S. pneumoniae community-acquired pneumonia (SP-CAP): relationship between mortality and antibiotic susceptibility and risk factors for drug resistance
J. Aspa, O. Rajas, F. Rodriguez de Castro, R. Zalacain, R. De Celis, J. Blanquer, A. Vargas, A. Fenoll, A. Torres (Madrid, Spain)
Source: Annual Congress 2001 - Community-acquired pneumonia: from diagnosis to discharge
Disease area: Respiratory infections
Abstract A prospective study including 634 patients with a pneumococcal strain isolated was performed to determinate the relation between mortality (M) and antibiotic (Ab) susceptibility (Standards of the NCCLS). Crude mortality (CM) was 14,3% (91 of 634 cases),we found 50 deaths in a total of 409 cases (12.2 %) in penicillin susceptible (PS) isolates, 29 of 162 (17,9%) in penicillin intermediate resistance (PIR) and 12 of 63 (19%) in penicillin high resistance (PR). Penicillin resistance was significantly associated with CM (p=0,048). Death was attributable to pneumonia in 72 of 93 cases: 10,5% in patients with PS isolates, 14,2% in PIR and 13,6% in PR. So,there was not significantly association between related mortality and penicillin resistance (p=0,425).To study relation between the resistance to different antibiotics tested (n=10) and M we have defined three groups of isolates: susceptible (S) when they are sensible to all Ab; resistant (R) if decreased susceptibility to 1 or 2 Ab and multiresistant (MR) if decreased susceptibility to 3 or more Ab. We found a significantly association between CM and susceptibility: 11,6% in S; 15,7% in R and 18,3% in MR isolates (p=0.024). The following factors were significantly associated with CM: bronchopneumonia, shock, aspiration, bilateral involvement, renal disease and resistant penicillin isolate. We have also determined the factors significantly associated with resistance to penicillin: chronic obstructive pulmonary disease, cardiac comorbid illness, haematological malignancy, HIV infection, aspiration and patients from a nursing home. In conclusion we have found a significantly association between crude mortality and susceptibility patterns to penicillin.
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J. Aspa, O. Rajas, F. Rodriguez de Castro, R. Zalacain, R. De Celis, J. Blanquer, A. Vargas, A. Fenoll, A. Torres (Madrid, Spain). S. pneumoniae community-acquired pneumonia (SP-CAP): relationship between mortality and antibiotic susceptibility and risk factors for drug resistance. Eur Respir J 2001; 16: Suppl. 31, 3394
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