Time to blood culture positivity as a predictor of clinical outcomes and severity in adults with bacteremic pneumococcal pneumonia
We aimed to investigate the association between the time to positivity of blood culture (TTP) with clinical outcome and severity of pneumococcal bacteremic pneumonia. Prospective observational study carried out in 278 hospitalized adult CAP patients with positive blood culture for Streptococcus pneu...
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| Veröffentlicht in: | PloS one 2017-08, Vol.12 (8), p.e0182436-e0182436 |
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| creator | Cillóniz, Catia Ceccato, Adrian de la Calle, Cristina Gabarrús, Albert Garcia-Vidal, Carolina Almela, Manel Soriano, Alex Martinez, José Antonio Marco, Francesc Vila, Jordi Torres, Antoni |
| description | We aimed to investigate the association between the time to positivity of blood culture (TTP) with clinical outcome and severity of pneumococcal bacteremic pneumonia.
Prospective observational study carried out in 278 hospitalized adult CAP patients with positive blood culture for Streptococcus pneumonia (2003-2015).
A total of 278 cases of bacteremic pneumococcal pneumonia were analyzed, median age 62 (46; 79) years. Fifty-one percent of the cases had PSI IV-V. Twenty-one (8%) died within 30-days after admission. The analysis of the TTP showed that the first quartile of the TTP (9.2h) was the best cut-off for differentiating 2 groups of patients at risk, early (TTP |
| doi_str_mv | 10.1371/journal.pone.0182436 |
| format | Article |
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Prospective observational study carried out in 278 hospitalized adult CAP patients with positive blood culture for Streptococcus pneumonia (2003-2015).
A total of 278 cases of bacteremic pneumococcal pneumonia were analyzed, median age 62 (46; 79) years. Fifty-one percent of the cases had PSI IV-V. Twenty-one (8%) died within 30-days after admission. The analysis of the TTP showed that the first quartile of the TTP (9.2h) was the best cut-off for differentiating 2 groups of patients at risk, early (TTP <9.2 h) and late (TTP ≥9.2 h) detection groups (AUC 0.66 [95% CI 0.53 to 0.79]). Early TTP was associated with a statistically significant risk of invasive mechanical ventilation (18% vs. 6%, p = 0.007), longer length of hospital stay (12 days vs. 8 days, p<0.001), higher in-hospital mortality (15% vs. 4%, p = 0.010), and 30-day mortality (15% vs. 5%, p = 0.018). After adjustment for potential confounders, regression analyses revealed early TTP as independently associated with high risk of invasive mechanical ventilation (OR 4.60, 95% CI 1.63 to 13.03), longer length of hospital stay (β 5.20, 95% CI 1.81 to 8.52), higher in-hospital mortality (OR 5.35, 95% CI 1.55 to 18.53), and a trend to higher 30-day mortality (OR 2.47, 95% CI 0.85 to 7.21) to be a contributing factor.
Our results demonstrate that TTP is an easy to obtain surrogate marker of the severity of pneumococcal pneumonia and a good predictor of its outcome.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0182436</identifier><identifier>PMID: 28787020</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adults ; Age ; Aged ; Alcohol use ; Analysis ; Antibiotics ; Antigens ; Bacteremia - complications ; Biological markers ; Biology and Life Sciences ; Blood ; Blood Culture ; Clinical outcomes ; Community-Acquired Infections - blood ; Community-Acquired Infections - complications ; Community-Acquired Infections - diagnosis ; Community-Acquired Infections - mortality ; Culture ; Cytokines ; Female ; Hospital Mortality ; Humans ; Infectious diseases ; Intensive Care Units - statistics & numerical data ; Length of Stay ; Male ; Mechanical ventilation ; Medicine and Health Sciences ; Meningitis ; Microbiology ; Middle Aged ; Mortality ; Neutrophils ; Patient Admission - statistics & numerical data ; Patients ; People and Places ; Pneumococcal pneumonia ; Pneumococs ; Pneumonia ; Pneumonia, Pneumococcal - blood ; Pneumonia, Pneumococcal - complications ; Pneumonia, Pneumococcal - diagnosis ; Pneumonia, Pneumococcal - mortality ; Pneumònia ; Prognosis ; Regression analysis ; Respiration, Artificial ; Risk ; Sepsis ; Statistical analysis ; Streptococcus ; Streptococcus infections ; Streptococcus pneumonia ; Time Factors ; Ventilation</subject><ispartof>PloS one, 2017-08, Vol.12 (8), p.e0182436-e0182436</ispartof><rights>COPYRIGHT 2017 Public Library of Science</rights><rights>2017 Cillóniz et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>cc-by (c) Cillóniz, Catia et al., 2017 info:eu-repo/semantics/openAccess <a href="http://creativecommons.org/licenses/by/3.0/es">http://creativecommons.org/licenses/by/3.0/es</a></rights><rights>2017 Cillóniz et al 2017 Cillóniz et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c734t-7c76307015dabe16461f45ecc52cde30fa7217e59728d6b8e09fc3b99825d9d93</citedby><cites>FETCH-LOGICAL-c734t-7c76307015dabe16461f45ecc52cde30fa7217e59728d6b8e09fc3b99825d9d93</cites><orcidid>0000-0002-5649-7699</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5546626/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5546626/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,26974,27924,27925,53791,53793,79600,79601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28787020$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Waterer, Grant</contributor><creatorcontrib>Cillóniz, Catia</creatorcontrib><creatorcontrib>Ceccato, Adrian</creatorcontrib><creatorcontrib>de la Calle, Cristina</creatorcontrib><creatorcontrib>Gabarrús, Albert</creatorcontrib><creatorcontrib>Garcia-Vidal, Carolina</creatorcontrib><creatorcontrib>Almela, Manel</creatorcontrib><creatorcontrib>Soriano, Alex</creatorcontrib><creatorcontrib>Martinez, José Antonio</creatorcontrib><creatorcontrib>Marco, Francesc</creatorcontrib><creatorcontrib>Vila, Jordi</creatorcontrib><creatorcontrib>Torres, Antoni</creatorcontrib><title>Time to blood culture positivity as a predictor of clinical outcomes and severity in adults with bacteremic pneumococcal pneumonia</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>We aimed to investigate the association between the time to positivity of blood culture (TTP) with clinical outcome and severity of pneumococcal bacteremic pneumonia.
Prospective observational study carried out in 278 hospitalized adult CAP patients with positive blood culture for Streptococcus pneumonia (2003-2015).
A total of 278 cases of bacteremic pneumococcal pneumonia were analyzed, median age 62 (46; 79) years. Fifty-one percent of the cases had PSI IV-V. Twenty-one (8%) died within 30-days after admission. The analysis of the TTP showed that the first quartile of the TTP (9.2h) was the best cut-off for differentiating 2 groups of patients at risk, early (TTP <9.2 h) and late (TTP ≥9.2 h) detection groups (AUC 0.66 [95% CI 0.53 to 0.79]). Early TTP was associated with a statistically significant risk of invasive mechanical ventilation (18% vs. 6%, p = 0.007), longer length of hospital stay (12 days vs. 8 days, p<0.001), higher in-hospital mortality (15% vs. 4%, p = 0.010), and 30-day mortality (15% vs. 5%, p = 0.018). After adjustment for potential confounders, regression analyses revealed early TTP as independently associated with high risk of invasive mechanical ventilation (OR 4.60, 95% CI 1.63 to 13.03), longer length of hospital stay (β 5.20, 95% CI 1.81 to 8.52), higher in-hospital mortality (OR 5.35, 95% CI 1.55 to 18.53), and a trend to higher 30-day mortality (OR 2.47, 95% CI 0.85 to 7.21) to be a contributing factor.
