Source: Annual Congress 2001 - Community-acquired pneumonia: from diagnosis to discharge
Disease area: Respiratory infections

Abstract

Little is known about community-acquired pneumonia (CAP) caused by mixed etiologies including Streptococcus pneumoniae (SP). We analyzed clinical symptoms, comorbidity, radiographic patterns, antibiotic resistance, severity and outcome in CAP caused by SP alone and involved in mixed-etiologic pneumonias in a prospective study. The analyzed data were from 1359 patients with CAP admitted to our hospital. 560 patients had a microbiological diagnosis, of whom 130 had mixed-etiologic pneumonias. We compared 104 from 560 cases with SP alone to 67 from 130 cases with SP and other etiologies. In the mixed etiologies group the most frequent microorganisms apart from SP were Chlamydia pneumoniae (n=22, 33%), viral pathogens (n=18, 26%); H. influenzae (n=14, 21%) and Coxiella burnetti (n=12, 18%). When comparing both populations in univariate analysis there was no significant difference according to age, gender previous antibiotic treatment and resistance patterns. Mixed etiologies were more frequent in the presence of pulmonary or other comorbidity, HIV and endovenous drug abuse. In the multivariate analysis only the presence of pulmonary comorbidity remained independently associated with CAP due to mixed etiologies (OR=3.2, CI=1.66/6.31, p=0.0004). Conclusion: pulmonary comorbidity is a risk factor for pneumonia caused by multiple pathogens including SP.

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A. de Roux, M. Ruiz, J. Angrill, M. A. Marcos, E. Garcia, J. Mensa, A. Torres (Barcelona, Spain). Pulmonary disease as a risk factor for community-acquired pneumonia caused by multiple pathogens, including Streptococcus pneumoniae. Eur Respir J 2001; 16: Suppl. 31, 3392

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