related factors were very similar in both groups. Severity of illness on admission measured by CURB-65 score was similar in both groups. Adjusted analysis showed a greater likelihood of septic shock during in-hospital course among patients with pneumococcal bacteremia (OR, 2.1; 95% CI, 1.2-3.5; P=0.006). Likewise, patients with positive blood culture had greater in-hospital mortality (OR 2.1; 95% CI, 1.1- -3.9; P=0.02), 15-day mortality (OR 3.6; 95% CI, 1.7-7.4; P=0.0006), and 30-day mortality (OR, 2.7; 95% CI, 1.5-5; P=0.002).

Conclusions: Although host related factors and severity on admission were very similar in the two groups, bacteremic patients had worse in-hospital course and outcomes. Bacteraemia in pneumococcal pneumonia is of prognostic significance.

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Figures

Figure 1
Figure 1
Kaplan-Meier survival curves for the blood culture positive and negative patients.
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