The Role of Pneumococcal Pneumonia among Community Acquired Pneumonia in Adult Turkish Population: TurkCAP Study

OBJECTIVE: To evaluate the rate of pneumococcal pneumonia (PP) among patients with community-acquired pneumonia (CAP) in Turkey and to investigate and compare features of PP and non-PP CAP patients.MATERIAL AND METHODS: This multicenter, non-interventional, prospective, observational study included adult CAP patients (age ≥ 18 years). Diagnosis of PP was based on the presence of at least 1 positive laboratory test result for Streptococcus pneumoniae (blood culture or sputum culture or urinary antigen test [UAT]) in patients with radiographic findings of pneumonia.RESULTS: Four hundred sixty-five patients were diagnosed with CAP, of whom 59 (12.7%) had PP. The most common comorbidity was chronic obstructive pulmonary disease (30.1%). The mean age, smoking history, presence of chronic neurological disease, and CURB-65 score were significantly higher in PP patients, when compared to non-PP patients. In PP patients, 84.8% were diagnosed based ony on the UAT. The overall rate of PP patients among CAP was calculated as 22.8% considering the UAT sensitivity ratio of 63% (95% confidence interval: 45-81). The rate of intensive care treatment was higher in PP patients (P = .007). While no PP patients were vaccinated for pneumococcus, 3.8% of the non-PP patients were vaccinated (P = .235). Antibiotic use in the preceding 48 hours was higher in the non-PP group than in the PP group (31.8% vs. 11.1%, P = .002). The CURB-65 score and the rate of patients requiring inpatient treatment according to this score were higher in the PP group.CONCLUSION: The facts that PP patients were older and required intensive care treatment more frequently as compared to non-PP patients underline the burden of PP.

Kaynakça

1. Henriques-Normark B, Tuomanen EI. The pneumococcus: epidemiology, microbiology, and pathogenesis. Cold Spring Harb Perspect Med. 2013;3:a010215-a010215. [CrossRef]

2. Drijkoningen JJ, Rohde GG. Pneumococcal infection in adults: Burden of disease. Clin Microbiol Infect. 2014;20:45-51. [CrossRef]

3. Almirall J, Bolíbar I, Vidal J et al. Epidemiology of communityacquired pneumonia in adults: a population-based study. Eur Respir J. 2000;15:757-763. [CrossRef]

4. Kolditz M, Tesch F, Mocke L et al. Burden and risk factors of ambulatory or hospitalized CAP: a population based cohort study. Respir Med. 2016;121:32-38. [CrossRef]

5. Blasi F, Akova M, Bonanni P et al. Community-acquired pneumonia in adults: highlighting missed opportunities for vaccination. Eur J Intern Med. 2017;37(8118):13-18. [CrossRef]

6. Wunderink RG, Waterer G. Advances in the causes and management of community acquired pneumonia in adults. BMJ. 2017;358:j2471. [CrossRef]

7. Steel HC, Cockeran R, Anderson R, Feldman C. Overview of community-acquired pneumonia and the role of inflammatory mechanisms in the immunopathogenesis of severe pneumococcal disease. Mediators Inflamm. 2013;2013:490346. [CrossRef]

8. Holter JC, Müller F, Bjørang O et al. Etiology of communityacquired pneumonia and diagnostic yields of microbiological methods: a 3-year prospective study in norway. BMC Infect Dis. 2015;15(11):64. [CrossRef]

9. Ieven M, Coenen S, Loens K et al. Aetiology of lower respiratory tract infection in adults in primary care: a prospective study in 11 european countries. Clin Microbiol Infect. 2018;24:1158- 1163. [CrossRef]

10. Lim WS, van der Eerden MM, Laing R et al. Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study. Thorax. 2003;58:377-382. [CrossRef]

11. Saukkoriipi A, Pascal T, Palmu AA. Evaluation of the BinaxNOW® Streptococcus pneumoniae antigen test on fresh, frozen and concentrated urine samples in elderly patients with and without community-acquired pneumonia. J Microbiol Methods. 2016;121(5):24-26. [CrossRef]

