Bacteraemic pneumococcal pneumonia in COPD patients: better outcomes than expected

• Published in: European journal of clinical microbiology & infectious diseases Vol. 28; no. 8; pp. 971 - 976
• Main Authors: Calbo, E, Valdés, E, Ochoa de Echagüen, A, Fleites, A, Molinos, L, Xercavins, M, Freixas, N, Rodríguez-Carballeira, M, Garau, J
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Berlin/Heidelberg : Springer-Verlag 01.08.2009; Springer-Verlag; Springer; Springer Nature B.V
• Subjects: Adult; Aged; Anti-Bacterial Agents - therapeutic use; Antibiotics; Bacteremia - drug therapy; Bacteremia - epidemiology; Bacteremia - microbiology; Bacteremia - physiopathology; Bacterial diseases; Bacterial sepsis; Biological and medical sciences; Biomedical and Life Sciences; Biomedicine; Case-Control Studies; Chronic obstructive pulmonary disease; Female; Hospitals; Human bacterial diseases; Humans; Infectious diseases; Internal Medicine; Male; Medical Microbiology; Medical sciences; Microbiology; Middle Aged; Mortality; Patients; Penicillin; Pneumology; Pneumonia; Pneumonia, Pneumococcal - complications; Pneumonia, Pneumococcal - drug therapy; Pneumonia, Pneumococcal - epidemiology; Pneumonia, Pneumococcal - physiopathology; Pulmonary Disease, Chronic Obstructive - complications; Respiratory system : syndromes and miscellaneous diseases; Risk Factors; Serotyping; Severity of Illness Index; Staphylococcal infections, streptococcal infections, pneumococcal infections; Streptococcus infections; Streptococcus pneumoniae; Streptococcus pneumoniae - classification; Streptococcus pneumoniae - isolation & purification; Survival Analysis; Treatment Outcome; Spain; Chronic Obstructive Pulmonary Disease; Chronic Obstructive Pulmonary Disease Group; Charlson Score; Chronic Obstructive Pulmonary Disease Patient; Pneumonia Severity Index; Human; Lung disease; Pneumonia; Prognosis; Microbiology; Respiratory disease; Bacteremia; Streptococcus pneumoniae; Infection; Streptococcaceae; Streptococcal infection; Bacteriosis; Bacteria; Micrococcales; Bronchus disease; Chronic obstructive pulmonary disease; Pneumococcal infection
• ISSN: 0934-9723; 1435-4373
• DOI: 10.1007/s10096-009-0737-1

The purpose of the study was to compare the clinical characteristics and outcomes of bacteraemic pneumococcal pneumonia (BPP) in chronic obstructive pulmonary disease (COPD) and non-COPD patients. A case-control study was conducted. Cases were any adult with BPP and forced expiratory volume in 1 second (FEV₁) <80% and FEV₁/forced expiratory vital capacity (FVC) <70%. Controls were patients with BPP without clinical diagnosis of COPD matched 1:2 by age, gender and date of isolation. Variables included co-morbidities, serotypes, pneumonia severity index (PSI), treatment and mortality. There were 45 cases and 90 controls. No significant differences were found in Charlson scores, antibiotic treatment, serotype distribution and severity. Malignancy, shock and mechanical ventilation were less frequent in COPD patients. One patient died vs 14 controls (p = 0.02). In univariate analysis, shock, multilobar involvement, Charlson score, heart failure and absence of COPD were associated with mortality. After adjustment for the presence of shock there were no differences in mortality. BPP presents less frequently with shock and has a lower mortality rate in COPD patients than in non-COPD patients.