دورية أكاديمية
Host-pathogen interactions and prognosis of critically ill immunocompetent patients with pneumococcal pneumonia: the nationwide prospective observational STREPTOGENE study.
| العنوان: | Host-pathogen interactions and prognosis of critically ill immunocompetent patients with pneumococcal pneumonia: the nationwide prospective observational STREPTOGENE study. |
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| المؤلفون: | Bedos, Jean-Pierre, Varon, Emmanuelle, Porcher, Raphael, Asfar, Pierre, Le Tulzo, Yves, Megarbane, Bruno, Mathonnet, Armelle, Dugard, Anthony, Veinstein, Anne, Ouchenir, Kader, Siami, Shidasp, Reignier, Jean, Galbois, Arnaud, Cousson, Joel, Preau, Sebastien, Baldesi, Olivier, Rigaud, Jean-Philippe, Souweine, Bertrand, Misset, Benoît, Jacobs, Frederic, Dewavrin, Florent, Mira, Jean-Paul |
| المصدر: | Intensive Care Medicine, 44 (12), 2162-2173 (2018) |
| بيانات النشر: | Springer, 2018. |
| سنة النشر: | 2018 |
| مصطلحات موضوعية: | Age Factors, Aged, Community-Acquired Infections, Critical Care, Critical Illness, Female, Hospital Mortality, Host-Pathogen Interactions, Humans, Logistic Models, Male, Middle Aged, Pneumonia, Pneumococcal/complications/mortality/therapy, Prognosis, Prospective Studies, Risk Factors, Sex Factors, Fluoroquinolones, Intensive care unit, Macrolides, Pneumococcal pneumonia, Pneumococcal serotypes, Severe community-acquired pneumonia, Human health sciences, Anesthesia & intensive care, Sciences de la santé humaine, Anesthésie & soins intensifs |
| الوصف: | PURPOSE: To assess the relative importance of host and bacterial factors associated with hospital mortality in patients admitted to the intensive care unit (ICU) for pneumococcal community-acquired pneumonia (PCAP). METHODS: Immunocompetent Caucasian ICU patients with PCAP documented by cultures and/or pneumococcal urinary antigen (UAg Sp) test were included in this multicenter prospective study between 2008 and 2012. All pneumococcal strains were serotyped. Logistic regression analyses were performed to identify risk factors for hospital mortality. RESULTS: Of the 614 patients, 278 (45%) had septic shock, 270 (44%) had bacteremia, 307 (50%) required mechanical ventilation at admission, and 161 (26%) had a diagnosis based only on the UAg Sp test. No strains were penicillin-resistant, but 23% had decreased susceptibility. Of the 36 serotypes identified, 7 accounted for 72% of the isolates, with different distributions according to age. Although antibiotics were consistently appropriate and were started within 6 h after admission in 454 (74%) patients, 116 (18.9%) patients died. Independent predictors of hospital mortality in the adjusted analysis were platelets /= 2 (4.58; 1.61-13), age > 65 years (2.92; 1.49-5.74), lactates > 4 mmol/L (2.41; 1.27-4.56), male gender and septic shock (2.23; 1.30-3.83 for each), invasive mechanical ventilation (1.78; 1-3.19), and bilateral pneumonia (1.59; 1.02-2.47). Women with platelets |
| نوع الوثيقة: | journal article http://purl.org/coar/resource_type/c_6501Test article |
| اللغة: | English |
| العلاقة: | urn:issn:0342-4642; urn:issn:1432-1238 |
| DOI: | 10.1007/s00134-018-5444-x |
| الوصول الحر: | https://orbi.uliege.be/handle/2268/242104Test |
| حقوق: | restricted access http://purl.org/coar/access_right/c_16ecTest info:eu-repo/semantics/restrictedAccess |
| رقم الانضمام: | edsorb.242104 |
| قاعدة البيانات: | ORBi |
| DOI: | 10.1007/s00134-018-5444-x |
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