Neumonía neumocócica adquirida en la comunidad en adultos hospitalizados

Background: S pneumoniae is the most common cause of community-acquired pneumonia. Aim: To evaluate the clinical characteristics, antibiotic resistance, management and prognostic factors in pneumococcal pneumonia. Methods: Prospective evaluation in 46 adults (age ± sd: 68±17 years) hospitalized with...

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Autores principales:	Díaz F,Alejandro, Torres M,Catalina, Flores S,Luis José, García C,Patricia, Saldías P,Fernando
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2003
Materias:	Hospital mortality Pneumonia, pneumococcal Pulmonary disease
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872003000500005
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spelling	oai:scielo:S0034-988720030005000052004-12-13Neumonía neumocócica adquirida en la comunidad en adultos hospitalizadosDíaz F,AlejandroTorres M,CatalinaFlores S,Luis JoséGarcía C,PatriciaSaldías P,Fernando Hospital mortality Pneumonia, pneumococcal Pulmonary disease Background: S pneumoniae is the most common cause of community-acquired pneumonia. Aim: To evaluate the clinical characteristics, antibiotic resistance, management and prognostic factors in pneumococcal pneumonia. Methods: Prospective evaluation in 46 adults (age ± sd: 68±17 years) hospitalized with pneumococcal pneumonia confirmed by sputum, blood or pleural fluid cultures. Clinical and radiographic variables, risk factors for antibiotic resistance, and hospital mortality rate were recorded. Results: Heart disease (39%), COPD/asthma (25%), and diabetes mellitus (18%) were the most frequent underlying diseases. None of the patients had previously received pneumococcal vaccine. Only 17% of the patients had the classic triad of chills, fever and productive cough. At admission, interestingly, 17% presented with congestive heart failure. Resistance of pneumococci to penicillin, cefotaxime or erythromycin was 15%, 6% and 11%, respectively. Antibiotic use prior to admission was significantly associated with antibiotic resistance (OR=6; CI 95% = 1.1-32; p <0.05). Fifty per cent of the patients were admitted to intermediate or intensive care units, 15% were mechanically ventilated, 20% developed septic shock, 20% developed acute renal failure and 13% died in the hospital. Clinical factors significantly associated with higher mortality were systolic hypotension (<FONT FACE=Symbol>£</FONT>90 mmHg), ICU admission and BUN >30 mg per dL. Conclusions: Our data suggest that pneumococcal pneumonia is still a severe infection with high mortality; hence, efforts should be made at prevention using pneumococcal immunization (Rev Méd Chile 2003; 131: 505-14).info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.131 n.5 20032003-05-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872003000500005es10.4067/S0034-98872003000500005
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Hospital mortality Pneumonia, pneumococcal Pulmonary disease
spellingShingle	Hospital mortality Pneumonia, pneumococcal Pulmonary disease Díaz F,Alejandro Torres M,Catalina Flores S,Luis José García C,Patricia Saldías P,Fernando Neumonía neumocócica adquirida en la comunidad en adultos hospitalizados
description	Background: S pneumoniae is the most common cause of community-acquired pneumonia. Aim: To evaluate the clinical characteristics, antibiotic resistance, management and prognostic factors in pneumococcal pneumonia. Methods: Prospective evaluation in 46 adults (age ± sd: 68±17 years) hospitalized with pneumococcal pneumonia confirmed by sputum, blood or pleural fluid cultures. Clinical and radiographic variables, risk factors for antibiotic resistance, and hospital mortality rate were recorded. Results: Heart disease (39%), COPD/asthma (25%), and diabetes mellitus (18%) were the most frequent underlying diseases. None of the patients had previously received pneumococcal vaccine. Only 17% of the patients had the classic triad of chills, fever and productive cough. At admission, interestingly, 17% presented with congestive heart failure. Resistance of pneumococci to penicillin, cefotaxime or erythromycin was 15%, 6% and 11%, respectively. Antibiotic use prior to admission was significantly associated with antibiotic resistance (OR=6; CI 95% = 1.1-32; p <0.05). Fifty per cent of the patients were admitted to intermediate or intensive care units, 15% were mechanically ventilated, 20% developed septic shock, 20% developed acute renal failure and 13% died in the hospital. Clinical factors significantly associated with higher mortality were systolic hypotension (<FONT FACE=Symbol>£</FONT>90 mmHg), ICU admission and BUN >30 mg per dL. Conclusions: Our data suggest that pneumococcal pneumonia is still a severe infection with high mortality; hence, efforts should be made at prevention using pneumococcal immunization (Rev Méd Chile 2003; 131: 505-14).
author	Díaz F,Alejandro Torres M,Catalina Flores S,Luis José García C,Patricia Saldías P,Fernando
author_facet	Díaz F,Alejandro Torres M,Catalina Flores S,Luis José García C,Patricia Saldías P,Fernando
author_sort	Díaz F,Alejandro
title	Neumonía neumocócica adquirida en la comunidad en adultos hospitalizados
title_short	Neumonía neumocócica adquirida en la comunidad en adultos hospitalizados
title_full	Neumonía neumocócica adquirida en la comunidad en adultos hospitalizados
title_fullStr	Neumonía neumocócica adquirida en la comunidad en adultos hospitalizados
title_full_unstemmed	Neumonía neumocócica adquirida en la comunidad en adultos hospitalizados
title_sort	neumonía neumocócica adquirida en la comunidad en adultos hospitalizados
publisher	Sociedad Médica de Santiago
publishDate	2003
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872003000500005
work_keys_str_mv	AT diazfalejandro neumonianeumococicaadquiridaenlacomunidadenadultoshospitalizados AT torresmcatalina neumonianeumococicaadquiridaenlacomunidadenadultoshospitalizados AT floressluisjose neumonianeumococicaadquiridaenlacomunidadenadultoshospitalizados AT garciacpatricia neumonianeumococicaadquiridaenlacomunidadenadultoshospitalizados AT saldiaspfernando neumonianeumococicaadquiridaenlacomunidadenadultoshospitalizados
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Neumonía neumocócica adquirida en la comunidad en adultos hospitalizados

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