caa a22 4500 606157158 CHVBK 20210128100612.0 cr unu---uuuuu 210128e20150401xx s 000 0 eng 10.1007/s10096-014-2278-5 doi (NATIONALLICENCE)springer-10.1007/s10096-014-2278-5 Effect of antimicrobial use on pneumococcal diagnostic tests in elderly patients with community-acquired pneumonia [Elektronische Daten] [A. Saukkoriipi, A. Palmu, J. Jokinen, V. Verlant, W. Hausdorff, T. Kilpi] Antimicrobial treatment decreases bacterial culture yields. We assessed the impact of antimicrobial treatment on pneumococcal assays in a prospective study of community-acquired pneumonia (CAP) in the elderly. We enrolled 323 cases aged ≥65 years with radiologically confirmed CAP and collected detailed data on antimicrobial exposure and pneumococcal assays on various samples. Complete antimicrobial use data were available for 303 (94%) cases; 61% had no antimicrobial exposure, 19% had received antibiotics at the acute visit only, and 20% within 2weeks before the acute visit (15% ongoing and 5% completed treatment). Ongoing use before the visit reduced pneumococcal detection by culture (nasopharyngeal swab 2 vs. 16% in the unexposed; high-quality sputum 0 vs. 25%) and sputum lytA polymerase chain reaction (PCR) (0 vs. 25%). Urine antigen test and serology were not affected. Among those who had received antibiotics only at the acute visit before study sampling, serology (29 vs. 15%), urine antigen (19 vs. 8%), and blood culture (9 vs. 2%) were more often positive than among the unexposed. Antimicrobial exposure before the visit reduced both culture and PCR-based detection. Patients given antibiotics at the visit had higher proportions of positive blood culture, serology, and urine antigen tests, suggesting higher pneumococcal CAP prevalence. Springer-Verlag Berlin Heidelberg, 2014 Saukkoriipi A. Department of Vaccination and Immune Protection, National Institute for Health and Welfare (THL), P.O. Box 310, 90101, Oulu, Finland aut Palmu A. Department of Vaccination and Immune Protection, National Institute for Health and Welfare, 33520, Tampere, Finland aut Jokinen J. Department of Vaccination and Immune Protection, National Institute for Health and Welfare, 00271, Helsinki, Finland aut Verlant V. GlaxoSmithKline Vaccines, 1300, Wavre, Belgium aut Hausdorff W. GlaxoSmithKline Vaccines, 1300, Wavre, Belgium aut Kilpi T. Department of Vaccination and Immune Protection, National Institute for Health and Welfare, 00271, Helsinki, Finland aut European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/4(2015-04-01), 697-704 0934-9723 34:4<697 2015 34 10096 https://doi.org/10.1007/s10096-014-2278-5 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/s10096-014-2278-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Saukkoriipi A. Department of Vaccination and Immune Protection, National Institute for Health and Welfare (THL), P.O. Box 310, 90101, Oulu, Finland aut NATIONALLICENCE 700 1- Palmu A. Department of Vaccination and Immune Protection, National Institute for Health and Welfare, 33520, Tampere, Finland aut NATIONALLICENCE 700 1- Jokinen J. Department of Vaccination and Immune Protection, National Institute for Health and Welfare, 00271, Helsinki, Finland aut NATIONALLICENCE 700 1- Verlant V. GlaxoSmithKline Vaccines, 1300, Wavre, Belgium aut NATIONALLICENCE 700 1- Hausdorff W. GlaxoSmithKline Vaccines, 1300, Wavre, Belgium aut NATIONALLICENCE 700 1- Kilpi T. Department of Vaccination and Immune Protection, National Institute for Health and Welfare, 00271, Helsinki, Finland aut NATIONALLICENCE 773 0- European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/4(2015-04-01), 697-704 0934-9723 34:4<697 2015 34 10096