The problem of early mortality in pneumococcal pneumonia: a study of risk factors

Burgos, Joaquín; Luján, Manel; Larrosa, Nieves; Pedro‐Botet, María Luisa; Fontanals, Dionísia; Quesada, María Dolores; Lung, Mayli; Bermudo, Guadalupe; Almirante, Benito; Falcó, Vicenç

doi:10.1183/09031936.00034415

Cited by 17 publications

(10 citation statements)

References 16 publications

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“…The antimicrobial therapy was considered to be appropriate if the initial antibiotics, which were administered within 24 h of acquisition of a blood culture sample, included at least one antibiotic that was active in vitro [ 32 ]. The 30-day mortality was considered as the number of deaths of patients with infections during hospitalization that occurred within 30 days of the diagnosis of infection [ 33 ], and the 5-day mortality, also known as early mortality, was considered as the number of deaths within 5 days of hospitalization [ 34 ]. Hospital stays were considered prolonged if they reached or exceeded 45 days [ 35 ].…”

Section: Methodsmentioning

confidence: 99%

Clinical and Molecular Epidemiology of Multidrug-Resistant P. aeruginosa Carrying aac(6')-Ib-cr, qnrS1 and blaSPM Genes in Brazil

et al. 2016

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We described a comprehensive analysis of the molecular epidemiology of multidrug-resistant (MDR) P. aeruginosa. Molecular analysis included typing by Pulsed Field Gel Electrophoresis, identification of genes of interest through PCR-based assays and sequencing of target genes. Case-control study was conducted to better understand the prognostic of patients and the impact of inappropriate therapy in patients with bacteremia, as well as the risk factors of MDR infections. We observed a high rate of MDR isolates (40.7%), and 51.0% of them was independently associated with inappropriate antibiotic therapy. Bacteremia was detected in 66.9% of patients, and prolonged hospital stay was expressive in those resistant to fluoroquinolone. Plasmid-mediated quinolone resistance genes (PMQR), qnrS1 and aac(6’)Ib-cr, were detected in two different nosocomial isolates (5.3%), and the aac(6’)-Ib7 variant was detected at a high frequency (87.5%) in those negative to PMQR. The presence of mutations in gyrA and parC genes was observed in 100% and 85% of selected isolates, respectively. Isolates harboring PMQR genes or mutations in gyrA and parC were not closely related, except in those containing SPM (São Paulo metallo-β-lactamase) clone. In addition, there is no study published in Brazil to date reporting the presence of Pseudomonas aeruginosa isolates harboring both qnrS1 and aac(6’)Ib-cr genes, with alarming frequency of patients with inappropriate therapy.

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Section: Methodsmentioning

confidence: 99%

Clinical and Molecular Epidemiology of Multidrug-Resistant P. aeruginosa Carrying aac(6')-Ib-cr, qnrS1 and blaSPM Genes in Brazil

et al. 2016

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“…IPD has high socioeconomic costs, 3 with increased (acute and late) morbidity and mortality, 4 especially in susceptible populations (children, the elderly, patients with cardiac comorbidities, patients with pulmonary comorbidities, and immunosuppressed patients in general). 5 IPD continues to be the leading vaccine-preventable cause of death in children under 5 years of age, even with the significant change in the epidemiology of this disease after the implementation of routine vaccination in Australia 6 and in western European countries. 7 …”

Section: Introductionmentioning

confidence: 99%

Theoretical pneumococcal vaccine coverage: analysis of serotypes isolated from inpatients at a tertiary care hospital

2018

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If the patients in this sample had been previously vaccinated with PCV13 plus PPV23, theoretically, 50.8% of the cases of invasive pneumococcal disease that required hospital admission could potentially have been prevented. Invasive pneumococcal disease should be prevented by vaccination not only of children and the elderly but also of adults in their economically productive years, so as to reduce the socioeconomic costs, morbidity, and mortality still associated with the disease, especially in underdeveloped countries.

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“…This raises the possibility of a future anti-inflammatory treatment for pneumococcal meningitis including this liposomal formulation. Serotype 3 strains are also associated with severe forms of pneumonia and with septic shock [ 19 , 20 ] and so the effectiveness of the liposome treatment against this serotype, as least in vitro, is encouraging.…”

Section: Discussionmentioning

confidence: 99%

Clinical Streptococcus pneumoniae isolates induce differing CXCL8 responses from human nasopharyngeal epithelial cells which are reduced by liposomes

et al. 2016

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BackgroundStreptococcus pneumoniae causes several human diseases, including pneumonia and meningitis, in which pathology is associated with an excessive inflammatory response. A major inducer of this response is the cholesterol dependent pneumococcal toxin, pneumolysin. Here, we measured the amount of inflammatory cytokine CXCL8 (interleukin (IL)-8) by ELISA released by human nasopharyngeal epithelial (Detroit 562) cells as inflammatory response to a 24 h exposure to different pneumococcal strains.ResultsWe found pneumolysin to be the major factor influencing the CXCL8 response. Cholesterol and sphingomyelin-containing liposomes designed to sequester pneumolysin were highly effective at reducing CXCL8 levels from epithelial cells exposed to different clinical pneumococcal isolates. These liposomes also reduced CXCL8 response from epithelial cells exposed to pneumolysin knock-out mutants of S. pneumoniae indicating that they also reduce the CXCL8-inducing effect of an unidentified pneumococcal virulence factor, in addition to pneumolysin.ConclusionThe results indicate the potential of liposomes in attenuating excessive inflammation as a future adjunctive treatment of pneumococcal diseases.Electronic supplementary materialThe online version of this article (doi:10.1186/s12866-016-0777-5) contains supplementary material, which is available to authorized users.

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The problem of early mortality in pneumococcal pneumonia: a study of risk factors

Cited by 17 publications

References 16 publications

Clinical and Molecular Epidemiology of Multidrug-Resistant P. aeruginosa Carrying aac(6')-Ib-cr, qnrS1 and blaSPM Genes in Brazil

Clinical and Molecular Epidemiology of Multidrug-Resistant P. aeruginosa Carrying aac(6')-Ib-cr, qnrS1 and blaSPM Genes in Brazil

Theoretical pneumococcal vaccine coverage: analysis of serotypes isolated from inpatients at a tertiary care hospital

Clinical Streptococcus pneumoniae isolates induce differing CXCL8 responses from human nasopharyngeal epithelial cells which are reduced by liposomes

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