Şenol Esin, Çilli Aykut, Günen Hakan, Şener Alper, Dumlu Rıdvan, Ödemiş Ayşe, Topçu Ayşe Füsun, Yıldız Yeşim, Güner Rahmet, Özhasenekler Ayhan, Mutlu Birsen, Köktürk Nurdan, Sevimli Nurgül, Baykam Nurcan, Yapar Derya, Ekin Selami, Polatlı Mehmet, Gök Şebnem Eren, Kılınç Oğuz, Sayıner Abdullah, Karaşahin Ömer, Çuhadaroğlu Çağlar, Sesin Kocagöz Ayşe, Togan Turhan, Arpağ Hüseyin, Katı Hakan, Köksal İftihar, Aksoy Firdevs, Hasanoğlu Canan
Department of Infectious Diseases, Gazi University, Faculty of Medicine, Ankara, Turkey.
Department of Pulmonary Diseases, Akdeniz University, Faculty of Medicine, Antalya, Turkey.
Turk Thorac J. 2021 Jul;22(4):339-345. doi: 10.5152/TurkThoracJ.2021.20223.
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.
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.
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.
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.
评估土耳其社区获得性肺炎（CAP）患者中肺炎球菌肺炎（PP）的发生率，并调查和比较PP与非PP的CAP患者的特征。
这项多中心、非干预性、前瞻性观察性研究纳入了成年CAP患者（年龄≥18岁）。PP的诊断基于肺炎影像学表现的患者中至少有1项肺炎链球菌实验室检测结果呈阳性（血培养或痰培养或尿抗原检测[UAT]）。
465例患者被诊断为CAP，其中59例（12.7%）患有PP。最常见的合并症是慢性阻塞性肺疾病（30.1%）。与非PP患者相比，PP患者的平均年龄、吸烟史、慢性神经系统疾病的存在以及CURB-65评分显著更高。在PP患者中，84.8%仅根据UAT诊断。考虑到UAT敏感性比率为63%（95%置信区间：45-81），CAP患者中PP患者的总体发生率计算为22.8%。PP患者的重症监护治疗率更高（P = 0.007）。虽然没有PP患者接种过肺炎球菌疫苗，但3.8%的非PP患者接种过疫苗（P = 0.235）。非PP组在前48小时内使用抗生素的比例高于PP组（31.8%对11.1%，P = 0.002）。PP组的CURB-65评分以及根据该评分需要住院治疗的患者比例更高。
与非PP患者相比，PP患者年龄更大且更频繁地需要重症监护治疗，这些事实凸显了PP的负担。
