A Retrospective Analysis of 111 Cases of Pneumococcal Pneumonia: Clinical Features and Prognostic Factors
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概要
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Objective Streptococcus pneumoniae is an important and common pathogen of acute pneumonia. The urinary pneumococcal antigen test has been increasingly used for the diagnosis of pneumococcal pneumonia, but there have been few studies on pneumococcal pneumonia after this test became prevalent. The present study was conducted to characterize the clinical features of pneumococcal pneumonia after the introduction of the urinary antigen test. Methods We retrospectively analyzed 111 cases from 105 patients with pneumococcal pneumonia in our hospital between 2007 and 2010, and collected data regarding background characteristics, laboratory data, isolated bacteria, and clinical courses. Results The cases analysed included 77 of community-acquired pneumonia (CAP), 21 of healthcare-associated pneumonia (HCAP), and 13 of hospital-acquired pneumonia (HAP). Penicillin-resistant Streptococcus pneumoniae was isolated in 12.5 and 55.6% of non-HAP and HAP cases, respectively. When the cases were divided into 5 groups according to A-DROP scores (0, 1, 2, 3 and 4 points), critical events occurred at 0, 0, 8.7, 15.4, and 75.0% in groups of cases of 0, 1, 2, 3, and 4 points, respectively. Similarly, critical events occurred at 66.7, 4.7, 3.8, and 9.1% in groups of cases according to WBC counts of <4,000, 4,000-9,999, 10,000-19,999, and ≥20,000 cells/μL, respectively. Conclusion Most of the pneumococcal pneumonia cases occurred as CAP and were treated successfully. HAP cases were frequently penicillin resistant. Elevated A-DROP scores and decreased WBC counts were found to be predictive of critical events.
著者
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Fujita Masaki
Department Of Bacteriology Faculty Of Medicine Kyushu University
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Kawasaki Masayuki
Department Of Respiratory Medicine National Hospital Organization Fukuoka-higashi Medical Center
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Harada Mine
Department Of Biosystemic Science And Medicine Kyushu University Graduate School Of Medical Sciences
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Wakamatsu Kentaro
Department Of Respiratory Medicine National Hospital Organization Omuta National Hospital
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Ikegame Satoshi
Department Of Respiratory Medicine National Hospital Organization Omuta National Hospital
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Kajiki Akira
Department Of Respiratory Medicine National Hospital Organization Omuta Hospital
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Kumazoe Hiroyuki
Department of Radiology, National Hospital Organization Omuta Hospital, Japan
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Kumazoe Hiroyuki
Department of Respiratory Medicine, National Hospital Organization Omuta National Hospital, Japan
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Nakanishi Yoichi
Research Institute for Disease of the Chest, Graduate School of Medical Sciences, Kyushu University, Japan
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