caa a22 4500 477070507 CHVBK 20180405111424.0 cr unu---uuuuu 170330e19960301xx s 000 0 eng 10.1007/BF01591354 doi (NATIONALLICENCE)springer-10.1007/BF01591354 Early recognition of Streptococcus pneumoniae in patients with community-acquired pneumonia [Elektronische Daten] [R. Bohte, J. Hermans, P. van den Broek] The objective of this study was to assess the predictive value of signs, symptoms, and rapidly available laboratory parameters for pneumococci in community-acquired pneumonia (CAP). A prospective study on patients with CAP who were admitted to hospital was conducted. Clinical and laboratory data were collected according to a protocol. Two hundred sixty-eight patients aged 18 years or older, not living in a nursing home or not admitted to hospital within one week of this admission, with a new infiltrate on the chest radiograph consistent with pneumonia were included. According to microbiological and serological tests, patients were allocated to one of two aetiological groups,Streptococcus pneumoniae or "other pathogens”. Seventy-three variables were examined for a correlation with one of the aetiological categories by means of univariate and multivariate analysis. The resulting discriminant function was considered a clinical test for which posttest probabilities for pneumococcal pneumonia were calculated.Streptococcus pneumoniae was demonstrated in 79 patients and other pathogens in 83; no pathogens were detectable in 106 patients. The variables "cardiovascular disease”, "acute onset”, "pleuritic pain”, "gram-positive bacteria in the sputum Gram stain”, and "leucocyte count” correctly predicted the cause of CAP in 80% of all cases in both groups. Depending on the prevalence ofStreptococcus pneumoniae, posttest probabilities for pneumococcal pneumonia were up to 90%. It is concluded that data on history, together with the result of the Gram stain of sputum and the leucocyte count, can help to distinguishStreptococcus pneumoniae from other pathogens causing CAP. Springer-Verlag, 1996 Bohte R. Department of Infectious Diseases, University Hospital, Building 1, C5-P, P.O. Box 9600, 2300, RC Leiden, The Netherlands aut Hermans J. Department of Medical Statistics, University Hospital, Building 1, C5-P, P.O. Box 9600, 2300, RC Leiden, The Netherlands aut van den Broek P. Department of Infectious Diseases, University Hospital, Building 1, C5-P, P.O. Box 9600, 2300, RC Leiden, The Netherlands aut European Journal of Clinical Microbiology and Infectious Diseases Springer-Verlag 15/3(1996-03-01), 201-205 0934-9723 15:3<201 1996 15 10096 https://doi.org/10.1007/BF01591354 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/BF01591354 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Bohte R. Department of Infectious Diseases, University Hospital, Building 1, C5-P, P.O. Box 9600, 2300, RC Leiden, The Netherlands aut NATIONALLICENCE 700 1- Hermans J. Department of Medical Statistics, University Hospital, Building 1, C5-P, P.O. Box 9600, 2300, RC Leiden, The Netherlands aut NATIONALLICENCE 700 1- van den Broek P. Department of Infectious Diseases, University Hospital, Building 1, C5-P, P.O. Box 9600, 2300, RC Leiden, The Netherlands aut NATIONALLICENCE 773 0- European Journal of Clinical Microbiology and Infectious Diseases Springer-Verlag 15/3(1996-03-01), 201-205 0934-9723 15:3<201 1996 15 10096 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer