Early Predictors of Mortality in Pneumococcal Bacteraemia

Balakrishnan, Indran; Crook, Paul; Morris, Richard W; Gillespie, SH

doi:10.1053/jinf.2000.0653

Cited by 59 publications

(36 citation statements)

References 17 publications

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“…This pneumococcus is a common colonizer of the nasopharynx in many healthy individuals, especially children (the so-called carrier state) and, by contiguity with the upper airway, can cause diseases such as otitis, sinusitis, and pneumonia; less commonly, it can invade sterile body sites, such as the pleura, meninges, and blood, causing an invasive disease. (1) Bacteremia has been reported to occur in 10% of cases of CAP, (2)(3)(4) and there is evidence associating the presence of bacteremia with poor outcomes in patients with CAP. (5) In a study of CAP in the pre-antibiotic era, Tilghman et al reported a high mortality rate (78%) in adults with bacteremic pneumococcal pneumonia (BPP), compared with 28% in those with non-bacteremic pneumococcal pneumonia (NBPP).…”

Section: Introductionmentioning

confidence: 99%

“…The inclusion criteria were as follows: being over 18 years of age; having been diagnosed with CAP in accordance with the criteria defined by Fang et al (i.e., presence of a new infiltrate on chest X-ray, together with one of the major criteria [fever ≥ 38.0°C, hypothermia < 35.0°C, cough, and pleuritic pain] or two of the minor criteria [dyspnea, leukocytosis > 12,000 cells/ mm 3 , altered level of consciousness, auscultatory signs of consolidation, and expectoration]) (8) ; not having been hospitalized for more than 48 h prior to symptom onset; and presenting with positive blood culture for S. pneumoniae, positive sputum culture for S. pneumoniae, positive urinary antigen test results for S. pneumoniae, or any combination of the three.…”

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confidence: 99%

“…The exclusion criteria were as follows: having been hospitalized in the last 30 days (or presenting with any other evidence suggestive of nosocomial pneumonia); having severe immunosuppression (e.g., having been under treatment with corticosteroids at a dose greater than 20 mg per day for more than 30 days); receiving chemotherapy for a lymphoproliferative disease or any other neoplastic disease; having neutropenia of any cause (< 1,000 cells/mm 3 ); and being HIV-positive and having an AIDSdefining illness or a CD4+ lymphocyte count < 200 cells/mm 3 . Clinical evaluation consisted of anamnesis and physical examination, the following data having been collected: demographic data (age, gender, and nursing home residence); data on flu and pneumococcal immunizations; data on clinical parameters at admission (temperature, blood pressure, HR, and RR, as well as level of consciousness, as determined by the Glasgow coma…”

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Impacto de la bacteriemia en una cohorte de pacientes con neumonía neumocócica

et al. 2012

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Objective: Bacteremia is the most common presentation of invasive disease in community-acquired pneumonia (CAP) due to Streptococcus pneumoniae. We investigated whether bacteremia in pneumococcal CAP worsens outcomes and whether it is related to pneumococcal vaccination (PV). Methods: Secondary analysis of a cohort of patients with pneumococcal CAP confirmed by blood culture, sputum culture, or urinary antigen testing. Demographic, clinical, radiographic, and biochemical data were collected, as were Acute Physiology and Chronic Health Evaluation II (APACHE II) and pneumonia severity index (PSI) scores, comorbidities, and PV history. We drew comparisons between patients with bacteremic pneumococcal CAP (BPP) and those with non-bacteremic pneumococcal CAP (NBPP). Results: Forty-seven patients had BPP, and 71 had NBPP (confirmed by sputum culture in 45 and by urinary antigen testing in 26); 107 had some indication for PV. None of the BPP patients had received PV, compared with 9 of the NBPP patients (p = 0.043). Among the BPP patients, the mean age was higher (76.4 ± 11.5 vs. 67.5 ± 20.9 years), as were APACHE II and PSI scores (16.4 ± 4.6 vs. 14.1 ± 6.5 and 129.5 ± 36 vs. 105.2 ± 45, respectively), as well as the rate of ICU admission for cardiopathy or chronic renal failure (42.5% vs. 22.5%), whereas hematocrit and plasma sodium levels were lower (35.7 ± 5.8 vs. 38.6 ± 6.7% and 133.9 ± 6.0 vs. 137.1 ± 5.5 mEq/L, respectively), although mortality was similar (29.8% vs 28.2%). Conclusions: In this population at high risk for CAP due to S. pneumoniae, the PV rate was extremely low (8.4%). Although BPP patients were more severely ill, mortality was similar between the two groups. Because PV reduces the incidence of BPP, the vaccination rate in at-risk populations should be increased.Keywords: Pneumococcal vaccines; Pneumonia, bacterial; Streptococcus pneumoniae; Pneumococcal infections; Mortality; Epidemiology. ResumenObjetivo: Bacteriemia es la forma invasiva más común de neumonía adquirida en la comunidad (NAC) por Streptococcus pneumoniae. Investigamos si la bacteriemia en NAC neumocócica empeora los resultados y si ella guarda relación con la vacunación antineumocócica (VAN). Métodos: Análisis secundario de una cohorte de pacientes con NAC neumocócica confirmada por cultivo de sangre o esputo o antígeno urinario. Se registraron datos demográficos, clínicos, radiográficos y de laboratorio, escores Higher Acute Physiology and Chronic Health Evaluation II (APACHE II) y pneumonia severity index (PSI), comorbilidades y antecedente de VAN. Se compararon pacientes con NAC neumocócica bacteriémica (NNB) vs. no bacteriémica (NNNB). Resultados: Cuarenta y siete pacientes tenían NNB y 71 NNNB (45 por cultivo de esputo y 26 por antígeno urinario); 107 tenían alguna indicación de VAN. Ningún paciente con NNB, pero 9 con NNNB, habían recibido VAN (p = 0,043). Los pacientes con NNB eran mayores (76,4 ± 11,5 vs. 67,5 ± 20,9 años), tenían mayor APACHE II (16,4 ± 4,6 vs. 14,1 ± 6,5) y PSI (129,5 ± 36 vs. 105,2 ± 45), más f...

