caa a22 4500 606155376 CHVBK 20210128100603.0 cr unu---uuuuu 210128e20150101xx s 000 0 eng 10.1007/s10096-014-2209-5 doi (NATIONALLICENCE)springer-10.1007/s10096-014-2209-5 Bacteraemic and non-bacteraemic/urinary antigen-positive pneumococcal community-acquired pneumonia compared [Elektronische Daten] [S. van Mens, A. van Deursen, S. de Greeff, H. de Melker, L. Schouls, A. van der Ende, M. Bonten, E. Sanders, B. Vlaminckx] The diagnosis of invasive pneumococcal pneumonia is based mainly on bacteraemia. Episodes without bacteraemia, but with a positive urinary antigen test (UAT), are considered non-invasive. We determined differences in outcome between patients with bacteraemic and non-bacteraemic/UAT-positive pneumococcal community-acquired pneumonia (CAP). Adult patients with clinical and radiological evidence of CAP with blood cultures and UAT tests performed at presentation in three Dutch laboratories between June 2008 and May 2010 were included. Clinical characteristics were retrospectively extracted from hospital records. Overall, 168 patients had non-bacteraemic/UAT-positive pneumococcal CAP and 123 had bacteraemic pneumococcal CAP. The day-30 mortality was 9% and 13% for non-bacteraemic/UAT-positive and bacteraemic pneumococcal CAP patients, respectively [risk difference −4%, 95% confidence interval (CI) −11% to +3%, p = 0.28]. In a multivariable logistic regression model, age ≥65years, admission to the intensive care unit/coronary care unit (ICU/CCU) and presence of an immunocompromising condition were associated with day-30 mortality. A non-significant association with mortality was found for bacteraemia [odds ratio (OR) 2.21, 95% CI 0.94-5.21, p = 0.07). No such trend was found for UAT positivity. The median lengths of hospital stay were 8 [interquartile range (IQR) 5-14] and 10 (IQR 6-18) days for non-bacteraemic/UAT-positive and bacteraemic pneumococcal CAP patients, respectively (p = 0.05). As compared to non-bacteraemic/UAT-positive pneumococcal CAP, bacteraemic pneumococcal CAP has a stronger association with day-30 mortality. Springer-Verlag Berlin Heidelberg, 2014 van Mens S. Department of Medical Microbiology and Immunology, St. Antonius Hospital, P.O. Box 2500, 3430 EM, Nieuwegein, The Netherlands aut van Deursen A. Linnaeus Institute, P.O. Box 770, 2130 AT, Hoofddorp, The Netherlands aut de Greeff S. National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA, Bilthoven, The Netherlands aut de Melker H. National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA, Bilthoven, The Netherlands aut Schouls L. National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA, Bilthoven, The Netherlands aut van der Ende A. Medical Microbiology, Academic Medical Center Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands aut Bonten M. Medical Microbiology, University Medical Center Utrecht, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands aut Sanders E. Paediatric Immunology and Infectious Diseases, Wilhelmina Children's Hospital, P.O. Box 85090, 3508 AB, Utrecht, The Netherlands aut Vlaminckx B. Department of Medical Microbiology and Immunology, St. Antonius Hospital, P.O. Box 2500, 3430 EM, Nieuwegein, The Netherlands aut European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/1(2015-01-01), 115-122 0934-9723 34:1<115 2015 34 10096 https://doi.org/10.1007/s10096-014-2209-5 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10096-014-2209-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- van Mens S. Department of Medical Microbiology and Immunology, St. Antonius Hospital, P.O. Box 2500, 3430 EM, Nieuwegein, The Netherlands aut NATIONALLICENCE 700 1- van Deursen A. Linnaeus Institute, P.O. Box 770, 2130 AT, Hoofddorp, The Netherlands aut NATIONALLICENCE 700 1- de Greeff S. National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA, Bilthoven, The Netherlands aut NATIONALLICENCE 700 1- de Melker H. National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA, Bilthoven, The Netherlands aut NATIONALLICENCE 700 1- Schouls L. National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA, Bilthoven, The Netherlands aut NATIONALLICENCE 700 1- van der Ende A. Medical Microbiology, Academic Medical Center Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands aut NATIONALLICENCE 700 1- Bonten M. Medical Microbiology, University Medical Center Utrecht, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands aut NATIONALLICENCE 700 1- Sanders E. Paediatric Immunology and Infectious Diseases, Wilhelmina Children's Hospital, P.O. Box 85090, 3508 AB, Utrecht, The Netherlands aut NATIONALLICENCE 700 1- Vlaminckx B. Department of Medical Microbiology and Immunology, St. Antonius Hospital, P.O. Box 2500, 3430 EM, Nieuwegein, The Netherlands aut NATIONALLICENCE 773 0- European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/1(2015-01-01), 115-122 0934-9723 34:1<115 2015 34 10096