Our results demonstrate that TTP is an easy to obtain surrogate marker of the severity of pneumococcal pneumonia and a good predictor of its outcome.</description><subject>Adults</subject><subject>Age</subject><subject>Aged</subject><subject>Alcohol use</subject><subject>Analysis</subject><subject>Antibiotics</subject><subject>Antigens</subject><subject>Bacteremia - complications</subject><subject>Biological markers</subject><subject>Biology and Life Sciences</subject><subject>Blood</subject><subject>Blood Culture</subject><subject>Clinical outcomes</subject><subject>Community-Acquired Infections - blood</subject><subject>Community-Acquired Infections - complications</subject><subject>Community-Acquired Infections - diagnosis</subject><subject>Community-Acquired Infections - mortality</subject><subject>Culture</subject><subject>Cytokines</subject><subject>Female</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Infectious diseases</subject><subject>Intensive Care Units - statistics & numerical data</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Mechanical ventilation</subject><subject>Medicine and Health Sciences</subject><subject>Meningitis</subject><subject>Microbiology</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Neutrophils</subject><subject>Patient Admission - statistics & numerical data</subject><subject>Patients</subject><subject>People and Places</subject><subject>Pneumococcal pneumonia</subject><subject>Pneumococs</subject><subject>Pneumonia</subject><subject>Pneumonia, Pneumococcal - blood</subject><subject>Pneumonia, Pneumococcal - complications</subject><subject>Pneumonia, Pneumococcal - diagnosis</subject><subject>Pneumonia, Pneumococcal - mortality</subject><subject>Pneumònia</subject><subject>Prognosis</subject><subject>Regression analysis</subject><subject>Respiration, Artificial</subject><subject>Risk</subject><subject>Sepsis</subject><subject>Statistical analysis</subject><subject>Streptococcus</subject><subject>Streptococcus infections</subject><subject>Streptococcus pneumonia</subject><subject>Time 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to blood culture positivity as a predictor of clinical outcomes and severity in adults with bacteremic pneumococcal pneumonia</title><author>Cillóniz, Catia ; Ceccato, Adrian ; de la Calle, Cristina ; Gabarrús, Albert ; Garcia-Vidal, Carolina ; Almela, Manel ; Soriano, Alex ; Martinez, José Antonio ; Marco, Francesc ; Vila, Jordi ; Torres, Antoni</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c734t-7c76307015dabe16461f45ecc52cde30fa7217e59728d6b8e09fc3b99825d9d93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adults</topic><topic>Age</topic><topic>Aged</topic><topic>Alcohol use</topic><topic>Analysis</topic><topic>Antibiotics</topic><topic>Antigens</topic><topic>Bacteremia - complications</topic><topic>Biological markers</topic><topic>Biology and Life Sciences</topic><topic>Blood</topic><topic>Blood Culture</topic><topic>Clinical outcomes</topic><topic>Community-Acquired Infections - blood</topic><topic>Community-Acquired Infections - complications</topic><topic>Community-Acquired Infections - diagnosis</topic><topic>Community-Acquired Infections - mortality</topic><topic>Culture</topic><topic>Cytokines</topic><topic>Female</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>Infectious diseases</topic><topic>Intensive Care Units - statistics & numerical data</topic><topic>Length of Stay</topic><topic>Male</topic><topic>Mechanical ventilation</topic><topic>Medicine and Health Sciences</topic><topic>Meningitis</topic><topic>Microbiology</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Neutrophils</topic><topic>Patient Admission - statistics & numerical data</topic><topic>Patients</topic><topic>People and Places</topic><topic>Pneumococcal pneumonia</topic><topic>Pneumococs</topic><topic>Pneumonia</topic><topic>Pneumonia, Pneumococcal - blood</topic><topic>Pneumonia, Pneumococcal - complications</topic><topic>Pneumonia, Pneumococcal - diagnosis</topic><topic>Pneumonia, Pneumococcal - mortality</topic><topic>Pneumònia</topic><topic>Prognosis</topic><topic>Regression analysis</topic><topic>Respiration, Artificial</topic><topic>Risk</topic><topic>Sepsis</topic><topic>Statistical analysis</topic><topic>Streptococcus</topic><topic>Streptococcus infections</topic><topic>Streptococcus pneumonia</topic><topic>Time Factors</topic><topic>Ventilation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cillóniz, Catia</creatorcontrib><creatorcontrib>Ceccato, Adrian</creatorcontrib><creatorcontrib>de la Calle, Cristina</creatorcontrib><creatorcontrib>Gabarrús, Albert</creatorcontrib><creatorcontrib>Garcia-Vidal, Carolina</creatorcontrib><creatorcontrib>Almela, Manel</creatorcontrib><creatorcontrib>Soriano, Alex</creatorcontrib><creatorcontrib>Martinez, José Antonio</creatorcontrib><creatorcontrib>Marco, 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BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials Science Collection</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>Recercat</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cillóniz, Catia</au><au>Ceccato, Adrian</au><au>de la Calle, Cristina</au><au>Gabarrús, Albert</au><au>Garcia-Vidal, Carolina</au><au>Almela, Manel</au><au>Soriano, Alex</au><au>Martinez, José Antonio</au><au>Marco, Francesc</au><au>Vila, Jordi</au><au>Torres, Antoni</au><au>Waterer, Grant</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Time to blood culture positivity as a predictor of clinical outcomes and severity in adults with bacteremic pneumococcal pneumonia</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2017-08-07</date><risdate>2017</risdate><volume>12</volume><issue>8</issue><spage>e0182436</spage><epage>e0182436</epage><pages>e0182436-e0182436</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>We aimed to investigate the association between the time to positivity of blood culture (TTP) with clinical outcome and severity of pneumococcal bacteremic pneumonia.