12. Jain S, Self WH, Wunderink RG et al. Community-acquired pneumonia requiring hospitalization among U.S. adults. N Engl J Med. 2015;373:415-427. [CrossRef]

13. Broulette J, Yu H, Pyenson B, Iwasaki K, Sato R. The incidence rate and economic burden of community-acquired pneumonia in a working-age population. Am Health Drug Benefits. 2013;6:494-503. [CrossRef]

14. Bertsias A, Tsiligianni IG, Duijker G et al. Studying the burden of community-acquired pneumonia in adults aged ≥50 years in primary health care: an observational study in rural Crete, Greece. NPJ Prim Care Respir Med. 2014;24(11):14017. [CrossRef]

15. Kabundji DM, Musekiwa A, Mukansi M, Feldman C. Determining need for hospitalisation: evaluation of the utility of the CRB-65 score in patients with community-acquired pneumonia presenting to an emergency department. S Afr Med J. 2014;104:769-772. [CrossRef]

16. Kaysin A, Viera AJ. Community-acquired pneumonia in adults: diagnosis and management. Am Fam Phys. 2016;94:698-706. [CrossRef]

17. Parrott G, Nebeya D, Kinjo T et al. Etiological analysis and epidemiological comparison among adult CAP and NHCAP patients in Okinawa, Japan. J Infect Chemother. 2017;23:452- 458. [CrossRef]

18. Köksal I, Ozlü T, Bayraktar O et al. Etiological agents of community-acquired pneumonia in adult patients in turkey; a multicentric, cross-sectional study. Tuberk Toraks. 2010;58:119-127.

19. Spoorenberg SM, Bos WJ, Heijligenberg R et al. Microbial aetiology, outcomes, and costs of hospitalisation for communityacquired pneumonia; an observational analysis. BMC Infect Dis. 2014;14:335. [CrossRef]

20. Remington LT, Sligl WI. Community-acquired pneumonia. Curr Opin Pulm Med. 2014;20:215-224. [CrossRef]

21. Sahuquillo-Arce JM, Menéndez R, Méndez R et al. Age-related risk factors for bacterial aetiology in community-acquired pneumonia. Respirology. 2016;21:1472-1479. [CrossRef]

22. Harat R, Alexander R, Gray S et al. Prospective, populationbased surveillance of the burden of streptococcus pneumoniae in community-acquired pneumonia in older adults, chrzanów county, poland, 2010-2012. Pneumonol Alergol Pol. 2016;84:95-103. [CrossRef]

23. Cilloniz C, Ewig S, Gabarrus A et al. Seasonality of pathogens causing community-acquired pneumonia. Respirology. 2017;22:778-785. [CrossRef]

24. Naderi H, Sheybani F, Sarvghad M, Meshkat Z, Jabbari Nooghabi M. Etiological diagnosis of community-acquired pneumonia in adult patients: a prospective hospital-based study in Mashhad, Iran. Jundishapur J Microbiol. 2015;8:e22780. [CrossRef]

25. Gelfer G, Leggett J, Myers J, Wang L, Gilbert DN. The clinical impact of the detection of potential etiologic pathogens of community-acquired pneumonia. Diagn Microbiol Infect Dis. 2015;83:400-406. [CrossRef]

26. Camou F, Issa N, Bessede É, Mourissoux G, Guisset O. Usefulness of pneumococcal antigen urinary testing in the intensive care unit? Med Mal Infect. 2015;45:318-323. [CrossRef]

27. Choi MJ, Song JY, Cheong HJ et al. Clinical usefulness of pneumococcal urinary antigen test, stratified by disease severity and serotypes. J Infect Chemother. 2015;21:672-679. [CrossRef]

28. Alici DE, Sayiner A, Unal S. Barriers to adult immunization and solutions: personalized approaches. Hum Vaccin Immunother. 2017;13:213-215. [CrossRef]

29. Demirdogen Cetinoglu E, Uzaslan E, Sayıner A et al. Pneumococcal and influenza vaccination status of hospitalized adults with community acquired pneumonia and the effects of vaccination on clinical presentation. Hum Vaccin Immunother. 2017;13:2072-2077. [CrossRef]

30. van Werkhoven CH, Bonten MJ. The community-acquired pneumonia immunization trial in adults (CAPiTA): what is the future of pneumococcal conjugate vaccination in elderly? Future Microbiol. 2015;10:1405-1413. [CrossRef]

31. Ullah S, Khan J, Khan A, Hashemy I. Assessing decision of inpatient or outpatient care in community acquired pneumonia: APT care study. J Pak Med Assoc. 2017;67:380-385.

