Related Experiment Videos
Pneumococcal community-acquired pneumonia in 148 hospitalized adult patients
A Porath1, F Schlaeffer, N Pick
1Department of Medicine F, Soroka Medical Center of Kupat Holim, Beer-Sheva, Israel.
Abstract:
In a previous prospective study, Streptococcus pneumoniae was identified as the causative agent in 148 (42.8%) of 346 adult patients hospitalized over the course of one year with community-acquired pneumonia (CAP) in the Soroka Medical Center, Beer-Sheva, Israel. The present study characterizes those cases in which Streptococcus pneumoniae was the only pathogen and those in which additional etiological agents were identified. Pneumococcal CAP was diagnosed by standard blood cultures or positive serological tests by one of two laboratory methods. In 100 (67.6%) patients, at least one other etiological agent of CAP was identified in addition to Streptococcus pneumoniae. Compared with patients who were not infected by Streptococcus pneumoniae, patients with Streptococcus pneumoniae CAP were older and had a higher rate of comorbidity (39.5% vs. 29.8%). Streptococcus pneumoniae CAP had a more severe clinical course and a higher mortality rate, especially when Streptococcus pneumoniae was the only pathogen. Community-acquired pneumonia due to Streptococcus pneumoniae only was more similar in its clinical manifestations to classic typical pneumococcal pneumonia. When an additional etiological agent was identified, the clinical characteristics could not be distinguished from those of atypical pneumonia. It is concluded that Streptococcus pneumoniae remains the principal cause of CAP in this region. The frequency of additional etiological agents of CAP and the difficulty in differentiating clinically between cases due to Streptococcus pneumoniae only and those due to Streptococcus pneumoniae plus other organisms necessitates initial empirical treatment that covers Streptococcus pneumoniae as well as other causative agents of atypical pneumonia.
Insights
Streptococcus pneumoniae is a key cause of community-acquired pneumonia (CAP). Coinfections with other pathogens complicate CAP presentation, necessitating broad empirical treatment for this common bacterial pneumonia.
Area of Science:
- Infectious Diseases
- Pulmonology
- Microbiology
Background:
- Community-acquired pneumonia (CAP) is a significant cause of hospitalization in adults.
- Streptococcus pneumoniae was previously identified as a leading pathogen in CAP cases.
Purpose of the Study:
- To differentiate clinical characteristics of CAP caused by Streptococcus pneumoniae alone versus coinfection.
- To inform empirical treatment strategies for CAP in the study region.
Main Methods:
- Retrospective analysis of adult CAP patients from a previous prospective study.
- Identification of Streptococcus pneumoniae via blood cultures and serological tests.
- Comparison of clinical data between monomicrobial and polymicrobial CAP cases.
Main Results:
- Streptococcus pneumoniae was identified in 42.8% of CAP cases.
- Coinfection with other etiological agents occurred in 67.6% of Streptococcus pneumoniae CAP cases.
- Monomicrobial Streptococcus pneumoniae CAP presented as typical pneumonia; polymicrobial cases resembled atypical pneumonia, with higher mortality in monomicrobial cases.
Conclusions:
- Streptococcus pneumoniae remains a primary cause of CAP in the region.
- The presence of additional pathogens complicates clinical presentation, blurring lines between typical and atypical pneumonia.
- Empirical CAP treatment should cover both Streptococcus pneumoniae and atypical pathogens.