Prospective observational study carried out in 278 hospitalized adult CAP patients with positive blood culture for Streptococcus pneumonia (2003-2015).
A total of 278 cases of bacteremic pneumococcal pneumonia were analyzed, median age 62 (46; 79) years. Fifty-one percent of the cases had PSI IV-V. Twenty-one (8%) died within 30-days after admission. The analysis of the TTP showed that the first quartile of the TTP (9.2h) was the best cut-off for differentiating 2 groups of patients at risk, early (TTP <9.2 h) and late (TTP ≥9.2 h) detection groups (AUC 0.66 [95% CI 0.53 to 0.79]). Early TTP was associated with a statistically significant risk of invasive mechanical ventilation (18% vs. 6%, p = 0.007), longer length of hospital stay (12 days vs. 8 days, p<0.001), higher in-hospital mortality (15% vs. 4%, p = 0.010), and 30-day mortality (15% vs. 5%, p = 0.018). After adjustment for potential confounders, regression analyses revealed early TTP as independently associated with high risk of invasive mechanical ventilation (OR 4.60, 95% CI 1.63 to 13.03), longer length of hospital stay (β 5.20, 95% CI 1.81 to 8.52), higher in-hospital mortality (OR 5.35, 95% CI 1.55 to 18.53), and a trend to higher 30-day mortality (OR 2.47, 95% CI 0.85 to 7.21) to be a contributing factor.
Our results demonstrate that TTP is an easy to obtain surrogate marker of the severity of pneumococcal pneumonia and a good predictor of its outcome.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>28787020</pmid><doi>10.1371/journal.pone.0182436</doi><tpages>e0182436</tpages><orcidid>https://orcid.org/0000-0002-5649-7699</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2017-08, Vol.12 (8), p.e0182436-e0182436 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_1926895918 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; Recercat; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Adults Age Aged Alcohol use Analysis Antibiotics Antigens Bacteremia - complications Biological markers Biology and Life Sciences Blood Blood Culture Clinical outcomes Community-Acquired Infections - blood Community-Acquired Infections - complications Community-Acquired Infections - diagnosis Community-Acquired Infections - mortality Culture Cytokines Female Hospital Mortality Humans Infectious diseases Intensive Care Units - statistics & numerical data Length of Stay Male Mechanical ventilation Medicine and Health Sciences Meningitis Microbiology Middle Aged Mortality Neutrophils Patient Admission - statistics & numerical data Patients People and Places Pneumococcal pneumonia Pneumococs Pneumonia Pneumonia, Pneumococcal - blood Pneumonia, Pneumococcal - complications Pneumonia, Pneumococcal - diagnosis Pneumonia, Pneumococcal - mortality Pneumònia Prognosis Regression analysis Respiration, Artificial Risk Sepsis Statistical analysis Streptococcus Streptococcus infections Streptococcus pneumonia Time Factors Ventilation |
| title | Time to blood culture positivity as a predictor of clinical outcomes and severity in adults with bacteremic pneumococcal pneumonia |
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