Department of Internal Medicine, Taipei County Hospital, Taipei County, Taiwan.
Epidemiol Infect. 2011 Sep;139(9):1307-16. doi: 10.1017/S0950268810002402. Epub 2010 Oct 26.
In contrast to bacteraemic pneumococcal community-acquired pneumonia (CAP), there is a paucity of data on the clinical characteristics and outcomes of non-bacteraemic pneumococcal CAP. This retrospective study compared the outcome of hospitalized patients with bacteraemic and non-bacteraemic pneumococcal CAP treated at a medical centre from 2004 to 2008. Data on clinical outcomes including all-cause mortality, length of hospital stay, need for intensive-care unit admission and extrapulmonary involvement were analysed. In all, 221 patients with pneumococcal pneumonia (87 bacteraemic, 134 non-bacteraemic) were included. Patients with bacteraemic pneumococcal pneumonia (BPP) were older than those with non-BPP (46·2 ± 30·7 years vs. 21·7 ± 30·8 years, P<0·001) and were more likely to have underlying medical diseases (66·7% vs. 33·6%, P<0·001). The overall mortality rates at 7, 14, and 30 days were significantly higher in BPP than non-BPP patients (12·6% vs. 2·2%, 14·9% vs. 3·7%, 19·5% vs. 5·1%, all P<0·01). Multivariate logistic regression analysis showed that pneumococcal bacteraemia was correlated with extrapulmonary involvement (odds ratio 5·46, 95% confidence interval 1·97-15·16, P=0·001). In conclusion, S. pneumoniae bacteraemia increased the risk of mortality and extrapulmonary involvement in patients with pneumococcal CAP.
与菌血症性肺炎球菌社区获得性肺炎（CAP）相比，关于非菌血症性肺炎球菌 CAP 的临床特征和结局的数据很少。本回顾性研究比较了 2004 年至 2008 年在一家医疗中心住院的菌血症性和非菌血症性肺炎球菌 CAP 患者的结局。分析了包括全因死亡率、住院时间、入住重症监护病房的需求和肺外受累在内的临床结局数据。共纳入 221 例肺炎球菌肺炎患者（87 例菌血症性，134 例非菌血症性）。菌血症性肺炎球菌肺炎（BPP）患者比非 BPP 患者年龄更大（46.2 ± 30.7 岁 vs. 21.7 ± 30.8 岁，P<0.001），且更有可能患有基础疾病（66.7% vs. 33.6%，P<0.001）。BPP 患者在 7、14 和 30 天时的总死亡率明显高于非 BPP 患者（12.6% vs. 2.2%，14.9% vs. 3.7%，19.5% vs. 5.1%，均 P<0.01）。多变量 logistic 回归分析显示，肺炎球菌菌血症与肺外受累相关（比值比 5.46，95%置信区间 1.97-15.16，P=0.001）。总之，肺炎球菌菌血症增加了肺炎球菌 CAP 患者的死亡风险和肺外受累风险。
