CONICET | Buscador de Institutos y Recursos Humanos

BACTEREMIC PNEUMOCOCCAL PNEUMONIA, A PROSPECTIVE STUDY OF 279 ADULTS PATIENTS IN A SINGLE CENTERBackground and aims: Bacteremic pneumococcal pneumonia (BPP) is the most common invasive pneumococcal disease (IPD). To gain insight into its epidemiological, clinical and microbiological features, BPP was studied in our hospital.Metodology: Observational prospective and analytic study of adult patients with BPP admitted to our hospital between 1990-2015. Results: 279 patients were studied (177 men), with 2.8/1000 admissions on average. An admission decrease to 0.8 was registered in the last two years. Population incidence was 11.8 cases /100000 inhabitants ( age= 59.7) 180 patients (64.5%) had one or more comorbidities; namely: cigarette smoking (26.9%), chronic obstructive pulmonary disease (18.1%), congestive heart failure (16.9%) and alcohol abuse (15.8%). Fever, cough, dyspnoea and chest pain were the main presenting symptoms. Non-respiratory manifestations occurred in 51.3%. Infiltrates on X-ray were unilateral in 209 (74.9%); and lobar in 160 (57.6%). 209 patients (74.9%) belonged to PSI (I-II-III), 49 (17.6%) had pleural effusion, 21 (7.5%) developed empyema and 60 (21.5%) were admitted to ICU. 49/279 (17.6%) patients died, 71.4% within 5 days of admission. No penicillin-resistant strains were identified. Multivariate analysis showed factors independently associated with mortality: dyspnoea (OR=8.62), leukopenia (OR=6.28), confusion (OR=5.43) and age >80 (OR=4.03). Conclusions: BPP is a common disease, with considerable (17.6%) and early mortality. Atypical presentation is common. Dyspnoea, leukopenia , confusion and age >80 years were predictors of death. Penicillin resistance was not found. Recent changes in incidence could be secondary to herd effect of PVC 13 vaccination of children in our city since 2012.