caa a22 4500 606155880 CHVBK 20210128100605.0 cr unu---uuuuu 210128e20150901xx s 000 0 eng 10.1007/s10096-015-2421-y doi (NATIONALLICENCE)springer-10.1007/s10096-015-2421-y Impact of bacterial coinfection on clinical outcomes in pneumococcal pneumonia [Elektronische Daten] [S. Kumagai, T. Ishida, H. Tachibana, Y. Ito, A. Ito, T. Hashimoto] The aim of this study was to investigate the influence of bacterial coinfection on patients with pneumococcal pneumonia. We retrospectively analyzed the incidence, clinical features, microbial distributions, and outcomes of patients with bacterial coinfection in a cohort of 433 hospitalized patients with pneumococcal pneumonia. Eighty-five patients (19.6%) were diagnosed with bacterial coinfection; the most frequent pathogens were Haemophilus influenzae (25 patients, 33.3%), methicillin-susceptible Staphylococcus aureus (MSSA) (15 patients, 20.0%), and Moraxella catarrhalis (13 patients, 17.3%). The CURB-65 score and pneumonia severity index (PSI) were significantly higher in patients with bacterial coinfection (both P < 0.001). In addition, the proportion of patients with bacterial coinfection who met the Infectious Disease Society of America (IDSA)/American Thoracic Society (ATS) severe pneumonia criteria was significantly higher (P < 0.001). Multivariate logistic regression analysis identified three risk factors for bacterial coinfection in patients with pneumococcal pneumonia: alcoholism (odds ratio [OR], 5.12; 95% confidence interval (95% CI), 1.60-16.4; P = 0.006), hospitalization for 2days or more within 90days preceding admission (OR, 2.02; 95% CI, 1.03-3.98; P = 0.041), and residence in a nursing home or extended care facility (OR, 3.22; 95% CI, 1.48-6.97; P = 0.003). Multivariate analysis for 30-day mortality showed that bacterial coinfection was a significant adverse prognostic factor (OR, 2.50; 95% CI, 1.13-5.53; P = 0.023), independent of IDSA/ATS severe pneumonia, PSI, or healthcare-associated pneumonia. In conclusion, bacterial coinfection may have an adverse impact on severity and outcomes of pneumococcal pneumonia. Springer-Verlag Berlin Heidelberg, 2015 Kumagai S. Department of Respiratory Medicine, Kurashiki Central Hospital, 1-1-1 Miwa, 710-0052, Kurashiki, Okayama, Japan aut Ishida T. Department of Respiratory Medicine, Kurashiki Central Hospital, 1-1-1 Miwa, 710-0052, Kurashiki, Okayama, Japan aut Tachibana H. Department of Respiratory Medicine, Kurashiki Central Hospital, 1-1-1 Miwa, 710-0052, Kurashiki, Okayama, Japan aut Ito Y. Department of Respiratory Medicine, Kurashiki Central Hospital, 1-1-1 Miwa, 710-0052, Kurashiki, Okayama, Japan aut Ito A. Department of Respiratory Medicine, Kurashiki Central Hospital, 1-1-1 Miwa, 710-0052, Kurashiki, Okayama, Japan aut Hashimoto T. Department of Respiratory Medicine, Kurashiki Central Hospital, 1-1-1 Miwa, 710-0052, Kurashiki, Okayama, Japan aut European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/9(2015-09-01), 1839-1847 0934-9723 34:9<1839 2015 34 10096 https://doi.org/10.1007/s10096-015-2421-y 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/s10096-015-2421-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kumagai S. Department of Respiratory Medicine, Kurashiki Central Hospital, 1-1-1 Miwa, 710-0052, Kurashiki, Okayama, Japan aut NATIONALLICENCE 700 1- Ishida T. Department of Respiratory Medicine, Kurashiki Central Hospital, 1-1-1 Miwa, 710-0052, Kurashiki, Okayama, Japan aut NATIONALLICENCE 700 1- Tachibana H. Department of Respiratory Medicine, Kurashiki Central Hospital, 1-1-1 Miwa, 710-0052, Kurashiki, Okayama, Japan aut NATIONALLICENCE 700 1- Ito Y. Department of Respiratory Medicine, Kurashiki Central Hospital, 1-1-1 Miwa, 710-0052, Kurashiki, Okayama, Japan aut NATIONALLICENCE 700 1- Ito A. Department of Respiratory Medicine, Kurashiki Central Hospital, 1-1-1 Miwa, 710-0052, Kurashiki, Okayama, Japan aut NATIONALLICENCE 700 1- Hashimoto T. Department of Respiratory Medicine, Kurashiki Central Hospital, 1-1-1 Miwa, 710-0052, Kurashiki, Okayama, Japan aut NATIONALLICENCE 773 0- European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/9(2015-09-01), 1839-1847 0934-9723 34:9<1839 2015 34 10096