32. Guo Q, Li HY, Zhou YP et al. Compliance with the CURB-65 score and the consequences of non-implementation. Int J Tuberc Lung Dis. 2011;15:1697-1702. [CrossRef]

Kaynak Göster

Turkish Thoracic Journal
  • ISSN: 2149-2530
  • Yayın Aralığı: Yılda 6 Sayı
  • Başlangıç: 2000
  • Yayıncı: AVES Yayıncılık

257

Sayıdaki Diğer Makaleler

Impact of Non-surgical Periodontal Therapy on Pulmonary functions, Periodontal Health and Salivary Matrix Metalloproteinase-8 of COPD Patients with Chronic Periodontitis: A Clinico-biochemical Study

Sakshi SHARMA, Ajay Kumar VERMA, Abhaya GUPTA, Anjani PATHAK, Sheetal VERMA, Shyam Chand CHAUDHARY, Shalini KAUSHAL, Nand LAL, Surya KANT, Umesh Pratap VERMA

Maternal and Fetal Problems in Patients with Non-Cystic Fibrosis Bronchiectasis During Pregnancy

Şermin BÖREKÇİ, Bahar KUBAT, Gizem ŞENKARDEŞLER, Benan MÜSELLİM

Re: Pneumococcal and Influenza Vaccination Status of Hospitalized Adults With Community-Acquired Pneumonia and the Effects of Vaccination on Clinical Presentation

Waseem BANI, Alshimaa ELMASRY, Mohammad Ibrar PERWAIZ, Faris HUSSEIN

Evaluation of Carbonmonoxide, Diffusion Capacity, Respiratory Muscle Strength Values, and Pulmonary Volume in Smoking Men over 40 Years Old

Kadir Burak AKGÜN, Cengiz ÖZGE, Bahar TAŞDELEN

The Perspective of the Turkish Thoracic Society Members on Institutional Preparedness During the COVID-19 Pandemic in Turkey

Abdulsamet SANDAL, Zehra Nur TÖREYİN, Cüneyt SALTÜRK, Peri Meram ARBAK

The Role of Pneumococcal Pneumonia among Community Acquired Pneumonia in Adult Turkish Population: TurkCAP Study

Esin ŞENOL, Aykut ÇİLLİ, Hakan GÜNEN, Alper ŞENER, Rıdvan DUMLU, Ayşe ÖDEMİŞ, Ayşe Füsun TOPÇU, Yeşim YILDIZ, Rahmet GÜNER, Ayhan ÖZHASENEKLER, Birsen MUTLU, Nurdan KÖKTÜRK, Nurgül SEVİMLİ, Nurcan BAYKAM, DERYA YAPAR, Selami EKİN, Mehmet POLATLI, Şebnem Eren GÖK, Oğuz KILINÇ, Abdullah SAYINER, Ömer KARAŞAHİN, Çağlar ÇUH

What are the Differences Between Smoker and Non-smoker COPD Cases? Is it a Different Phenotype?

Filiz GÜLDAVAL, Gülru POLAT, Sibel DORUK, Gülistan KARADENİZ, Aysu AYRANCI, Merve TÜRK, Mine GAYAF, Melike YÜKSEL YAVUZ, Melih BÜYÜKŞİRİN, Ceyda ANAR

Management of Patients with Connective Tissue Disease-associated Interstitial Lung Diseases During the COVID-19 Pandemic

Canan GÜNDÜZ, Dilek KARADOĞAN, Furkan UFUK, Osman CÜRE, Göksel ALTINIŞIK

Effect of Obstructive Sleep Apnea on Bone Mineral Density

Shadan SADAF, Mohammad SHAMEEM, Sheelu Shafiq SİDDİQİ, Shahzad ANWAR, Shahnawaz MOHD