Impact of penicillin susceptibility on medical outcomes for adult patients with bacteremic pneumococcal pneumonia

被引:213
作者
Metlay, JP
Hofmann, J
Cetron, MS
Fine, MJ
Farley, MM
Whitney, C
Breiman, RF
机构
[1] Univ Penn, Ctr Clin Epidemiol & Biostat, Sch Med, Philadelphia, PA 19104 USA
[2] Vet Affairs Med Ctr, Philadelphia, PA USA
[3] Univ Pittsburgh, Vet Affairs Hlth Care Syst, Ctr Res Hlth Care, Pittsburgh, PA 15260 USA
[4] Univ Pittsburgh, Vet Affairs Hlth Care Syst, Div Gen Internal Med, Pittsburgh, PA 15260 USA
[5] Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Childhood & Resp Dis Branch, Atlanta, GA USA
[6] Emory Univ, Sch Med, Dept Med, Div Infect Dis, Atlanta, GA 30322 USA
[7] Vet Affairs Med Ctr, Atlanta, GA 30033 USA
关键词
D O I
10.1086/313716
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
The impact of penicillin susceptibility on medical outcomes for adult patients with bacteremic pneumococcal pneumonia was evaluated in a retrospective cohort study conducted during population-based surveillance for invasive pneumococcal disease in the greater Atlanta region during 1994. Of the 192 study patients, 44 (23%) were infected with pneumococcal strains that demonstrated some degree of penicillin nonsusceptibility. Compared with patients infected with penicillin-susceptible pneumococcal strains, patients whose isolates were nonsusceptible had a significantly greater risk of in-hospital death due to pneumonia (relative risk [RR], 2.1; 95% confidence interval [CI] 1-4.3) and suppurative complications of infection (RR, 4.5; 95% CI, 1-19.3), although only risk of suppurative complications remained statistically significant after adjustment for baseline differences in severity of illness, Among adults with bacteremic pneumococcal pneumonia, infection with penicillin-nonsusceptible pneumococci is associated with an increased risk of adverse outcome.
引用
收藏
页码:520 / 528
页数:9
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