Impact of preceding respiratory viral infections on the clinical severity of patients with pneumococcal pneumonia

Influenza and Other Respiratory Viruses

Young Kyung Yoon¹  Kyung Sook Yang³  Jang Wook Sohn¹  Chang Kyu Lee² 

[1] Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea;Department of Laboratory Medicine, Korea University College of Medicine, Seoul, Korea;Department of Biostatistics, Korea University College of Medicine, Seoul, Korea

关键词: Clinical severity;    pneumonia;    respiratory viruses;    Streptococcus pneumoniae;   

DOI  :  10.1111/irv.12265

来源: Wiley

【 摘 要 】

Abstract

Background

This study aimed to investigate the impact of preceding respiratory viral infections (RVI) on the clinical severity of pneumococcal pneumonia patients.

Methods

A retrospective observational study was conducted at a university hospital from January 2009 to March 2013. Study subjects included adults (aged ≥18 years) with pneumococcal pneumonia who had undergone laboratory tests for RVI. Multivariate logistic regression analysis was performed to identify risk factors associated with severe pneumococcal pneumonia, defined as severity with the Pneumonia Severity Index (PSI) score ≥91.

Results

In total, 191 patients with pneumococcal pneumonia were included for analysis and stratified into 2 groups: the severe group with a PSI score ≥91 (n = 99) and the non-severe group with a PSI score <91 (n = 92). Preceding RVIs were detected in 48 patients, including influenza A virus (n = 20), influenza B virus (n = 4), parainfluenza viruses (n = 5), metapneumovirus (n = 4), rhinovirus (n = 4), respiratory syncytial viruses (n = 6), coronaviruses (n = 2), and mixed viral infections (n = 3). In the multivariate logistic regression analysis, preceding RVIs (odds ratio [OR], 2·49; 95% confidence interval [CI], 1·10–5·60), male sex (OR, 2·58; 95% CI, 1·24–5·38), old age (OR, 2·92; 95% CI, 1·37–6·24), hypoalbuminemia (OR, 3·26; 95% CI, 1·56–6·84)], and azotemia (OR, 2·24; 95% CI, 1·08–4·67) were significantly associated with severe pneumococcal pneumonia.

Conclusion

This study suggests that preceding RVIs might be one of the risk factors affecting the clinical severity of pneumococcal pneumonia.

【 授权许可】

CC BY   
© 2014 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.