Bacteraemia in outpatient with community-acquired pneumonia
2015
Background: Community-acquired pneumonia (CAP) remains a common and potentially life-threatening condition; we aimed to determine the incidence, microbial aetiology, risk factors and outcomes of bacteremic CAP that received outpatient care.
Methods: Between January 2000 and July 2014 we prospectively evaluated all consecutive patients with CAP treated as outpatients; every patient had at least one blood culture.
Results: We studied 372 patients treated outside the hospital, 26 (7%) presented bacteraemia, PSI clasess I- II (90%) and CURB65 0-1 (91%) of these group. Only S. pneumoniae (93%) and H. influenzae (7%) was found in bacteremic cases. A multivariate analysis showed : age ≥50 years, pleuritic pain, and C-reactive protein ≥22.9 mg/dL were independently associated with bacteraemia . None of the patients with bacteremia was readmitted or died.
| Variable | | Univariate | | | Multivariate* | |
||
| | OR | 95% CI | p-value | OR | 95% CI | p-value |
| Age ≥ 50 years | 2.47 | 1.1-5.5 | 0.028 | 3.16 | 1.1-8.4 | 0.021 |
| Prior antibiotic treatment | 0.26 | 0.06-1.1 | 0.070 | | | |
| Pleuritic pain | 2.50 | 1.02-6.1 | 0.044 | 4.06 | 1.3-11.8 | 0.010 |
| C-reactive protein ≥22.9 mg/dL | 8.81 | 3.4-22.7 | 0.001 | 10.08 | 3.7-27.2 | 0.001 |
| WBC count ≥10 x 109/L | 2.28 | 0.8-5.8 | 0.087 | | | |
Significant univariate and multivariate logistic regression analyses of predictors for bacteraemia in outpatients
Conclusions: following our findings we proposed a score based on age, C-reactive protein and pleuritic pain to suspect bacteremia in outpatients with CAP.
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