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Section: Introductionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Impacto de la bacteriemia en una cohorte de pacientes con neumonía neumocócica

et al. 2012

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“…Streptococcus pneumoniae is a common pathogen of the respiratory tract that causes a wide spectrum of disease in man including otitis media, pneumonia and meningitis [1]. Pneumococcal pneumonia is a major cause of mortality amongst the very young and the elderly and is frequently associated with bacteraemia [1].…”

Section: Introductionmentioning

confidence: 99%

“…Pneumococcal pneumonia is a major cause of mortality amongst the very young and the elderly and is frequently associated with bacteraemia [1]. To cause meningitis, the pneumococcus must pass through the blood-brain barrier.…”

Section: Introductionmentioning

confidence: 99%

Purification of native α-enolase from Streptococcus pneumoniae that binds plasminogen and is immunogenic

Whiting

Evans

Patel

et al. 2002

Journal of Medical Microbiology

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Many pathogenic bacteria express plasminogen receptors on their surface, which may play a role in the dissemination of organisms by binding plasminogen that, when converted to plasmin, can digest extracellular matrix proteins. A 45-kDa protein was purified from Streptococcus pneumoniae and confirmed as an AE-enolase by its ability to catalyse the dehydration of 2-phospho-D-glycerate to phosphoenolpyruvate and by Nterminal sequencing. The activity of AE-enolase was found in the cytoplasm and in whole cells. Activity was also demonstrated in cell wall fractions, which confirmed that AEenolase is a cytoplasmic antigen also expressed on the surface of S. pneumoniae. The plasminogen-binding activity of AE-enolase was examined by Western blot, which showed that purified AE-enolase was able to bind human plasminogen. Immunoblots of the purified 45-kDa AE-enolase with 22 sera from patients with pneumococcal disease showed binding in 15 cases, indicating that pneumococcal enolase is immunogenic.

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Integrated Electrochemical Aptamer Biosensing and Colorimetric pH Monitoring via Hydrogel Microneedle Assays for Assessing Antibiotic Treatment

Keyvani,

GhavamiNejad,

Saleh

et al. 2024

Advanced Science

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Current methods for therapeutic drug monitoring (TDM) have a long turnaround time as they involve collecting patients' blood samples followed by transferring the samples to medical laboratories where sample processing and analysis are performed. To enable real‐time and minimally invasive TDM, a microneedle (MN) biosensor to monitor the levels of two important antibiotics, vancomycin (VAN) and gentamicin (GEN) is developed. The MN biosensor is composed of a hydrogel MN (HMN), and an aptamer‐functionalized flexible (Flex) electrode, named HMN‐Flex. The HMN extracts dermal interstitial fluid (ISF) and transfers it to the Flex electrode where sensing of the target antibiotics happens. The HMN‐Flex performance is validated ex vivo using skin models as well as in vivo in live rat animal models. Data is leveraged from the HMN‐Flex system to construct pharmacokinetic profiles for VAN and GEN and compare these profiles with conventional blood‐based measurements. Additionally, to track pH and monitor patient's response during antibiotic treatment, an HMN is developed that employs a colorimetric method to detect changes in the pH, named HMN‐pH assay, whose performance has been validated both in vitro and in vivo. Further, multiplexed antibiotic and pH detection is achieved by simultaneously employing the HMN‐pH and HMN‐Flex on live animals.

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Early Predictors of Mortality in Pneumococcal Bacteraemia

Cited by 59 publications

References 17 publications

Impacto de la bacteriemia en una cohorte de pacientes con neumonía neumocócica

Impacto de la bacteriemia en una cohorte de pacientes con neumonía neumocócica

Purification of native α-enolase from Streptococcus pneumoniae that binds plasminogen and is immunogenic

Integrated Electrochemical Aptamer Biosensing and Colorimetric pH Monitoring via Hydrogel Microneedle Assays for Assessing Antibiotic Treatment

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